Tuesday, August 10, 2010

Couple TTC, Husband With Diabetes & 42 Yr Old Wife on Fertomid (Clomid): What Can Be Done?


Hello. My husband and I have been trying to conceive for over one year. I am 42 yrs old and have one ovary. I have regular menstrual cycles but when the ovulation test was done there was no ovulation. I have started to take Fertomid for the first time. The first treatment was a month ago. Also my husband is diabetic, type 2. Can this affect his fertility? He is age 36.

I appreciate any advice you can give. B. from Ohio


Dear B. from Ohio,

Yes, diabetes can affect male fertility. Diabetes affects the blood vessels in our body and causes the vessels to shrink, thereby limiting blood flow. This is the reason that diabetics end up getting leg ulcers and require amputation. In the genital region, it can reduce blood flow to the testicles and reduce sperm production. To check your husband's fertility, all he would need at this point would be a semen analysis. It is a simple test and will answer the question of whether or not his diabetes is affecting his fertility.

Your one ovary is not an issue, the bigger issue, which you mentioned in passing, is your age factor. Your chances of natural pregnancy at 42 years old is only 1% per year. That is probably the major factor in your failure to conceive. Fertomid is NOT an appropriate treatment for you (Fertomid is the generic form of Clomid).

You need to go to the advanced treatment level called IVF (in vitro fertilization) if you truly want to have the opportunity to get pregnant. Anything less than that is a waste of precious time, such that even at 43, IVF could still be an option without donor eggs. I would strongly recommend that you go see a Fertility specialist that provides IVF as soon as possible. Your age combined with your husband's possible male factor problem would indicate that this might be the best option for you both at this time. I see way too many patients like you, after the age of 40, that have wasted years doing simple treatments with their Ob/Gyn docs. Then, when they come to see me, it is too late and I have limited resources to offer them. Most leave very disappointed. Don't let this happen to you!

Good Luck,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.

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