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Dear Doc | Why can't I get pregnant?

Published:Monday | November 20, 2017 | 12:00 AM

Q: Doc I am 28 years old and I have been married for five years. My concern is I don't know why it's so hard for me to conceive. I was taking Provera provided by my doctor, and I have PCOS and weigh about 360 or more pounds.

I want a child really bad, and this is very frustrating. I spent thousand of dollars and nothing is happening. I need a child before I reach 30. My husband has a daughter. He did his check-up, but he is a little short in sperm count. He is working on that. Help!

A:All the factors you have outlined above are affecting your ability to conceive. What can you do? Work with your health care providers to address these issues.

Lifestyle changes which lead to weight loss and maintaining an ideal body weight can be difficult for some people, but is an important factor in improvement fertility in women with polycystic ovarian syndrome (PCOS). Engaging the support of your partner for regular exercise and employing the services of a nutritionist at least on a one-time basis may be of benefit.

The factors you described do not resolve overnight and will require repeated investigation, long-term treatment, compliance with treatment, and regular follow-up for you and your husband.

There are many gynaecologists and urologists local, who specialise in fertility problems and are able to address the above factors. Overseas, there is a barrage of clinics to choose from, so getting a second, third or even more opinions/approaches may lead to a positive outcome.


Did something go wrong during C-section?


Q: Dear Doc, I am a young woman who recently gave birth via C-section. Ever since, I have been having recurring bouts of bacterial vaginosis.

I have been going to the doctor, and after being treated, it comes back in three to four weeks' time. I exercise proper hygiene, I try to eat healthy, and I am not diabetic. What could be the cause of this? Could it be a sign of cancer? Is it possible that something went wrong during the surgery? Please enlighten me.

A: Bacterial vaginosis is a common condition in women around the world. Treatment of recurrent infection can be challenging, as multiple organisms can be involved, and their interaction is complex.

Preserving the vaginal acidity plays an important role in the prevention and treatment of this condition, so avoiding vaginal douching is advised. Limiting your number of sexual partners is also protective.

Testing a sample of vaginal/cervical secretions can identify which organisms are responsible. A number of these organisms may be resistant to the medication you have received. Failure to follow the guidelines for using prescribed medication contributes to this microbial resistance as many women discontinue the treatment as soon as they get relief. Resuming sexual activity (especially without condoms) during the course of treatment can also have a negative effect on the outcome. Perhaps a change of medication/combination of different classes of medication and/or extended treatment is indicated. Seek the help of a gynaecologist to determine which factors are at play in your situation.

There is presently no correlation between having a Caesarean section, and the development of bacterial vaginosis. There is also no conclusive evidence that bacterial vaginosis is a sign or cause of cancer.

Q: Dear Doc, I am a 32-year-old female. I have kidney stones and Iam taking medication to relax my bladder. I saw on the Internet that apple cider vinegar can dissolve the stones, so I bought it and started taking it and felt the stones moving. I want to know if the apple cider vinegar will affect the medication I'm on and if it's safe.

A: Recently, apple cider vinegar has been touted as a 'natural remedy' for many health problems. The research in this area is very limited, and so far there is no scientific evidence that it dissolves kidney stones. There is no known interaction with bladder relaxants, but it has been shown to have an effect on certain medication used for heart problems and diabetes mellitus.

The main ingredient is acetic acid, which in large doses can damage the teeth, stomach lining, and lower your blood potassium which can cause heart palpitations and other serious consequences.

The common practice of taking one to two teaspoons of apple cider vinegar in a glass of water once or twice daily has not been shown to be harmful. In fact, the increased volume of water being consumed may be the agent responsible for 'moving' the kidney stones. One should always err on the side of caution by consulting a health professional before taking any supplement or natural remedy, especially if one has a medical condition and/or taking medication.


Did I get HIV from oral sex?


Q: Good afternoon doc, I am so worried. I'm a 24-year-old virgin, but I've been a little rude when it comes to receiving oral sex. Recently, I realised that my vagina was itching a little before and after my period, so I went for a check-up. The doctor said it was yeast and gave me some medication, which really helped.

But about three years ago, I've noticed two wart-like things growing on my vagina and near my anus, and over time, they have got bigger (and itch when moist) so I told the doctor. He gave me a paper to take to a lab for testing of HIV and I think HPV. Does this mean that oral sex has given me one of the above, especially HIV? What is it that you suggest that I do? Looking forward to hearing from you.

A: High levels of the hormones progesterone before the period and oestrogen after, causes change in vaginal micro-organisms which lead to a decrease in vaginal acidity, causing the yeast that live on the vaginal walls to overgrow. This may produce symptoms such as itching/white vaginal discharge to a varying degree of severity, so the condition has a tendency to recur.

Generally, oral sex has a lower risk of transmission of HIV, however, the risk increases with multiple exposure, recent dental work, wounds in the mouth/vaginal mucosa. Viral particles have been detected in the saliva of some HIV-positive persons, but in low concentrations. There has not been a documented case of anyone contracting HIV from contact with saliva alone. However, many sexual encounters can result in minor bruises/abrasions to mucous membranes. This broken skin significantly increases the risk of contracting/transmitting HIV, so safe sex practices is advised.

HPV, along with herpes, syphilis, gonorrhoea and chlamydia, can be transmitted via oral sex.

Please follow your doctor's advice.