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Understanding reproductive Endocrinology and Infertility
It takes about 2 years for a normal cou¬ple who is cohabiting regularly to have a pregnancy. However, in this jet age, where immediate gratifications are the or¬der of the day, couples want to have a baby within 2-3 months of planning it! When they seek medical help, they are looking for a quick fix! With late marriages being in fashion, this is but a natural expecta¬tion.

It is helpful if couples are aware that starting about 12-19 days before the next expected period, is the time of maximum fertility, for about a week. This is the time when regular daily or alternate day sexual intercourse can result in a pregnancy. In many circumstances, couples are doing it all at the wrong times, fertility wise. Tim¬ing the intercourse correctly is the first step towards managing infertility.

There are many causes, which may result in difficulty in conceiving. Diseases in the uterus like polyps, submucous fibroids or adenomyomas, adhesions, synechiae and tuberculosis can result in inability of the uterus to receive or hold a baby. Hor¬monal problems can prevent ovulation or eggs from being released. Cysts in the ova¬ries, dermoid, tumors, endometriosis and endometriomas in the ovaries are other causes that may compromise conception.

Tubal blocks from previous infections or surgeries can prevent the sperms from fertilizing or mating with the released ovum (egg) from the ovary. Other general medical problems with thyroid disorders, asthenias & other chronic medical disor¬ders, excessive stress, smoking may be the causes detected for infertility in a few women.

Simple measures from changing to a healthy life style, trying to conceive before the age of 35 or preferably 30, regular sex during the fertile period can solve this is¬sue in many couples. If despite this, preg¬nancy is not happening, a couple should seek help from a specialist and get inves¬tigated. It is my personal opinion that all causes should be looked for simultane¬ously without wasting time by getting all the tests done together instead of only a handful of staged investigations.

Prescrib¬ing treatment that fails just after doing a few tests and thereafter unearthing a pre-existing cause that has been missed from lack of initial adequate investiga¬tions, wastes a lot of time and causes a lot of heartache. In very young couples, with the female partner being less than 25-26, staging investigations over a prolonged period may be acceptable but not in older women. Male partners