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Suggest treatment for infertility

Answered by
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Dr. Vaishalee Punj

General & Family Physician

Practicing since :2003

Answered : 1777 Questions

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Posted on Tue, 2 Sep 2014 in Infertility Problem
Question: I am 38 trying to get pregnant. I have been sexually active since I was 26 and never had contraceptive and never been pregnant but intercourse was like twice a month. The past 12 months have been regular once or twice a week.
Do you see it possible for me to get pregnant naturally?
I worry about infertility as I weigh 16 stone but lost 2 stone and my husband smokes and drinks bitter but has cut down tremendously within guidelines.
He will not have a semen analysis.
1. Can I conceive naturally
2. Can I be assessed for infertility just for myself
3. How can naturally increase sperm just in case it is low
Thank you very much
doctor
Answered by Dr. Vaishalee Punj 2 days later
Brief Answer:
Mostly yes

Detailed Answer:
Hi
Thanks for your query.

Yes you can still conceive naturally.

Regarding infertility testing, it is preferable to do it for male partner first as it may subject to invasive tests unnecessarily when your partner will be having issues. But you go for testing anyways.

Though some medicines are given to increase sperm. The best measure would be stop smoking and drinking alcohol.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Vaishalee Punj 19 minutes later
My husband has really cut down on smoking and alcohol he won't stop but he has made major changes. Can I still conceive naturally or am I at a losing battle
doctor
Answered by Dr. Vaishalee Punj 5 minutes later
Brief Answer:
Yes you can conceive naturally

Detailed Answer:
Hi again

Do not lose hope. There are still good chances of conceiving. You need to make sure that the sperm are deposited near the cervical canal during sexual intercourse. You need to have intercourse more frequently during the ovulation period. You can also use ovulation kits to predict ovulation.

Intrauterine insemination is also a less invasive method that can be used in your case.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vaishalee Punj 1 hour later
I am using Clearblue fertility monitor which shows 3 bars which I think means I ovulate. Am I right?
I sometimes ovulate late in my cycle last month ovulated day 22 on 29 day cycle can you still get pregnant?
If I ovulate do I need to worry about me being infertile? I worry with my age 38 and my husband smoking and drinking though he has cut down.
Do you really think I can conceive naturally without any intervention at this point. How long should I try before asking for any kind if fertility help please?
doctor
Answered by Dr. Vaishalee Punj 12 hours later
Brief Answer:
Will answer queries specifically as below

Detailed Answer:
Hi again

I am using Clearblue fertility monitor which shows 3 bars which I think means I ovulate. Am I right?
A. one bar for Low Fertility, two bars for High Fertility and three bars for Peak Fertility. Yes three bars mean you ovulate.


I sometimes ovulate late in my cycle last month ovulated day 22 on 29 day cycle can you still get pregnant?
A. Yes you can still get pregnant. Chances get lower mainly because endometrium may be in a different phase.

If I ovulate do I need to worry about me being infertile? I worry with my age 38 and my husband smoking and drinking though he has cut down.
A. There can be many causes of infertility. Anovulation (no ovulation) is just one of them. There may be other causes like pelvic factors (blocked fallopian tubes, Ashermans syn, endometriosis, pelvic inflammatory disease, etc), cervical factors (infection, instrumentation, antibodies against sperms, etc). Thus further tests are done to rule these out. At least you can go for noninvasive tests like ultrasound of the pelvis, blood and urine tests etc.

Do you really think I can conceive naturally without any intervention at this point?
A. Yes, you can conceive. In fact in western countries, large proportion of pregnancies happen after the age of 35y.

How long should I try before asking for any kind if fertility help please?
A. We wait for one year from start of regular intercourse before we subject the couple to testing. If it has been one year since regular intercourse, you can go for tests.

Hope it helps

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Vaishalee Punj 5 hours later
I have no blood test results all I know is all my hormone levels are normal and day 3 FSH was 4.2. My Gynaecologist says I have good egg reserve.

My Gynaecologist has ruled out PCO as investigated with blood tests also which show everything is normal.

I am just worried I will never be a mum naturally. Once reviewed all my information, please let me know your thoughts. Many thanks XXXX
doctor
Answered by Dr. Vaishalee Punj 20 hours later
Brief Answer:
Ultrasounds show good egg reserve

Detailed Answer:
Hi again

Though the ultrasounds show good egg reserve, I am still worrying if egg release is actually happening or not. Thus I would recommend a better method to detect it.

I would suggest a serial ultrasound of the ovaries from day 10 onwards from your previous menstrual cycle. This ultrasound is taken everyday and actually shows an egg being released.

If the egg release does not show up in this ultrasound, I would suggest that you go for ovulation induction using medicines like clomiphene.

Hope it helps.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj 33 minutes later
But ovulation sticks and fertility monitor show ovulation? Can I get pregnant naturally
Do you suggest I get a full female fertility check up now or use Clearblue fertility monitor for consecutive 6 months then have a check up?
I just worry as Clearblue fertility monitor shows ovulation and I have never had a period problem so why would I not release an egg?
Thank you


Day 21 progesterone blood test does show I ovulate
doctor
Answered by Dr. Vaishalee Punj 29 hours later
Brief Answer:
Can take it one step at a time

Detailed Answer:
Hi

I suggested serial ovarian ultrasounds because they are non-invasive and will confirm egg release (seeing the history of some PCOS like cysts in ovaries). Fertility monitors measure LH surge, which is not very confirmatory.

Regarding other fertility tests, some of them are invasive tests. I would suggest that your male partner goes for his test before you go for your tests. If he resists, then you may take it one test at a time.

Dr Vaishalee


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj 1 hour later
Do you think with Clearblue fertility monitor showing ovulation I do release an egg because some months it doesn't peak so I think I do but maybe not every month. Please tell me what scan is called and I will pay for it. I will wait 6 months first using monitor as I think I maybe panicking
doctor
Answered by Dr. Vaishalee Punj 53 minutes later
Brief Answer:
Called serial ovarian ultrasound for ovulation

Detailed Answer:
Hi again

The test is called serial ovarian ultrasound for ovulation. It is usually done to see a response to ovulation induction, but it can be used otherwise too.

If it is not showing the peaks every month, then you may not be ovulating regularly. In such a case, you can chose to wait or you can go for ovulation induction. Ovulation induction is done with medicines that can have some side effects.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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