By AJ MORGAN,
Contributor
Dear Readers,
K.O. from Clarendon has blocked tubes. This has been confirmed by X-ray investigation. Her gynaecologist has advised further investigations such as a laparoscopic examination to assess the extent of tubal damage. She visited her personal doctor for a second opinion. He did not agree that she needed this expensive second investigation because results of the Hysterosalpingogram (H.S.G.) X-ray indicated that she needs to "clear her tubes". K.O. also writes that her blocked tubes had been caused by the use of the birth control pill. Her boyfriend is tired of spending money on infertility investigations without seeing any results.
The reality is, of course, that the investigation of infertility is a long, tedious and expensive procedure, the cost of which is often not covered, in Jamaica, by health insurance.
The H.S.G. test has confirmed that K.O.'s tubes are blocked. Determining the cause of infertility is the first step towards treatment and is a most necessary step for which her boyfriend has had to pay. This is an important result. It is hard to cure a condition without proper knowledge of the cause.
The H.S.G. test does not, however, indicate the severity of the condition. LAPAR-OSCOPY permits the doctor to view the severity of the tubes with his own eyes and allows him to assess more accurately the extent of the damage to the organ. There are also some minor operative procedures which help to correct disorders of the reproductive organs which can be performed at the time of the laparoscopic examination. It is an extremely useful procedure without which the doctor's treatment is more likely to be based on his experience of the disorder over the years rather than the "specifics" of the patient's own condition. This can ultimately be a more expensive way - "Penny wise and pound foolish"!
If the lady's tubes are seriously scarred by recurring bouts of Pelvic Inflammatory Disease (P.I.D.) then no minor procedure exists which will miraculously clear these tubes. Often a very technical operation of "splicing the tubes" involving microscopic surgery is necessary. This surgery is quite expensive for the average Jamaican woman to afford but often, it depends on one's priorities. Some couples do save over time and schedule the procedure down the line. Certainly, this surgery is still significantly less expensive than "In Vitro Fertilisation", (the test tube baby), a procedure which is available at the University Hospital in Kingston. The real costs are not just financial. The emotional costs are significant as couples are often "desperate" to have a child and despite the financial burden, none of these methods guarantee a successful pregnancy.
K.O. has the false belief that her blocked tubes were caused because she used the oral contraceptive pill (O.C.P.) for a time. Several women believe this misinformation. Blocked tubes most often are the result of recurring bouts of P.I.D, that is, recurring episodes of infection with sexually transmitted organisms such as Gonorrhoea and chlamydia which ultimately destroy the females tubes. Endometriosis is another cause of tubal occlusion. The oral contraceptive pill (O.C.P.) does, in fact, give some slight but measurable protection against womb infection with serious organisms. The progestogen component of the O.C.P. can facilitate the development of yeast infection when the yeast is already present in the female vagina. This is however not serious. Yeast NEVER causes womb infections or blocked tubes. It is therefore a total MYTH that the O.C.P. or "pill" can block a females tubes.
The physical causes of infertility can lead to pain and suffering in the involved female but of even greater significance is the emotional "test" to the couple involved. The investigation and treatment process requires several months and the financial outlay is significant. Often there are no short-cuts.
A.J.M.
