• Q. My husband and I are having trouble getting pregnant. It's been 14 months and we're going to go for some tests. What's in store for us? Any advice on how to improve our chances?

  A. Infertility is a question on many people's minds and the topic of many visits to the doctor.

  Infertility is defined as 1 year of unprotected sexual intercourse without resulting conception. It affects approximately 10-15% of all couples and is a source of much anxiety.

  If you're trying to get pregnant, there's a three step approach.

  First Step

• TRY- You might think this sounds silly, but you need to have sexual intercourse, with penetration, without the use of any contraceptive device. If you do this regularly for over a year without succes, then it's time to visit the doctor for further investigation.

• Reduce any factors that may be contributing- your family doc can help guide you with this one. Make sure no hazards at work are interfering with potential potency (ex. exposure to certain chemicals/toxins), men may need to wear less tight underwear (heat is a factor here), and any previous factors in both partners medical histories should be reviewed (any previous sexually transmitted diseases, any surgeries to the involved anatomy, etc.).

  Second Step- The Investigations

  The first test to be done is the easiest and involves the male partner. A simple SPERM ANALYSIS will help clarify any causes secondary to poor quality or quantity of sperm. The World Health Organization has published guidelines of a normal sperm analysis.

  The investigation of the male partner being finished, if no answers are apparent yet, the investigation of the female partner can begin. There are 3 tests used for this investigation.

  1. POST-COITAL TEST- as the name implies, this test is performed about 2- 8 hours after having intercourse, at the time of month when you expect to be ovulating. (There are a variety of ways to tell when this is, one of the most popular being basal body temperature readings.) The purpose of this test is to give information on the quality of the mucus at the woman's cervix (opening of the uterus/womb). It can also assess how the male's sperm is doing in getting through the mucus. It is painless, but sometimes awkward to coordinate the timing!

  2.HYSTEROSALPINGOGRAPHY- a fancy name for injecting dye into the woman's uterus and tubes and taking an X-ray to see where it goes. The purpose of this test is to look for any anatomical problems of the uterus/womb or any blocked tubes which may be causing the problem. This one needs to be done in the X-Ray department and can be uncomfortable to endure (cramping mostly).

  3. HYSTEROSCOPY- a look inside the uterus by the specialist. This is done in the operating room usually and requires some technical skill on the part of the doctor. The idea is to look for anything unusual in the uterus which may be causing the problem.

  Third Step- try not to try to hard

  There is no doubt that stress can interfere with fertility. Increased anxiety about the testing going on or deciding on the perfect time of the perfect day to have intercourse can actually be counterproductive at times. 30 % of infertile couples will conceive on their own, even if the doctor doesn't do anything but investigate.

  - Question on basal body temperature charts

  - Statistics on infertility.

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