Q:We are facing the prospect of having to undergo investigations in an attempt to determine the cause of our infertility. We have been trying to have a baby for almost three years. Tests done have shown that I appear to be ovulating regularly with
It has been advised by one gynecologist at Western Isles Hospital that my husband see a urologist with a specialist knowledge of fertility problems. The urologist he is advised to see would in fact be connected to the assisted conception clinic, where we could eventually be referred should we choose to embark on assisted conception treatment, such as in vitro fertilization.
Although it was not actually advised that I should have any investigations done at this stage, as my medical history does not indicate any possible damage to tubes or ovaries though infection, I have voiced some concern that there might be a problem which is remaining undetected, as to date I have not had any form of physical examination by a gynecologist. The psychological pressures of infertility are taking their toll on both of us and I sometimes think that just getting something done would seem beneficial.
I have been put on the waiting list for a laparoscopy at Western Isles Hospital, and I am told that I will be seen very soon. Before actually going ahead with the laparoscopy my husband and I have arranged an appointment to meet the senior gynecologist at the hospital to discuss things a bit more fully.
I am apprehensive and extremely anxious about what will be involved and I am concerned as to whether I will be putting myself through something which is not absolutely necessary. My GP, for example, is all for me having the laparoscopy and doesn't seem so interested in my husband's lower than normal sperm count.
Is laparoscopy the best method of checking tubal patency? I have read briefly about hysterosalpingogram, involving dye and x-rays, and gas insufflation. Would ultrasound show anything? Would any of these methods be safer or preferable for any other reason? I am particularly concerned about any risk of damage to my fallopian tubes or ovaries by the tests themselves, through, say, infection, and also risks from general anesthesia.
Finally, can anyone suggest anything that could be done in the meantime to try to raise my husband's sperm count? M M, Western Isles......
A:Most doctors helping a couple investigate infertility are quick to rush into piecemeal investigations, without a systematic overview to determine where the problem lies. Mystifyingly, they also tend to automatically look to the woman as the source of the couple's infertility, even when a man demonstrates a low sperm count.
Because conventional medicine has so little understanding of the cause of infertility, they tend to hand out fertility drugs indiscriminately, at the couple's first sign of problem in conceiving, or subject the couple to a barrage of risky tests.
This has important repercussions, since fertility drugs taken over a year have been associated with an increased risk of ovarian cancer.
Most doctors aren't aware of the scientific evidence demonstrating the role that deficiencies of a variety of nutrients play in a couple's ability to conceive. Three researchers at Biolab, John McLaren Howard, et al, found a correlation between low red cell magnesium and selenium and a history of unexplained infertility or early miscarriage. In their study (Magnesium Research, 1994, 7; 1: 49-57) McLaren Howard demonstrates that a deficiency of magnesium has been scientifically associated with infertility , an increased miscarriage rate and increased incidence of premature or small babies. We know that magnesium deficiency causes increases in smooth muscle reactivity, which can influence the patency (openness) of the fallopian tubes. Magnesium also has a role in regulating the various hormones responsible for ovulation and the preparation of the endometrium for egg implantation.