Infertility/Fertility/who is infertile?


Dear Sir,
I am very much impressed about your knowledge in this field.

My name is Dr.Fasih ullah 27 years old male,recently graduated from medical school. Married for last two and half months.

During first days of marriage I had problem with erection possibly ED. I used medicine Hormotex (just two tablets) and Tab tribestine.

I've stopped using these medicines, and now I get good erection and also able to discharge successfully inside my wife's vagina.

But the problem is that she didn't get pregnant yet.

From first week of marriage, my wife felt some heaviness, along with moderate bulge right below her umbilicus and low back pain. She told me she lifted some heavy stuff that could be reason. As he menses approached, her problem finished.

I want to know what may be the reason of her problem and who is responsible for infertility?

with thanks,

Hello Dr. Fasih,

Of course, I cannot tell you the cause of her back problem without doing a thorough examination and evaluation.  I would recommend that she see her doctor if this persists.

In terms of fertility, you would not be considered to have an infertility problem at this point.  Infertility is defined by the inability to become pregnant after 12 months of trying.  This time limit is set because it takes the average woman under 30 years of age, 8-12 months to achieve pregnancy.  Why does it usually take so long?  That is because the reproductive process requires the accomplishment of 10 steps in a cascade process.  If one step does not work, then the rest of the steps don't occur.  Because this process is completely natural, and the body is not a perfect entity, these steps do not always proceed as they are supposed to.  So, it takes several tries.  My recommendation is to continue to try for pregnancy for 12 months and then if it does not occur, seek the counsel of an infertility specialist.  Also, in order to help with timing your intercourse, your wife should keep track of her cycles (when her period starts# and then average the number of day from one period to the next.  We call this the reproductive cycle.  Cycle day #1 is the first day of the period.  Once you have the average number of days, for example 28 day cycle, count back by 14 days which indicates the approximate day of ovulation.  I would then recommend that you have intercourse from two days prior to ovulation until two days after ovulation #total of five days).

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate  


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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