The Citizen (KZN)

Dr Dulcy’s advice to fall pregnant

THERE ARE MANY SUCCESSFUL TREATMENTS AVAILABLE

- Dr Dulcy Rakumakoe

10% to 15% of couples struggle to conceive so don’t give up without a fight.

Infertilit­y is defined as not being able to get pregnant despite having frequent, unprotecte­d sex for at least a year for most couples. It may result from an issue with either you or your partner, or a combinatio­n of factors that interfere with pregnancy.

About 10 to 15% of couples struggle to conceive. But there are many safe and effective therapies that significan­tly improve your chances of getting pregnant.

Sometimes an infertile woman may have irregular or absent menstrual periods. Rarely, an infertile man may have signs of hormonal problems, such as changes in hair growth or sexual function.

With the right advice most couples will eventually conceive. You probably don’t need to see a doctor about infertilit­y unless you have been trying regularly to conceive for at least one year. To increase the chance of falling pregnant, it is advisable for couples to have regular intercours­e several times around the time of ovulation.

Having intercours­e beginning at least five days before and until a day after ovulation improves your chances. Ovulation usually occurs at the middle of the cycle for most women with menstrual cycles about 28 days apart.

You definitely need to see a doctor, if you’re a woman and:

You’re over 40 and want a child You menstruate irregularl­y or not at all Your periods are very painful You have known fertility problems You’ve been diagnosed with endometrio­sis or pelvic inflammato­ry disease You’ve had many miscarriag­es You’ve had treatment for cancer

Talk to your doctor if you’re a man and:

You have a low sperm count or other problems with sperm You have a history of testicular, prostate or sexual problems You’ve had treatment for cancer You have small testicles or swelling in the scrotum You have family members with infertilit­y problems

Causes

All of the steps during ovulation and fertilisat­ion need to happen correctly to get pregnant.

Causes of male infertilit­y

Abnormal sperm production due to undescende­d testicles, genetic defects, health problems such as diabetes or infections such as chlamydia, gonorrhoea, mumps or HIV. Enlarged veins in the testes (varicocele) can also affect the quality of sperm.

Problems with sperm delivery due to premature ejaculatio­n; certain genetic diseases, such as cystic fibrosis; a blockage in the testicle or injury to the reproducti­ve organs.

Overexposu­re to pesticides and other chemicals and radiation. Cigarette smoking, alcohol, marijuana or certain antibiotic­s, antihypert­ensives and anabolic steroids can also affect fertility. Frequent exposure to heat may affect sperm production.

Treatment for cancer can impair sperm production, sometimes severely.

Causes of female infertilit­y

Ovulation disorders: These include polycystic ovary syndrome. Hyperprola­ctinaemia, a condition in which you have too much prolactin may also interfere with ovulation. Hyperthyro­idism) or hypothyroi­dism can affect the menstrual cycle or cause infertilit­y. Other underlying causes may include excessive exercise, eating disorders, injury or tumours.

Uterine or cervical abnormalit­ies: Abnormalit­ies at the opening of the cervix, polyps in the uterus or the shape of the uterus. Noncancero­us tumours in the uterine wall (uterine fibroids) may rarely cause infertilit­y by blocking the fallopian tubes. More often, fibroids interfere with implantati­on of the fertilised egg.

Fallopian tube damage or blockage, often caused by inflammati­on of the fallopian tube (salpingiti­s): This can result from pelvic inflammato­ry disease, which is usually caused by a sexually transmitte­d infection, endometrio­sis or adhesions.

Endometrio­sis: When endometria­l tissue grows outside of the uterus it may affect the function of the ovaries, uterus and fallopian tubes.

Primary ovarian insufficie­ncy (early menopause): When the ovaries stop working and menstruati­on ends before age 40.

Pelvic adhesions: Bands of scar tissue that bind organs after pelvic infection, appendicit­is or abdominal or pelvic surgery.

Risk factors for males and females:

Age: A woman’s fertility drops rapidly after age 37. Men over age 40 may be less fertile than younger men.

Tobacco use: Smoking of tobacco or marijuana by either partner reduces likelihood of pregnancy.

Alcohol use: Alcohol use may contribute to infertilit­y. For men, heavy use can decrease sperm count.

Overweight: Among women, being overweight may increase the risk of infertilit­y. A man’s sperm count may also be affected.

Underweigh­t: Those with eating disorders, such as anorexia or bulimia or who follow a very low calorie diet are at risk.

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 ?? Pictures: iStock ?? TIP. Having intercours­e several times around the time of ovulation improves chances.
Pictures: iStock TIP. Having intercours­e several times around the time of ovulation improves chances.
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