Frequently Asked Questions
Q. We have been trying for a baby since
the past two years but failed. What could be wrong
and what do we need to do ?
A. We know today
that 50% of infertility is due to a male factor. A
simple semen analysis for your husband would be the
first test. Subsequently, we could run routine hematological
investigations for you followed by an transvaginal
ultrasound, a hysterosalpingography, hormonal estimations
and if required a laparoscopy and hysteroscopy. Once
we have run through the above investigations, we would
be in a position to suggest remedial measures.
Q. My gynecologist has done an internal
examination and said I am normal. Do I still need
to get tests done to determine why I am not conceiving
A. A routine gynecological
examination does not provide information about possible
problems which can cause infertility, such as blocked
fallopian tubes or ovulatory disorders. You need a
systematic infertility workup.
Q. Do painful periods cause infertility
A. Painful periods
do not affect fertility. In fact, for most patients,
regular painful periods usually signal ovulatory cycles.
However, progressively worsening pain during periods
(especially when this is accompanied by pain during
sex) may mean you have endometriosis.
Q. My periods come only once every
6 weeks. Could this be a reason for my infertility
A. As long as the
periods are regular, this means ovulation is occurring.
Some normal women have menstrual cycle lengths of
as long as 40 days. Of course, since they have fewer
cycles every year, the number of times they are "fertile"
in a year is decreased. Also, they need to monitor
their fertile period more closely, since this is delayed
(as compared to women with a 30 day cycle).
Q. My husband's blood group is B positive
and I am A negative. Could this blood group "incompatibility"
be a reason for our infertility ?
A. There is no
relation between blood groups and fertility.
Q. After having sex, most of the semen
leaks out of my vagina. How can we prevent this ?
Should we change our sexual technique ? Could this
be a reason for our infertility ?
A. Loss of seminal
fluid after intercourse is perfectly normal, and most
women notice some discharge immediately after sex.
Many infertile couples imagine that this is the cause
of their problem. If your husband ejaculates inside
you, then you can be sure that no matter how much
semen leaks out afterwards, enough sperm will reach
the cervical mucus. This leakage of semen ( which
is called effluvium seminis) is not a cause of infertility.
In fact, this leakage is a good sign - it means your
husband is depositing his semen normally in your vagina.
Of course, you cannot see what goes in - you can only
see what leaks out - but the fact that some is leaking
out means enough is going in!
Q. My colleagues at work tell me that
if we "work" hard at getting pregnant, and
want it enough, we definitely will ! In fact, my mother
in law is even suggesting that the fact that I am
not conceiving means that subconsciously I do not
wish to have a baby ( because it may interfere with
my career) and that this psychological barrier is
the reason for our infertility ?
A. Unlike many
other parts of your lives, infertility may be beyond
your control. Don't blame yourself if you are not
getting pregnant - it's a medical problem which often
needs appropriate medical treatment. The attitudes
you are encountering are often born out of ignorance
- and are a kind of "victim-blaming" - ignore
Q. My grandmother says that if I just
pray and have faith, I will definitely conceive. How
far is this true ?
A. Believing in
god can help you to maintain a positive outlook -
but sheer will and blind faith won't overcome a physical
problem like blocked tubes or absent sperms.
Q. My husband refuses to get his semen
tested. He says the fact that it is thick and voluminous
means it must be normal.
A. Semen consists
mainly of seminal fluid, secreted by the seminal vesicles
and the prostate. The volume and consistency of the
semen is not related to its fertility potential, which
depends upon the sperm count. This can only be assessed
by microscopic examination.
Q. My sister conceived only after 6
years of marriage. Does this mean I will also have
difficulty conceiving ?
A. If your mother,
grandmother or sister has had difficulty becoming
pregnant, this does not necessarily mean you will
have the same problem! Most infertility problems are
not hereditary, and you need a complete evaluation.
