Infertility: Key Questions and Tests for Women

Q: Infertility: Key Questions and Tests for Women

Hello： In response to your question... <br>Difficulty in conceiving is related to many factors, such as whether the male sperm is normal, whether the fallopian tubes are functioning properly, and there are also cases of unexplained infertility. <br>In summary, if you wish to beco

I'm sorry, but I need more context or specific information to provide assistance. Please provide details about your situation or question?

Hello Dr.
Wang, I would like to ask a question.
I have been with my boyfriend for almost three years, and we have never used contraception, but for some reason, we have not been able to conceive.
This issue has been bothering me for a while.
My last menstrual period started on the 5th of last month, and my periods are regular every month with what I would consider a normal flow.
I would like to know if a person's constitution can affect her chances of getting pregnant.
I am 155 cm tall and weigh 41 kg (I am also troubled by my difficulty in gaining weight).
Could this be the reason for my issues? I have been getting Pap smears every April, and the results from the past two years showed uterine inflammation.
I have been taking medication prescribed by my doctor, and this year's examination results were normal.
So, what could be the problem? I went to see a doctor today, and he asked me to get a blood test to check for ovulation issues and told me to return next week for the results.
Dr.
Wang, could you advise me on what tests would be best? Should I undergo a hysterosalpingography or a laparoscopy? The doctor I saw today mentioned that if I do not conceive after taking ovulation medication for three months, I would need to have a hysterosalpingography, which he said would be very painful and uncomfortable.
Why is that? I previously consulted a traditional Chinese medicine practitioner who said my constitution is "cold." Sometimes when I drink cold water, I experience increased vaginal discharge, which is quite bothersome.
Additionally, I usually do not take any medication, but I feel nauseous and want to vomit before my period, which I have not experienced before.
What could be the reason for this? Please let me know what I should do.
Thank you very much! I really appreciate it!

Fenfen, 20~29 year old female. Ask Date: 2004/11/01

Dr. Wang Jionglang reply Obstetrics and Gynecology

Hello: In response to your question...
Difficulty in conceiving is related to many factors, such as whether the male sperm is normal, whether the fallopian tubes are functioning properly, and there are also cases of unexplained infertility.
In summary, if you wish to become pregnant, you can visit a hospital outpatient clinic for further detailed information.
As for the issue of vaginal discharge, it may be related to an infection; you should consult a hospital for evaluation.
Department of Health, Keelung Hospital, Wang Jiong-Lang.

Reply Date: 2004/11/01

More Info

Infertility can be a complex and emotionally challenging issue for many couples. Based on your situation, it seems you have been trying to conceive for almost three years without success, despite having regular menstrual cycles and no apparent issues with your menstrual flow. Your concerns about your body type, previous health issues, and the potential need for further testing are valid and deserve careful consideration.

Understanding Your Body and Its Impact on Fertility
Your body composition, including height and weight, can influence fertility, but it is not the sole determinant. A body mass index (BMI) that is significantly below the normal range can sometimes affect hormonal balance and ovulation. In your case, a weight of 41 kg at a height of 155 cm gives you a BMI that is considered underweight. This could potentially impact your fertility, as being underweight can lead to irregular ovulation or even anovulation (not ovulating at all). It is essential to maintain a healthy weight to support reproductive health.

Previous Health Issues
You mentioned having a history of uterine inflammation, which can affect fertility. Chronic inflammation can lead to scarring or other changes in the reproductive organs that may hinder conception. It’s good to hear that your recent Pap smear results were normal, indicating that there are no current issues with cervical health.

Recommended Tests for Infertility
Given your situation, it is wise to follow your doctor's advice regarding blood tests to check for ovulation issues. If you are not pregnant after three months of trying while on ovulation-inducing medication, further testing may be warranted. Here are some common tests and procedures that could be beneficial:
1. Hormonal Blood Tests: These tests will check levels of hormones such as progesterone, estrogen, and others that are crucial for ovulation and overall reproductive health.

2. Ovulation Monitoring: Tracking your basal body temperature and using ovulation predictor kits can help determine if and when you are ovulating.

3. Hysterosalpingography (HSG): This is a special X-ray of the uterus and fallopian tubes. It can help determine if your fallopian tubes are open and if there are any abnormalities in the uterine cavity. While some women report discomfort during the procedure, it is generally quick and can provide valuable information.

4. Laparoscopy: This is a surgical procedure that allows doctors to look inside your abdomen and pelvis. It can help diagnose conditions like endometriosis or pelvic adhesions that might be affecting fertility.

Addressing Your Concerns
You expressed concerns about the pain associated with HSG. While some discomfort is common, many women find it manageable. It is essential to communicate with your healthcare provider about your concerns, as they can provide pain management options or reassurance.

Regarding your mention of feeling nauseous before your period, this could be related to hormonal fluctuations that occur during your menstrual cycle. If this symptom persists or worsens, it would be wise to discuss it with your doctor.

Next Steps
1. Follow Up on Blood Tests: Wait for the results of your blood tests to see if there are any hormonal imbalances that need to be addressed.

2. Consider HSG: If your doctor recommends it after three months of treatment without success, consider proceeding with the HSG test to check for any blockages.

3. Healthy Lifestyle: Focus on maintaining a balanced diet and a healthy weight. Consulting with a nutritionist may help you find ways to achieve a healthier weight that supports your fertility.

4. Explore Other Options: If conventional treatments do not yield results, you might want to explore other avenues, such as consulting a fertility specialist or considering assisted reproductive technologies.

In conclusion, infertility can stem from various factors, and understanding your body and its needs is crucial. By working closely with your healthcare provider and following through with recommended tests, you can gain clarity on your situation and take informed steps toward achieving your goal of conception.

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