QuestionDear Doctor, I am a 34 year old married Indian woman, currently living in Melbourne, Australia. We got married in June 2005.In October 2005, I conceived naturally but had to terminate the pregnancy in 17 weeks gestation as I was infected with Melioidosis. I was told that the treatment for this infection will affect the baby and had to undergo MTP in Feb 2006. After MTP, we were asked not to try for a baby for 6 months. In 2007, we tried and in Jun 2007, I got a positive HPT but started bleeding 10 days after my due date. The doctor informed me that I had a spontaneous abortion and again had to recover for the next 3 months. In Feb 2008, I was asked to take Rubella IgG level test and it came negative for which I was vaccinated and again was asked to stop trying for the baby for 3 months. In the meantime, I also had my HSG done and it is normal. My husband had his sperm tested and the results are as below:
Sperm Concentration - 86.0 million/ ml
Motility - 55%
Rapidly Progressive - 05%
Moderately Progressive - 40%
Sluggishly Progressive - 10%
Spermatological Diagnosis - Asthenozoospermia
We were told that since the overall motility is 55%, it is still normal.
All the above tests were carried out in India. We have moved to Melbourne one month back.
We have started trying for the baby again and I am not sure if we will succeed this month. I would like to know if there is anything that both of us should / should not do in our conditions to increase the chances of conception.
Thank you,
Anitha
AnswerDear Anitha,
Thannk you for your question. Overall, you have been pregnant spontaneously twice and are still young so I am not worried that you will not be able to conceive naturally. I would recommend that you not worry about it too much as this worry and stress can decrease your chances by itself.
In terms of your husband's semen analysis, we usually look at the total motile count to determine if there are adequate numbers for fertilization (count x motility = total motile count). In your husband's case it is 30.25 million. The minimum required is 20 million. Therefore, your husband's semen analysis findings are normal and not a problem.
I would encourage you to keep trying. Now that you have been cleared to try consistently, give yourself 12 months of trying for pregnancy naturally. If it does not occur by that time, then you should undergo an infertility evaluation. You've jumped the gun a little by your current testing but that is okay. I would recommend that you use the calendar method which I recommend to my patients. It goes like this:
Cycle day # 1 - the day your period starts. Start counting each day from this point. For example, the next day is cycle day # 2, the day after than is cycle day # 3, etc.
Cycle day # 10 - stop having intercourse on this day. You can have intercourse up to this day
Cycle day # 13 - begin having intercourse daily, once per day, only one ejaculation per day for the next five days (until cycle day # 17). After day # 17 you can resume normal amounts of intercourse.
This method will allow you to hit ovulation. Based on your previous history, that should work within 12 months.
Sincerely,
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
