Does the Pill Impact Your Fertility + Can You Vaccinate Against HIV?
Dr Lindi Murray and Dr Ilana Johnson are our COSMO gynae gurus. Together, these clued-up ladies own Lila, an ob/gyn practice in Cape Town – and they’re here to answer your questions
Can I do anything to increase my chances of having a boy or a girl?
The truth is that methods aimed at increasing the success of conceiving either a boy or a girl are not much better than nature’s own odds of 50:50. Strategies involving diet, sexual positions and timing of intercourse in relation to ovulation have found no reliable improvement in success. The only way to ensure you have a boy or girl is pre-implantation diagnosis through the process of in vitro fertilisation (IVF), where the sex of the embryo can be determined before it is introduced back into the uterus. However, IVF should never be used for this reason, and sex selection is banned in many parts of the world – except in cases where a couple is known to carry a severe chromosomal abnormality affecting either boys or girls specifically, and sex selection could prevent the birth of an affected child. Our advice? Let nature decide.
Does being on the Pill or using a hormonal IUD impact my fertility in the long term?
Long-term use of oral contraceptive pills does not lead to impaired fertility over time. Some studies have seen a three-to-five-month lag in restoration of ovulation after stopping the Pill, but this lag is mainly a concern in women on high-dose contraceptives – which is uncommon. Studies that have looked at pregnancy rates in women who have stopped the Pill in order to become pregnant have found that the average time it takes to conceive is four months. If you were on the Pill to sort out troublesome periods, there may be an underlying problem preventing you from falling pregnant that has nothing to do with the Pill. There are also some fertility benefits to using the Pill: the risk of pelvic infection is slightly reduced, as is the risk of ovarian cancer and ectopic pregnancy. What’s more, some women actually experience a fertility surge after stopping the Pill.
The Mirena also doesn’t have an impact on longterm fertility. However, if the Mirena was inserted for a medical reason (and not for pure contraception), underlying gynae issues may affect fertility, and help should be sought if you’re not pregnant within six to 12 months of regular trying.
Is there a vaccination for HIV?
At the moment, no: we don’t have a vaccine proven to be fully effective in preventing HIV infection, and research for the last 20 years has been disappointing. However, a recent study conducted in Thailand showed promising results, with a 31% reduction in HIV rates – meaning we might not be too far away from developing a global vaccine to assist in the fight against HIV.
A National Health Insurance trial began last November, aiming to test 3 200 women in southern Africa. Excitingly, southern Africa will also be part of a second and much-anticipated vaccine trial starting this year and involving 2 600 women considered to be at risk of contracting HIV. The vaccine being tested is a new two-vaccine combination. Experts predict that if results are promising, a commercially available vaccine may be a reality within three years. Until then, protect yourself against HIV by always (repeat, always) using a condom. If you find out you’re HIV-positive, enquire about antiretroviral medication – and take it responsibly.