Dear Readers,

Fin, 35, writes Lifeline from Whitfield Town. Her first child is 11 and she is trying to get pregnant. Fin used family planning contraceptive methods for nine years. Last January has been a year since she has stopped.

Fin has visited her gynaecologist for check ups and has been told she has uterine fibroids, which can hinder pregnancy. She has also been told her sexually transmitted infections screen revealed she had herpes simplex infection (HSI) in the past. Fin is worried the HSI could prevent her from concieving.

Lifeline reassures Fin that an HSI will not affect her fertility. There are other concerns with having an active HSI infection, especially at the time of birth, but these are not usually fertility concerns, instead impacting on the health of the newborn. They, however, can be avoided with proper antenatal care.

Dependant on the location of the uterine fibroids and their size, they can have some effect on a woman's ability to conceive, as well as her ability to carry a pregnancy to full term. Large uterine fibroids are associated with a higher incidence of miscarriage. Nevertheless, with proper monitoring, uterine fibroids usually are not a significant problem.

As Fin has only been off birth- control methods for a year she does not need to worry about her fertility as yet. Many women take this long to conceive naturally, even when there are no known impediments to achieving pregnancy. Many factors may play a part in this including:

❒ Frequency of sexual intercourse especially during the fertile time.

❒ Current womb infections which provide a hostile environment for pregnancy.

❒ Use of the Depo Provera injection for birth control, which can have a dampening effect on fertility for several months after its use has been discontinued.

❒ Abnormalities with the male sperm and semen content.

❒ Stress

Usually, all these above factors can be corrected and if the woman does not wish to wait, her monthly production of eggs available for fertilisation can be increased with fertility drugs. Clomid is the preparation which is most readily available by prescription and is also the least expensive.

Beyond this front-line fertility care, there are also other, more invasive and intrusive, methods of achieving pregnancy. These would include:

❒ Intra-uterine insemination, which involves the insertion of specially prepared sperm from the male partner directly into the woman's womb, through the vagina at the time of ovulation.

❒ Intra-cytoplasmic sperm injection, which involves the insertion of a single sperm directly into a mature egg, using a special microscope. This fertilised egg is then transferred into the woman's womb. This method is used when the male partner has abnormalities with his sperm production.

These techniques are available at the Hugh Wynter Fertility Management Unit at the University Hospital.

Lifeline encourages Fin to have a full gynaecological check-up. If this remains fairly normal after ultrasound evaluation of her uterine fibroids, then she should relax and see if her pregnancy will happen naturally. If her situation is unchanged by the middle of this year, she can seek further help.

Write to:

Lifeline

PO Box 1731

KGN 8