Trying to Conceive for a Year
Question
I am 34 years old and my husband is 35. We tried to have a child for a year but we did not have very frequent or well-planned sex because we traveled a lot. My husband then had a semen analysis which showed E-Coli in his sperm he had a treatment with antibiotics and his next semen analysis ten days after finishing the treatment showed 50 mil sperms /ml and excellent mobility in the first hour there were 85% living in the second 75%, in the third 61% i9n the fourth 42% in the fifth 32% and in the sixth 20% and none in the seventh. I also had tests for LH (4,99)and FSH (6,09)which were normal and prolactin (536,4 while the limit was 511) was slightly elevated and the doctor said it was because of stress.
We tried for three months regularly and while I did BBT charting had a biphasic pattern of temperature and clear ovulation and did another sperm analysis which showed: 35 mil/ml, weak mobility and 51% of sperm live in the first hour and 10% in the second and none in the third. Everything else was normal. My husband visited an expert who gave him Vitamin E 1000 mg once a day and L-carnitine twice a day BUT MY HUSBAND TAKES IT ONLY ONCE A DAY.
I had some pain in my breasts and I had a progesterone test in the midluteal phase which was normal(50,5). I also had a prolactin test which showed 55,40 of prolactin when the limit was 25. I started parlodel but I could not stand it and changed it into Dostinex which is Ok. My breasts were OK since they had grown in size previously and I also had a HSG and everything was normal but it was a little difficult for the dye to go through both my tubes so I felt a little pain but everything was OK.
I must also tell you that I had two pregnancies in the past which I stopped but my husband did not have one of his partners pregnant. I did have an infection with Chlamydia but had adequate therapy. I did not have any other problems except the usual occasional infections and had normal cycles of 24-28 days. I also had thyroid tests but were OK.
Can you please help me? Should we run any other tests? We really want a baby what should I do?
Thank you for your help and support in advance
Answer
Last Updated: June 17, 2013
The other thing I would check is luteal progesterones and estradiols. We check values on 5, 7 and 9 days after ovulation, or peak day. The progesterone 7 days after ovulation should be 15 or higher; the others at least 12. The estradiols should be 110 or 120 (the values in your local laboratories may be somewhat different). If these hormones are lower, they should be treated, with progesterone, or possibly low dose Clomid and HCG. Also, I did not see any information about a FSH on day 2 or 3 of your cycle, or your weight, height and exercise habits. It is best to not be too heavy or thin, and have a body mass index between 21-25.
I am concerned about stress in your lifestyle, and would encourage you and your husband to try to be healthy physically, emotionally and spiritually. It would be good to give up smoking, most over the counter medications, alcohol and other drugs for the preconception period. The old chlamydia infection could have caused scar tissue that is not visible on the hysterosalpingogram. If you are not pregnant after several cycles of perfecting your hormones, consider a laparoscopy to look at your pelvic organs and remove any possible pelvic adhesions and endometriosis.
You are a little older, wanting to be a mother at this point, and may be looking at your past experiences with chlamydia and pregnancy terminations with some regret. Millions of women of your generation and mine(I am about 20 years older than you) have had similar experiences, and did not appreciate God’s gift of fertility in their youth. It is possible you are in need of emotional healing, and it can be very helpful to get some help from organizations such as www.hopeafterabortion.com and www.rachelsvineyard.com. For fertility the physical, psychological and spiritual all work together, and I would urge you to work on all three areas.
Dr. Davenport
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