HRM HEALTH: Infertility Options

Having Trouble Conceiving? Help is at Hand

You’ve been trying to get pregnant for a year but get disappointing news every month. You’re not alone; infertility affects one out of every five couples who are trying to conceive, according to the Center for Women’s Health, with offices in Newport News and Hampton. Yes, you have options, including lifestyle changes that could help put a baby in your arms.

The first step toward diagnosis is a general exam, says Dr. Douglas Thom of the Center for Women’s Health. Usually that involves the woman initially because women are usually more acutely concerned about the biological clock.

But responsibility is shared. About 40 percent of infertility problems are linked solely to the female partner; 40 percent are linked to the male partner; and 20 percent are shared, Thom says. “We may find more than one reason,” he says.

Diagnostic tests help determine if and when ovulation is occurring, Thom says. Other tests measure whether the woman’s hormone levels are high enough to allow and support pregnancy, he says.

Thyroid tests may be called for because both an underactive (more likely) or overactive thyroid can prevent pregnancy, he says. If a woman is over 30, early menopause can be an issue, Thom says. Hormone therapy can be helpful for these conditions.

An ultrasound is another diagnostic tool and can help determine if a woman has polycystic ovary syndrome (PCOS), which can impede pregnancy because eggs aren’t released from the ovaries, Thom says.

Excess weight is a common cause of PCOS, Thom says. One study found that overweight PCOS patients who lost 30 pounds had a 60 percent success rate at getting pregnant, he says. “It was amazing,” he says, while acknowledging that losing the weight can be tough. Thom recommends his overweight patients with PCOS go to Weight Watchers.

On the other hand, being extremely underweight also can cause failure to ovulate, Thom says.

Sometimes PCOS and other causes of failure to ovulate can be treated with fertility drugs, such as Clomid, and sometimes with fertility injections, Thom says.
 

 

Blocked fallopian tubes, which can be caused by a current or past infection, also can prevent pregnancy, Thom says. If the blockage is caused by a current infection, doctors can often clear the blockage by treating the infection, he says.

If the blockage is near the ovary, a doctor can do laparoscopic surgery to remove the blockage. If the blockage is deep inside the muscle of the womb, the preferred treatment now is to proceed to in-vitro fertilization (IVF) because that has a better success rate than clearing a blockage deep in the womb, he says.

Fibroid tumors present another problem. Endometriosis can also cause infertility. Hormonal therapy and surgical excision are used to treat these problems, he says.

For men, tests include a semen analysis to make sure the body is producing enough normal sperm, he says. Just five percent healthy sperm is normal, he says. But when only 1 percent or 0.5 percent are healthy, this poses a problem, he says.

For 20 to 25 percent of men with this issue, a lifestyle change can help boost the numbers of good sperm, Thom says. That change would include cutting back or eliminating alcohol, smoking, drugs, even some prescription medications, he says. “We want to decrease the amount of poison people are taking in,” Thom says.

Some couples come in knowing the options they are willing to try to get a pregnancy, he says. If they don’t get pregnant, they stop after they’ve pursued those options, he says.

Of the rest, about 60 percent get pregnant, Thom says. He refers the remaining 40 percent for IVF at the Jones Institute for Reproductive Medicine in Norfolk or the New Hope Center for Reproductive Medicine in Virginia Beach. IVF success rates are continually improving—from 23 percent 20 years ago to approaching 65 percent today, Thom says.
 

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