Dear Doctor, 

I have been married for two years but still failed to conceive. My husband works upcountry and only comes over the weekends. How can I know the danger days when I can conceive? Is there a way to get a baby of your choice?

Patricia

Dear Patricia,

Not conceiving a baby for up to 2 years, i.e. primary sterility can be due to a number of causes, with either one or both partners. In a man it could be due to hormonal imbalance, testicular abnormalities or blocked vas deferens.

In a woman it could be due to hormonal disturbances, failure to ovulate, ovarian diseases and / or blocked fallopian tubes. There may be one or more than one problems existing.

Tests are available to diagnose the underlying cause(s) of infertility and treatment is available for most of the conditions. To know the sperm count and quality of sperm in a man it is vital to abstain from sex for at least a week before giving samples otherwise false results may be obtained. Tight nylon underpants, using laptops on a lap for long hours are reasons which can reduce sperm count, hence fertility in men.

Stress, both physical and mental, can reduce fertility in both genders by causing spasm of the tubes. Diet deficient in vitamin E may also cause infertility and supplements of vitamin E may help people to become fertile.

Conventionally the danger days, i.e. days of voulation are said to be between the 14th and the 21st day of menstrual cycle. But it is not hard and fast. It is suggested that sexual stimulation anytime can induce ovulation.

Moreover in women with irregular menstrual cycles, days of ovulation may be variable. The day of ovulation can be judged by measuring the basal body temperature which is usually 1 degree higher in the morning. The cervical mucous also becomes thick around ovulation. Days of ovulation can be judged precisely by serial ultrasound studies.

One can have a baby of one’s choice of gender by sperm concentration and chromosomal separation technique. Then there are traditional folklores based on experience of people, which say as to which position is better to conceive a boy or girl.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital