Dear Dr Mitchell,
I am a 25 year old woman and I have been diagnosed with PID. I went for a scan about a year and a half ago and I was told one of my tubes was blocked. But the doctor made me think that it was no big deal and I would have no trouble getting pregnant. But it's been a year and half now. I keep turning down my fiancé's marriage proposal because I am afraid I might not be able to give him kids when we marry.
Pelvic Inflammatory Disease (PID) is caused by infection that is sexually transmitted. The common organisms are gonorrhoea and chlamydia. This means that you contracted this infection from one of your sexual partners. This is what has caused the damage to your fallopian tubes. The x-ray showed that one of your tubes was blocked but the other might not be blocked but still damaged and hence has resulted in your inability to become pregnant. Infection can cause scarring around the tubes, making the fallopian tubes useless in picking up the egg once ovulation occurs and so conception does not take place.
In order for you to become pregnant it is important that you ovulate (release an egg) every month. Some women have a period every month but do not ovulate. It is important for you to do a blood test to check the progesterone level 21 days from the start of the menstrual period. This will determine whether you ovulate or not.
In order for you to conceive, your partner needs to have a normal semenanalysis. The total number and movement of the sperms are two important factors that need to be assessed. Your inability to conceive may be totally due to the fact that your partner is infertile. Some men have no sperms at all. It is important for both of you to be thoroughly evaluated.
Now you should also be concerned because you are only 25 years old with PID and this suggests that you are putting yourself at risk for other major sexually transmitted diseases such as human immunodeficiency virus (HIV). This means that your partner has been unfaithful and so you need to have a serious talk with him and decide on the way forward. It is important for you to practice safe sexual activity and use a condom to prevent sexually transmitted infections and also your future fertility. It is unfortunate that you should have to prove your fertility before feeling secure about accepting a marriage proposal. This is not the essence of marriage. You should both go for some serious counselling before undertaking such a serious lifetime commitment.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@ jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025.