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Unable to conceive? Trying to have sex for a year before seeking help

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“When I failed to conceive on the first, second, third and even fourth month, I got anxious and I began to believe that there was a problem with me,” Lucy recounts.

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Nine months into the marriage, Lucy missed her periods. It was an exciting time for all of us. During her wedding, a hater in the name of her auntie had expressed doubts over her ability to conceive.

Coming from a village where girls rarely sought higher education, her undoing was that she had been in school for too long. All her age mates were already married and had children.

“She has swallowed all the pills and done all the abortions”, her auntie said sarcastically, “her womb is rotten.”

You see, several girls get pregnant and fall out of school so often that this has become the norm in some communities.

Others conceive while in college and by the time they finish their courses, they have a certificate and a baby.

Lucy, on the other hand, committed to finishing college, getting a job and only marrying thereafter. She believed that the baby should follow after the wedding.

She made a personal choice to follow this tortuous road. She finished her course at the university and started the difficult road of job-searching.

She got a job two years later after a series of attachments and volunteer work in a number of organisations.

It was only after that that she accepted to settle down. She had dated Erick for over seven years and made him understand her desire to live a systematic life. Erick let her have her way and, in fact, supported her through the journey. By the time the wedding came, she was 29.

“I know what your auntie and others of her kind have said but I love you for the kind of person you are – decisive and forward-looking,” Erick reassured her.

But as it happens, when you are described by people in a certain way, over time it sticks in the heart and the mind and you begin to believe them. You begin to question yourself and it falsely occurs to you that the majority cannot be wrong.

“When I failed to conceive on the first, second, third and even fourth month, I got anxious and I began to believe that there was a problem with me,” Lucy recounts, “If anything almost all of my peers had children.”

It is in the fourth month that Lucy therefore decided to seek medical help.

In taking her medical history, I found no health problems that could have caused infertility. I examined her and found all her body systems to be normal. I concluded that she was healthy and advised her to have sex two to three times a week and wait for eight more months for conception.

Conventionally, the definition of infertility is failure to conceive within twelve months despite having unprotected sex two to three times a week.

Two months after reviewing Lucy, I got a call from a doctor's colleague. Lucy was in his office seeking infertility treatment.

“She is anxious and is requesting for fertility pills,” the doctor said. “She is threatening that if we cannot help her situation, she will fly to another country for help.”

We decided to refer Lucy to a counsellor. The delay in conceiving was really getting on her nerves.

She spent most of her seventh month in marriage undergoing counselling.

“My once jolly wife is no longer happy,” Erick reported in one of the phone calls. “She is missing meals and her weight has gone down. She breaks down and cries easily at anything.”

Lucy dragged through the eighth month. I began to wonder whether she had a point.

Was one year actually not too long to wait for a pregnancy? I wondered whether we needed to break the rules of medicine and just diagnose her with infertility. I was crossing my fingers by the day, hoping to hear a different story from her. I was becoming part of Lucy’s anxiety and feeling pressured to do something.

“I will not break the rules, I will stick to the guidelines, yes, it will be fine,” I found myself mumbling as I walked to the office one morning, not sure that I believed my own words.

It was the beginning of Lucy’s ninth month in marriage and the pressure was building from all over the place. I started to imagine that the 12 months would soon be over and Lucy would remind me that she knew better and we failed to listen to her.

And so, it was a great relief when the pregnancy test turned positive on that Monday morning.

“So you have proved that science is right and we should follow it,” Lucy reminded me. “It happened within the 12-month window!”

“Even if you are busy, we must just have lunch today,” Erick added. “We can carry it to your office if that is what works for you.”

As we enjoyed the three-course lunch together, I remembered the words of my professor in medical school: that as much as one act of sex can lead to pregnancy, as many acts of sex can fail to cause pregnancy for a whole year, and that pregnancy happens when it happens and when it is least expected and unplanned.

In fact, said the professor, many of us came as accidents.