Woman With Chronic BV Asks: "Will Simply Taking Birth Control Pills, Then Going Off, Cure My Infertility?"

Question:

Hello. My partner and I have been together for 3 years and have not been able to conceive. He has a daughter from another relationship. We are pretty sure I'm the problem. I was told by a gyno that with some people to treat infertility they are put on the pill and taken off and then they see if they can get pregnant. Is this true? If so how long should I go on the pill. Also I have chronic bv (bacterial vaginosis) could this contribute to infertility?

I was on birth control 5 years ago... I've taken the pill patch and nuva ring. Since I got off we haven't used protection ever and have never gotten pregnant. I have pretty regular periods. They are off no more then 3 days at the most.

Thank you! R. from the U.S.

Answer:

Hello R. from the U.S.,

The answer to your first question is absolutely NO. That is a wives tale propagated by Gynecologists that don't know better.

Regarding the BV: Chronic vaginal infections can certainly kill the sperm, thereby preventing pregnancy. When you have Bacterial Vaginosis, there are changes to the acid environment of your vagina. Many factors can contribute to BV including: use of highly scented soaps, douches and bubble baths; use of an IUD or the coil; or because of certain types of sexual acts. It can also happen when the pH level of the vagina alters during the menstrual cycle. But it can also happen without any of these factors in place. It is, after all, the most common form of odorless bacterial discharge.

Bacterial Vaginosis is easily treated with antibiotics, like metronidazole or clindamycin. Women who are trying to become pregnant should be treated with an oral antibiotic. In fact, the Center for Disease Control recommends that all women receive some form of treatment for the condition because there is some evidence that chronic bacterial vaginosis could lead to pelvic inflammatory disease. With chronic, unresolved BV, the solution would be to do intrauterine insemination (IUI), to bypass the bacteria.

My recommendation is to see a fertility specialist. You are at the point where you need to undergo an infertility evaluation and your Gyno is not going to be able to help. Since your partner has had children before, you could assume that he is fertile, but you never know. Things change with time. Also, you don't seem to have any obvious reason, other than the BV, as to why you are not getting pregnant so the only way to find out what the problem is, is to have an evaluation. Once this is done and the problem(s) found, an appropriate treatment can be provided for you to achieve pregnancy.

Good Luck,

Edward J. Ramirez, M.D., FACOG

Executive Medical Director

The Fertility and Gynecology Center

Monterey Bay IVF Program

http://www.montereybayivf.com/

Monterey, California, U.S.A.

Permanent infertility from past infections?

Question:
I am 35 years old and have never achieved a pregnancy. In the past I have been diagnosed with chronic BV, trichomonas, HPV, PID, and endometriosis. I recently read that all of these conditions could be symptomatic of a unicellular microorganism called microplasma genitalium. What information do you know of this organism? I have been successfully treated for each of these infections. Is there a specific fertility treatment that I should try with these past issues? Is my infertility permanent? I have been symptom free since my divorce 3 years ago.

Answer:
Hello Lynn from the U.S.,

The main problem with this variety of infections, is that some of them could have led to tubal damage. That is, the bacteria ascend into the tubes leading to inflammation and scarring. Once the tubes are damaged, they do not function and so natural pregnancy cannot occur. The way that we currently check for this is using a test called the HSG (hysterosalpingogram) to see if the tubes are open. This still is not specific enough but if there is severe damage to the tubes, it will return showing the blockage. If one tube is blocked, you can assume that the other is damaged as well, although it may not be blocked. If the tubes are blocked there is no other alternative other than IVF for treatment of the infertility. IVF works by bypassing the tubes by extracting the eggs directly from the ovaries.

Endometriosis can also be a cause for infertility. Endometriosis is a pelvic disease that causes the pelvis to be inflamed. It is thought that this inflammation attacks and kills the egg at the time of ovulation. In addition, it can cause scar tissue formation in the pelvis that will prevent the egg from getting to the tube. Again, in cases of severe endometriosis, IVF is the treatment of choice.

At 35 years old, your age is now going to be a factor A woman's fertility decreases significantly after the age of 35. Therefore, if you are contemplating getting pregnant or having children, you might want to start aggressively trying with IVF. If you have never undergone an infertility evaluation, then you should start there. IVF may not be your only option.

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
http://www.blogger.com/www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com/ check me out on facebook and twitter with me at @montereybayivf