Small Cervical Os & Infertility: Causes, Diagnosis & Options

Question
I'm 29 years old and have been trying to conceive for 2 years. I'm of normal weight (5'4", 120 lbs) and healthy (exercise, eat well, don't smoke, etc). My husband is 33 and in good health although he occasionally smokes cigarettes. I've had LSH, FH, & Progesterone blood work done and all were in the excellent to very good categories. My husband's semen analysis was good as well (110 mil) and good form, etc. I had a HSG done and my tubes are open, but the doctor had trouble inserting the catheter all the way through my cervical os b/c it was so small and tight. Could this be the problem for not conceiving? I had a cryo on my cervix 8 years ago for mild dysplasia after an abnormal pap smear, and no problems after that. I am going to try Clomid next month even though I seem to be ovulating fine, and am getting frustrated. Can you offer some insight on the cervical os? My ob/gyn tried to manually dilate it herself, but it didn't change much. Please help - we're starting to feel scared we might not be able to have children.

Answer
Dear Kate,

If you have normal menstrual bleeding, then the size of the cervical os is large enough for sperm cells (which are microscopic in size) to flow through also. I would not consider that a hindrance to your fertility.

It sounds like you have had all the testing done that would indicate a potential issue with fertility. The Clomid may give you the little boost that is needed to conceive. Also ask your doctor about starting on some prenatal vitamins while trying to conceive. Some women have had some luck with that. Most of all - relax. Don't let this "rule your world". Many times the very time that women actually conceive is when the decide to take a little break for a month or two from trying so hard.

I know it is incredibly frustrating - especially in the summer when you seem to see babies everywhere - but don't give up hope so easily. If the Clomid would not happen to work, your OB can refer you to a fertility specialist and there are other options available to you to conceive a child.

I hope this has helped you and answered your question. I wish you well.

Brenda