The First Consultation on Sterility

“I have always wanted to be a mother, I waited until I had all I considered necessary to offer to my child. At the age of 33, with a lot of enthusiasm, a daily pill of folic acid and a calendar, I stopped using contraceptive methods, with the hope of becoming pregnant the same month. I have now been trying for more than one year without any success. How is it possible?”

Dr. López-Teijón

Look, Lourdes, after one year of trying only half of the couples your age will obtain a  pregnancy. After the second year, another 30%, while only a further one out of five will become pregnant after seeking medical help. I don’t know why you did not get pregnant, however we will now begin to investigate your sterility problem.

Lourdes

Sterility? (outraged and surprised)

Dr. López-Teijón

I know it is a shock to learn that trying one year without becoming pregnant is called sterility. It is a horrible word which can cause very negative feelings.

Lourdes

I have never thought this could happen to me, that you are saying that I am sterile… Moreover, in the last months I haven’t been well, every time I have the period I feel it like a failure, my world is sinking down.

Dr. López-Teijón

Lourdes, we will find the cause and its solution but today, besides prescribing some tests, I want to talk about how you feel and how all this can be a positive experience.

Lourdes

The experience hasn’t been good so far. My husband thinks some days I reject him while others I look for him, and never knows how to react. Of course, I am scheduling our sexual intercourse around ovulation. He says I no longer enjoy sex and he is partly right.

Dr. López-Teijón

It is very important not to neglect your relationship, you should continue as you always have. Nowadays it is known that some days of abstinence are not convenient to improve sperm quality; in fact it improves the amount of sperm ejaculated, but negatively affects other parameters, such as DNA fragmentation. The ideal thing would be to keep the same frequency as always, and make sure you have sexual intercourse on the 13th day of your cycle. Also, I would suggest that you spend no more than 15 minutes each day talking about it.

Lourdes

If I follow your recommendations I am sure he will be very happy; moreover you told me the only thing he has to do is a sperm analysis. On the other hand, I have to do hormonal tests, scans, checking my Fallopian tubes, and I don’t know what else.

One month later Lourdes comes back with Andrés, who is very anxious to know the results of his sperm analysis.

Dr. López-Teijón

The sperm test shows all is normal and the same for the fallopian tubes test. What is striking is that your ovarian age is greater than expected, as if you were 40 years old, which means your fertility is reduced.

Andrés

This means I am well and Lourdes can stop telling me not to drink, (not) to smoke, to stress me and all this.

Lourdes

Andrés, you make me feel guilty. It looks like I have only got the problem and you don’t have anything else to do. Congratulations, I am happy for you.

Andrés

Doctor, please tell her something, she keeps blaming me, and acting like she is the victim. It looks like she has become obsessed with pregnancy and that it is the only thing that matters.

Dr. López-Teijón

You should be more united and support each other now more than ever. Everyone will react his or her own way to this situation, depending to his or her own personality, the same as you would deal with every problem in your life. I would suggest you take it as a challenge, as a process that can bring you closer if you approach it with a healthy dose of irony, love and romanticism.

Now I will explain how we will do the In Vitro Fertilization, and how we will find your best oocytes.

Lourdes

We will do it because we don’t have a choice, but it seems all so unnatural. My sister has a 6 months old baby; it took two years for her to get pregnant and she recommends me to wait and see if I get pregnant without undergoing an IVF.

Dr. LT

You are right, but nature also expects us women to have our children before we are 30 years old, and with men who have an excellent semen.

It is very important for you to know that during the time we look for a pregnancy until we actually get there, our relationship with our loved ones can change. Your sister loves you but she doesn’t know how her comments can hurt you.

Lourdes

My mother is constantly telling us “all you think of is traveling and going out with your friends” and it really hurts me. Now I told my parents and my sisters and they give me advice all the time.

Dr. López-Teijón

It is a good thing people around you know it, but the best would be to ask them to be silent. Do not allow them to talk about anything related to fertility treatments or telling you what you should and should not do.

Also you should avoid going out with friends with kids or who are pregnant. It is normal that you felt uncomfortable when your sister was pregnant, surely all she talked about was this, and now she is only talking about her baby.

This will also happen to you, however for the moment it will be better not to spend time with friends with kids, or who are pregnant.

Lourdes

What else can I do to not keep thinking about this day in and day out?

Dr. López-Teijón

I think you should concentrate on keeping busy, with your work, your personal interests, etc, filling up you free time. And then spend five minutes of every day thinking about this, your objective, and on how you will feel when you have your baby in your arms, please, think only of this.

This conversation repeats itself during the consultation. A sterility diagnosis is followed by feelings of suffering, negativity, anger, fear to have high hopes, fear of not achieving what you desire, and anxiety. But, with current scientific advances, 95% of women who undertake fertility treatments get pregnant, and so, it is good to know, accept these emotions and know that they are only temporary, that your most intimate, deep and beautiful wish, is about to be fulfilled.

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