Fertility Challenges: Insights on Misdiagnosis and Health Factors

Other

1.
At the age of 18 and 19, I experienced nerve pain in the inner thigh and went to an orthopedic examination.
I was told that I had pelvic inflammation, bone spurs on my back, and scoliosis.
I subsequently underwent rehabilitation, but my scoliosis has not improved.
Now, whenever I have an X-ray, doctors mistakenly think I am not standing straight, and they comment that my curvature resembles that of an elderly person with an S-shaped spine.
2.
On April 1 of this year, I underwent a medical abortion due to my baby's heartbeat weakening and then stopping.
However, that night I experienced severe abdominal pain and went to the emergency room, where I felt I was not properly diagnosed; they just administered pain relief through an IV, which was ineffective.
The next day, my doctor explained that it was due to blood flowing back to the ovaries.
I remember that many gynecologists I consulted previously said I had an anteverted uterus, but the doctor who performed my abortion said it was retroverted.
Additionally, my classmate had only one day of bleeding after her abortion, while I bled for 14 days.
Which duration is considered normal?
3.
My in-laws have a cat, and every time my mother-in-law bathes the cat, she throws the towel used on the cat into the washing machine with everyone else's clothes.
Besides me, all the family members also wash their underwear in the same machine.
Given the poor hygiene, could this be a reason for my previous miscarriage? I have not been pregnant since then.
Last month, we tried every three days, and this month every two days, but I still did not conceive.
My husband sometimes works in high-temperature environments, and he recently started a joint factory venture, which has caused him significant stress.
Could this affect his sperm quality? I would like to ask the doctor what might be causing my difficulty in conceiving.
Was the previous abortion procedure poorly performed? If we need to do a sperm analysis, which department should we consult, and what are the costs and procedures involved? Does having been pregnant before indicate that my fallopian tubes are patent?

Qi, 20~29 year old female. Ask Date: 2005/10/02

Dr. Huang Jianxun reply Obstetrics and Gynecology

If you have scoliosis, please discuss it in detail with an orthopedic surgeon regarding treatment options.
Anterior or posterior uterine tilt is mostly congenital; if you are concerned, please have your doctor conduct a thorough examination.
Post-abortion vaginal bleeding or menstrual irregularities can have various causes, so please consult your doctor for further evaluation and explanation.
If you have concerns or suspicions, please wash your clothes yourself.
A husband working in a high-temperature environment is detrimental to sperm health; please have him undergo a sperm analysis.

Reply Date: 2005/10/02

More Info

Understanding fertility challenges can be a complex and emotional journey, especially when compounded by previous pregnancy losses and health issues. Based on your detailed account, several factors may be contributing to your current fertility struggles, and it’s essential to address them systematically.

1. Medical History and Misdiagnosis: You mentioned a history of pelvic inflammation, spinal issues, and previous misdiagnoses regarding your uterine position. It’s crucial to have a comprehensive evaluation by a specialist who can accurately assess your reproductive anatomy. A tilted uterus (anteverted or retroverted) typically does not affect fertility, but if there are underlying structural issues or complications from previous surgeries, these could impact your ability to conceive or carry a pregnancy to term. A referral to a reproductive endocrinologist or a fertility specialist may provide more clarity.

2. Post-Abortion Complications: After your recent abortion, you experienced significant pain and prolonged bleeding. While some bleeding is normal after such a procedure, excessive bleeding or pain could indicate complications such as retained products of conception or infection. The statement regarding blood flow to the ovaries may suggest a vascular issue or a complication from the procedure. It’s essential to follow up with your healthcare provider to ensure that your reproductive system has returned to its baseline state and to rule out any complications that could affect future pregnancies.

3. Environmental and Lifestyle Factors: You raised concerns about hygiene in your household, particularly regarding the washing of clothes and potential exposure to pathogens. While maintaining good hygiene is essential, it’s unlikely that this alone would cause a miscarriage. However, if there are concerns about infections (like bacterial vaginosis or sexually transmitted infections), these should be addressed with your healthcare provider.
4. Male Partner’s Health: You mentioned your husband’s exposure to high temperatures and work-related stress, which can indeed affect sperm quality. Elevated temperatures can impair sperm production and motility, while stress can impact hormonal balance. A semen analysis is a critical step in evaluating male fertility. This test can be performed at a urology clinic or a fertility center, and it typically involves providing a sample for analysis. Costs can vary widely based on location and insurance coverage, so it’s advisable to check with your provider.

5. Fertility Testing and Next Steps: Given your history of miscarriage and current challenges, a thorough fertility evaluation for both partners is recommended. This may include blood tests to check hormone levels, imaging studies (like an ultrasound or hysterosalpingogram) to assess uterine and fallopian tube health, and possibly genetic testing if there are concerns about inherited conditions.
6. Timing and Frequency of Intercourse: You mentioned trying to conceive with varying frequency. While timing intercourse around ovulation is crucial, it’s also important to ensure that both partners are in optimal health. Tracking ovulation through methods like basal body temperature or ovulation predictor kits can help identify the best times to conceive.

7. Emotional Support: Lastly, navigating fertility challenges can be emotionally taxing. Consider seeking support from a counselor or support group specializing in fertility issues. This can provide a safe space to express your feelings and connect with others who understand your journey.

In summary, addressing your fertility challenges will require a multi-faceted approach, including thorough medical evaluations, lifestyle modifications, and emotional support. It’s essential to work closely with healthcare providers who can guide you through this process and help you understand the best steps forward for your reproductive health.

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