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Infertility

Infertility

07/20/2009

Question:

i AM 33 YEARS OLD WITH ONE DAUGHTER ABOUT 4.5 YEARS, MARRIED SINCE 6 YERAS. WITH SECONDERY INFERTILITY, NORMAL MENSTRUAL CYCLE EVERY 26 DAYS FOR 3-4 DAYS. i SEEK FOR ADVICE WHICH SAY THAT: NORMAL OVULATION, NORMAL HORMONES AND WITH HYSTOSALPINOGRAPHY NORMAL TUBES. SEMEN ANALYSIS WAS SLIGHTLY DECREASE IN MOTILITY AND INCREASE IN ABNORMAL FORMS, MY HUSBAND ASKED TO DO VARCOCELECTOMY AND DID IT SINCE 2 YEARS BUT ALSO NO PREGANCY OCCUR WITH NORMAL SEMEN ANALYSIS. i UNDERWENT iui FIRSTLY FAILED, AND THE SECOND TIME SINCE 3 MONTHES SUCSESS BUT ENDED IN ECTOPIC PREGNANCY AFTER 40 DAYS ONLY. WHAT IS THE CAUSE OF MY SCONERY INFERTELITY AND WHAT IS THE TREATMENT.

Answer:

The cause of your infertility is most likely to be related to a male factor, although you could have more than one cause. Your evaluation and treatment appears to have been thorough and appropriate. Treatment with IUI resulted in pregnancy, and thus would be reasonable treatment to repeat. Some women have a tubal pregnancy as a result of scar tissue from a previous undiagnosed infection, although this is not always the case. Your doctor might want to evaluate your tubes further by repeating a hysterosalpingogram or performing diagnostic laparoscopy. If you have the resources, in vitro fertilization is a reasonable step when all other treatments have been unsuccessful.

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Response by:

William W Hurd, MD William W Hurd, MD
Professor of Reproductive Biology
School of Medicine
Case Western Reserve University