Dear Doc,

How can I increase my chances of becoming pregnant? I am 44 years old going on to 45 by the end of the year. I have been having sex for 14 years without any form of protection and I cant get pregnant. I have been to two gynaecologists, done many tests like HSG, fertility pill and blood tests. My partner has done semen analysis, fertility pills without success. I have given up all hopes. I am too old, it seems. I am also disappointed with everything.

Discouraged.

Dear Discouraged,

I am truly sorry to learn about your unsuccessful attempts at trying to become pregnant. I notice that you are now approaching 45 years old. Unfortunately, fertility decreases significantly after the age of 40 years because of reduction in the frequency of ovulation and also, too, because the quality of a woman's eggs decline after this age. If conception occurs after 45 years there is also the increased chance of having a baby with a chromosomal abnormality such as Down's Syndrome. However, there are tests that can be done to detect Down's Syndrome during early pregnancy. I assume that all your tests done showed normal results including the semen analysis.

At age 45 years, there is still the chance that you can conceive normally but in your case it seems unlikely that this will happen. However, there is still hope. You may consider doing In Vitro Fertilization (IVF) which is available at the University Hospital. However, most IVF centres will probably encourage you to consider using donor eggs since the quality of your eggs at age 45 years is probably poor. This facility to use eggs from another individual is unfortunately not done in Jamaica at this time since our laws currently make no provision for this. This may be done in the USA, however.

It would still be wise to make contact with the IVF centre, operated by Professor Joseph Frederick at the University Hospital, and they will certainly advise you appropriately if attempts using your eggs are unsuccessful. It would also be a good idea to discuss the idea of adoption with your partner. This may prove quite satisfying and fulfill the need to become parents since it is possible to love an adopted child as much as you would love your own biological child.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send your health queries to Dr Mitchell at mclymonti@jamaicaobserver.com or Dear Dr Mitchell, c/o all woman, Jamaica Observer, 40-42 1/2 Beechwood Ave, Kgn 5.

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