Dear Doctor,
I am a regular reader of your column "You and Your Health" in The Sun newspaper on Tuesdays. Please I would like you to use your wealth of experience to help me find a solution to my problems which are as follows: I’m presently 23 yrs old and have been trying to get pregnant since 2008 but could not. I have sex regularly with my fiancé but have never missed my period. I notice that after having sexual intercourse, immediately I get up the sperm ( semen) released will start coming out of my vagina. Doctor what could be responsible for this? Or is my fallopian tube blocked or what? Secondly, I have been having discharge (yellowish) with severe itching in my vagina for a very long time. At first I felt shy to discuss it but when the pain became unbearable last year I consulted a doctor who asked me to go for a test. On seeing the result he gave me an injection and placed my partner and I on Nizoral tablets for 5 days. The itching and discharge still continued despite the fact that I took all the drugs and changed my towels, undies, sponge and all others. I later had typhoid and while on admission the doctor told me he carried out some tests which indicated I have this infection. He then gave me Ciprovet tablets and some other drugs. Doctor this itching still comes and goes and I’m just confused as the discharge seems to be permanent. Also I menstruate for just two days and the flow is not always heavy. Could all this be responsible for my not being able to get pregnant? Doctor please try and bail me out. Lastly, my fiancé was advised to go for semen analysis by my doctor and the result is as follows: Colour: milky straw. Ph: alkaline. Volume: 3.0 ml. Viscosity: viscid. Mobility and morphology grading: Azoospermia. Non spermatid cells: no ova, crystals, yeast cells or T. vaginalis seen. Doctor, what does this result indicate or is he the one having problem? What can we do to have a child of our own ? I'm anxiously waiting for your reply.
Lolli Babe, Kogi P S-- Further test results follow: Pus cells: Numerous Rbcs : 0-1 PHF. Epith cells: Fair.
Thank You.
My dear Lolli Babe,
If you understood the meaning of the word azoospermia you would not need to ask whether your man was the cause of your woes or not. Why the lab scientist decided to use that word instead of plain language I cannot understand. Azoospermia simply means "no sperm cells in the semen"; pure and simple. Now, with no sperm cells at all in your man’s semen, how in the world can he ever get you pregnant? It is impossible unless his azoospermia is cured. If azoospermia or oligospermia occurs because of infection or blocked tubes in the man (the vas deferens is the tube or conduit pipe that brings the sperm cells from the sperm making factory called the testes or the balls, to the prostate (an organ found only in males which adds fluid to the sperm cells to make up the semen – and this tube can be blocked by gonorrhea or Chlamydia--STD's) it is possible to correct or treat the condition using antibiotics for infection and surgery for the blockage. Azoospermia can be due, apart from the 2 causes above, to hormonal imbalance when the hormone FSH ( Follicle Stimulating Hormone) is found to be too high because the testes are not functioning or producing sperm cells at all. Atimes this can be helped but in primary testicular failure there used to be no way to help the man until recently when ICSI ( intra cytoplasmic sperm injection ) was developed and holds an amount of hope for these men. Apart from ICSI, of course, the options still available are adoption or AID (Artificial Insemination by Donor) where the woman is impregnated by using sperm cells harvested from donors. ICSI, of course, is really very high tech, costly and hifalutin – hardly practical, although some centres offer it in Nigeria now. It is the only way in which such a man whose azoospermia is not due to blockade or infection and who cannot be stimulated to produce sperm cells of his own can get to father a child of his own. Barring ICSI, HE’LL HAVE TO BE FATHER TO SOMEONE ELSE’S CHILD EITHER BY OUTRIGHT ADOPTION OR AID. That's just it.
As for your intractable on and off itching the enclosed literature will help with it. It can be expertly treated so that it does not occur again. Titled "When Itching Refuses to Stop", we wrote it to give helpful medical information to
those suffering chronic itching of their private parts or genitals and will be sent on request to any sufferer. Suffice it to say that it is usually a yeast(or fungal ) infection --Candida --to be precise. Your permanent discharge (yellowish) needs to be properly diagnosed and treated. It could be candidiasis, trichomoniasis, bacterial vaginosis or it could be PID ( pelvic inflammatory disease). This latter cause can block your tubes and encourage infertility. Again expert treatment is what you need and I am also worried about your 2 day menses. Has it always been 2 days? If the 2 day pattern just started recently, it needs proper investigation and diagnosis as, in that case, it is very likely contributory to your inability to get pregnant. Infertility is traceable to male causes in roughly one third of cases; female causes in another third and a combination of both male and female causes in a last third. Azoospermia is a male cause. PID is female cause. You are right to be concerned that you have not gotten pregnant in 5 years of unprotected sex. Apart from purely medical or psychologic problems that could contribute to be blocking fertility, one of the areas we have learnt to take time to probe properly in cases like yours is the spiritual-- if we are to get results. Why, for example would semen, newly released and properly deposited deep in the vagina begin to climb out of the vaginal vault to the outside-- defying all the laws of gravity and fluid mechanics like you state has been happening in your case? I've never heard any doctor explain this phenomenon satisfactorily on the basis of the purely physical. However you can try to put a pillow under your buttocks so that the angle would be sharper and the semen can be retained better while you make sure you do not leave the bed until at least an hour after sex. However some couples will swear that this measure still regularly fails to keep the semen from climbing out!! Now, with no sperm cells at all and no semen left in the vagina and almost no menses, my advice is to see some experienced doctor/ gynaecologist who also understands the spiritual to check and sort you out while you yourself should consciously tackle that area pointedly. We'd be glad to help you with our experience if you send feedback.
Cheers
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