Q. My doctor just did a physical examination
for me, and he feels that the reason for my infertility
is that my uterus is tipped backwards, and this prevents
the sperm from swimming into the uterus. He is advising
I have surgery to correct this problem. Should I go
A. About one in
five women will have a retroverted uterus. If the
uterus is freely mobile, this is normal, and is not
a cause of infertility. This is not an indication
Q. My husband says we should be having
intercourse every day to achieve pregnancy. Is this
A. Sperm remain
alive and active in woman's cervical mucus for 48-72
hours following sexual intercourse; therefore, it
isn't necessary to plan your lovemaking on a rigid
Q. My friends say I should have sex
exactly on the day I ovulate to get pregnant. How
can I do this ?
A. Although having
sexual intercourse near the time of ovulation is important,
no single day is critical. So, don't be concerned
if intercourse is not possible or practical on the
day of ovulation.
Q. My sister in law is advising me
to keep a pillow under my hips during and after intercourse
. Will this increase my chances of conceiving ?
A. Sperm are already
swimming in cervical mucus as sexual intercourse is
completed and will continue to travel up the cervix
to the fallopian tube for the next 48 to 72 hours.
The position of the hips really doesn't matter.
Q. My mother feels I am too tense,
and that if I just relax, I'll get pregnant ?
A. If pregnancy
has not occurred after a year, chances are there is
a medical condition causing infertility. There is
no evidence that stress causes infertility. Remember,
all infertile patients are under stress - it's not
the stress which causes infertiliity, it's the infertility
which causes the stress!
Q. I just had a HSG ( X-ray of the
uterus and tubes) done, and this shows my tubes are
blocked. I've never had symptoms of a pelvic infection,
so how could my tubes get blocked ?
A. Many pelvic
infections have no symptoms at all, but can cause
damage, sometimes irreversibly, to the tubes.
Q. My doctor has advised me to take
fertility drugs . I don't want to take them because
if I am scared that if I do, then I'll have a multiple
Although fertility drugs do increase the chance of
having a multiple pregnancy (because they stimulate
the ovaries to produce several eggs), the majority
of women taking them have singleton births.
Q. My husband's sperm count varies
every time we test it ! How do we determine what the
"real" sperm count is ?
A. Even a normal
( fertile ) man's sperm count can vary considerably
from week to week. Sperm count and motility can be
affected by many factors, including time between ejaculations,
illness, and medications. There are other factors
which affect the sperm count as well, all of which
we do not understand.
Q. I have no problems having sex. Since
I am virile, my sperm count must be normal ?
A. There is no
correlation between male fertility and virility. Men
with totally normal sex drives may have no sperms
Q. I don't think infertility treatment
should not be offered in India, because there are
too many babies in this country already. Why should
we exacerbate the population problem by producing
more? In any case, IVF treatment is too expensive
for India to be able to afford ?
A. The right to
have children is a fundamental right of every human
being and a very basic biological urge. Just because
a neighbour has too many children should not deprive
the infertile couple of their right to have their
own. IVF and related technologies are undoubtedly
expensive, but, then, so is heart surgery. Yet no
one objects when over Rs 1 lakh are spent to try to
salvage the heart of a 70 year old man (whose life
expectancy in any case is only about 5 years and is
not extended by the surgery). Why then should medical
technology not be used to help couples in their thirties
(with their whole lives ahead of them) have their
own baby? In fact, IVF is a much more cost-effective
use of medical resources than a number of other accepted
surgical procedures (such as joint replacement surgery
or kidney transplants).
Q. My semen analysis report shows I
have no sperm in the semen (azoospermia ). Is this
because I used to masturbate excessively as a boy
is a normal activity which most boys and men indulge
in. It does not affect the sperm count. You cannot
"run" out of sperms, because these are constantly
being produced in the testes.
Q. My wife is frigid and does not enjoy
having sex. Could this be the reason for her infertility?
A. There is no
connection between sexual pleasure and fertility.
Don't forget that even a woman who gets raped can
get pregnant! And don't forget that the commonest
reason women do not enjoy sex is because their husbands
are unskilled lovers ! Maybe you should improve your
sexual technique, and spend more time in foreplay
and in pleasuring your wife.
Amazon will work with you and our India
Affiliates to create a package where all your Gynecological
concerns/problems can be addressed. If you have any
questions, please do not hesitate to contact us by
phone or email.