QuestionDear Joseph Ramirez,
I am a 37 year old woman who has been married for 2,5 years and my husband is 36 years old. We have been trying to consive for 1,5 years without any result. We have been in contact with a infertility clinic and the results show that mostely i do not ovulate when it's time so i need to take clomid. For my husband the results show that his sperm quality and quantity is bad. We tried 4 cicles with Clomid and no result. We went for 3 IUI and it showed that the sperm was between 2-5 millions. According to our doctor we should go for IVF and IUI would be a waste of time in this case.
Now, my husband has a hard time accepting that it's his sperms for the most that can't reach the egg. To prove that he told me he had an abortion with a previous girlfried when he was 23. My question is if he is telling the truth then should we go for new tests and does that mean that the tests done at the fertility clinic was not accurate?
Thank you,
AnswerHello Rita from Canada,
I think that you have three problems affecting your fertility and the more problems you have, the harder it is to become pregnant. Even if we assume that you husband is fertile, as evidenced by his ability to get someone pregnant in the past, that still leaves two problems. However, I would not make that assumption despite his past history. With fertility, you have to work with the present, not the past. Things change with time and it is the present conditions that are going to impact your ability to become pregnant. This is equally true for men and women. It is possible that the sperm count and/or quality was fine when your husband was 26 years old, however, that is not the current situation so different measures have to be taken. I have had many women patients that have been easily pregnant in the past, and either delivered the child or terminated the pregnancy, but in their older years are having great difficulty. So you have to deal with the present situation only, and that includes your husband.
The three main problems that you have told to me are (1) sperm disorder, (2) ovulation disorder and (3) age factor. The latter is a significant factor because it is due to the age of the eggs, which decreases your fertility. If you combine all these problems, the treatment of choice is IVF with ICSI. That is the only treatment that can overcome all three of these problems. IUI may overcome the sperm disorder and ovulation disorder but it does not overcome the age factor. If the sperm is severely abnormal, then the IUI does not overcome that problem either. So my advice is to proceed with IVF/ICSI before the age factor becomes an even bigger problem than it already is. Time is not on your side.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf
