Q: I am 41 years of age and my wife is 30 years old and we have been having unprotected sex for the passed 8 months now and up till this moment, she is yet to get pregnant and I have already had 3 kids from my previous marriage. What could be responsible?

A: In the medical world, we can only agree that perhaps there might be an issue after one full year of trying to have babies with no luck. This, however, implies that there is frequent and unprotected sexual intercourse. Frequency in this respect means that sexual intercourse should be at least 3 times in a week. Unprotected means that there should be no barrier protection like a condom. Don’t laugh…this has been known to happen. People use a condom and then expect to get pregnant J The ejaculate (semen) should also be of significant volume.

Therefore, if this has been established to have been happening for one year (and in your case, it hasn’t), the next thing is to run tests. The less ‘invasive’ tests are usually done first. This usually involves the husband who provides his semen for analysis. Other tests will now be run on the wife, which presumably has already happened in the case above.

Some causes of infertility in men include problems with the production of sperm, problems with the delivery of sperm, being exposed to environmental toxins (like sitting in hot tubs) and cancer. In a case where you have had children before, the causes also include erectile dysfunction, or new disease conditions in males.

Some causes of infertility in women include problems with ovulation, problems with the uterus and cervix, blockage or damage of the fallopian tube, thyroid problems, cancer etc. Fibroids may or may not cause inability to have a pregnancy. It depends on size and position. Big fibroids in the area of the womb where a baby is meant to implant may cause a miscarriage or indeed, failure of the fertilized embryo to implant. Your doctor will take a decision on what to do with the fibroids based on size, symptoms etc., if this is still a problem.

Other risk factors for both sexes include use of alcohol and tobacco, being overweight or even underweight and age (the older people get, the more difficult it is to get pregnant).
Where a problem is identified, this is taken care of through various options like the use of drugs or surgery.

Oftentimes, no reason can be found for infertility. In these instances, the couple may want to consider assisted reproduction. Your doctor will discuss the different options available in your area and if you can afford it, he will suggest other centers where better facilities exist.

Prevention of infertility is targeted at the risk factors. Quit smoking, reduce alcohol consumption, exercise moderately and keep your weight within normal limits.
Infertility is really nerve wracking, because nobody has an idea how long it’s going to last or what treatments are going to work best. Joining support groups and/or counseling sessions may be helpful during this period of waiting, patiently and prayerfully J

All the best!