Hi XXXXXXX and thank you so much for this query.

I am pleased having this opportunity to address some of your health concerns about marriage today.

The true test to know whether a man and a woman can have children is actually having the children already. No other test can tell you with a 100% certainty whether you would be able to have children as a couple or not. At best, we conclude by saying we have not found any reasons why you may not be able to have children together but never the other way that we are certain that you both will have children together. This is because, becoming pregnant is ore complex than we actually think. There are so many factors that cannot be evaluated though they play major roles in a couple's ability to have children together.

An example is what we call cervical factors, woman having antibodies against husbands sperms etc. As for me, the best test is trying it out together and this must take at least a year before we can start to worry why you are not able to have children. So it is actually a very difficult question.

However, there are some basic tests that can be done to rule out potential barriers to having children together. A sperm count for the man is enough. The woman's menstrual cycle history, pelvic ultrasound can also help in eliminating some very evident barriers like fibroids, infections of the tubes, abnormalities of the uterus etc. These tests can only give an idea and are never conclusive. They are no routine tests because this is rarely an indication for infertility workup. Honestly, there are so so many different causes of infertility and the choice to do one test or the other is largely influenced by what the perceived problem is by the treating physician.

Blood group match is never a problem in marriage. However, if the lady is rhesus negative and the husband rhesus positive, special measures need to be taken during pregnancy to prevent sensitising the woman and causing potential problems for future pregnancy and babies.

There are diseases that can be transmitted from couples on to their offspring. Most of them rely on probabilities and you can never tell whether the children would definitely be affected or not. And we can't really ask somebody not to go on with a marriage based on probabilities that are not guaranteed to take place. Some of these diseases include sickle cell anemia, thalassemias, clotting disorders etc.

Some of these tests can be advised before marriage and others not. What to do and what not to do depends on what information you provide to us and what we are most concerned about. There is no standard list and I cannot list propose any at this time. Tests may be normal today and you fall sick tomorrow and develop a condition that totally makes becoming pregnant impossible...We cannot really dictate the future or predict it with so much certainty.

Marriage is for better, for worse. No amount of testing can guarantee the outcome of any marriage. Making up your minds to face every challenge and sticking to each other is very important. That's is the attitude that will guarantee a successful marriage and not all the testings before marriage.

As for diseases, getting screened for transmissible diseases like HIV/AIDS, STDs, Hepatitis will be helpful.

Considering all the above, I will suggest that you XXXXXXX and talk with a premarital counselor and your doctor. Your doctor will make a demand for some basic tests depending on your past history and what he/she thinks warrants more investigation.

I wish you well. I hope this addresses your query.

If you want some more specifics or have questions, please feel free to ask me.

I wish you good health, a successful marriage and success in having children together.

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Hi and thanks for these further questions.

After marriage, there is no special way of having sex. Express yourselves the best way you can. Whenever you both accept and feel comfortable having sex, then it is the right thing to do. Having sex more often, at least every other day increases the chances of getting a pregnancy.

I understand your fears and anxiety as you have never had sex before. Each and everyone feels same before ever having a sexual encounter and yet most of them are very successful. You may not be stellar the first time, but assuredly you would be better subsequently and that is same for everybody. Doing is the best way of being better.

Not having sex up to now should not be any abnormality or mental disorder. I have any clients who have made this choice and have gone on to be very successful marriage partners. I think it is just a healthy choice you made. It will in no way affect your marriage unless there is a perceived problem that you have not disclosed and i don't think so.

I hope all these answers have been very helpful to wish.
I wish you a very successful marriage life.
If you don't have any more questions, you may consider closing the discussion at this time.
Dr. Ditah

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Hi and thanks for this follow up question.

Protecting your partner is very important after marriage but make sure they also get the freedom to express themselves fully. So make sure you accomplish both.

NO she needs no female security officers,female police,millitary etc? Protect her like being there for her, advising her and making meaningful suggestion on how you both can be better together and have a successful and happy marriage.

I hope this helps and answers your question.
If you have no further questions related to this query, you may consider closing the discussion now, writing a review on our interaction and rating the answers I provided to you.
Wish you both a successful and happy marriage.
Dr. Ditah, MD.

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