Dear Doctor,

My husband and I have been trying to have kids for over a year now but we’ve failed. My husband has one child from a previous relationship so I thought the issue was with me. I am 27 years old and I went for a check-up but nothing could be detected that is hindering the process. What could be the issue?

Flavia

Dear Flavia,

As it takes two to make a baby, failure to make one can be due to fault in any of the partners. As your tests have been normal, the problem could be with your husband. Viral infections in childhood like mumps can cause inflammation of the testes and impair sperm production. Orchitis (an inflammation of the testicles caused by either bacteria or a virus), due to any reason later in life, can also cause sterility in a man. Uncontrolled diabetes makes one more vulnerable to these infections.  Alcohol use can disturb the hormonal balance and affect reproduction. Constant use of laptop computers by putting them on one’s lap tends to raise the scrotal temperature and can reduce sperm production. Similarly, the use of tight or nylon undergarments also hampers sperm production by raising scrotal temperature.  At times, the male partner may have no problem. But sperms passed may not be compatible with the pH of vaginal fluid. This tends to destroy the sperms, thus failure to conceive. If intercourse is done at the time of ovulation, chances of conception increase. But the chance is reduced when it is done at any other time. Time of ovulation can be determined by measuring basal body temperature and examining the cervical mucous and by serial ultrasound examination.

It is good to abstain for some days and then indulge in sex around ovulation time. Both the partners may be normal physically but if one of them is stressed, conception can fail. Stress tends to block the tubes transporting the eggs or sperm.

Your husband may have had one child before and now some physical problem may have come up causing secondary sterility.  It is advisable for him to undergo necessary tests to exclude it. Both should shun alcohol, be relaxed and follow a healthy life style. Try to limit sex to around time of ovulation. Positive results will definitely be obtained. Various techniques are also available to assist reproduction.                       

Dr.Rachna   Pande is a specialist in internal medicine.