Dear Dr Rainford,

If I had chlamydia for more than six months, is there a chance that I could be infertile? If that's possible, where must I go to check if I can get pregnant.

Dear Reader,

Chlamydia is a bacteria and it is the most common bacterial cause of sexually transmitted infections worldwide. It can cause pelvic inflammatory disease or PID. This infection can lead to damage of the fallopian tubes and causes infertility in some women.

That being said, only a fraction of women with chlamydia will get PID and only some of these women will have tubal damage. Therefore, although the infection could affect your ability to get pregnant, it is still very likely that it did not.

Infertility

While there is no one test that will determine with certainty that you can get pregnant, a hystersalpingogram or HSG is a test that can check whether your tubes are blocked. You might be infertile if you and your partner are unable to achieve a pregnancy after one year of unprotected sex. Many couples with infertility are still able to achieve pregnancy with the appropriate help. You should visit a gynaecologist to check on your concerns.

Dear Dr Rainford,

I am 28 years old, happily married but I have a problem. I always read your column and I even had a visit to you about my irregular cycle. It seems like it has started again and maybe it's because of my weight. In December, I checked my weight and it was 185 pounds. In January, my period came for two weeks.

Right now, I am a little confused about my body. I was going to the doctor to see if I can get pregnant. She had put me on fertility pills three times and then I would go to the laboratory and take a blood test and the result was that I wasn't producing any progesterone. I got fed up and stopped going because the doctors told me that if that didn't work they would have to do something else.

I am really depressed about this matter and would feel much better with some good news. I am not infected with any disease. My womb is okay although I had a surgery when I was about four months.

Dear Reader,

Thank you for reading. It is true that obesity can lead both to irregular periods and difficulty getting pregnant. However, I am unable to comment on how much of a factor weight actually is in your case. A number called a body mass index (BMI), which is calculated by dividing a person's weight in kilograms by their height in metres squared is helpful in determining whether someone has a healthy weight. If your BMI is 30 or over, you are obese.

It appears from your letter that you are not ovulating (making an egg monthly) and this is a common cause of infertility. This problem is also associated with irregular and prolonged periods. A fertility pill called clomiphene citrate (which your doctor might have prescribed) can help some women to ovulate. However, sometimes the dose has to be adjusted a few times before it is successful.

Progesterone level

Ovulation can be confirmed by testing progesterone level a week before a woman sees her period. Since you are not ovulating, your doctor may have tried to adjust your medication or might consider using an alternative or additional medication. This process sometimes takes several visits, so keep heart. It is still possible that the treatment will succeed.

You have mentioned that you had surgery on your tubes. If you have not already done so, I would recommend an hystersalpingogram or HSG to confirm if they are open and appear to be functioning.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.