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Question
hi,

My husband and I have been trying to get pregnant for almost two years now with no luck, we have tried almost everything and no luck, I have had a child but it was from a pervious relationship. I have no trouble getting pregnant with her, infact it was only weeks after trying I fell pregnant.

I have now been tracking my ovulation and having sex during that time but still have not been successfully.. With my husband, his sperm seems to stay very close to the surface and no matter how long i lay still or put my legs in the air it still comes out... even when i am laying still i can feel it close to surface..

Why is this happening and what can we do to increase our chances, We don't have private health care so we cant access fertility treatment without handing out a lot of money :(

Thank you heaps

Queensland, Australia

Answer
Hello Anne from Australia,

It sounds like you are trying all that you can to achieve a pregnancy naturally.  There is no more than I can advise.  At this point you should see an infertility specialist and have some testing done.  It is possible, and likely, that there is something obvious going on such as a sperm problem.  In the U.S. there is a home sperm test available to help you to do a screen, although it cannot be used as a definitive test.  You might want to see if it is available where you are and use it just as a screening test.  If it's obviously abnormal then you have your answer.  In terms of the sperm coming out, that is really the semen and not necessarily the sperm.  The sperm that enters the cervix enters it immediately upon ejaculation.  It does not matter how long you stay laying down or with your hips up.  The sperm in the vagina is of no consequence.  Also, the amount of SEMEN is what liquefies and leaks out, especially if your husband has a large amount of semen with ejaculation.

Good Luck,

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

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com 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

Expertise

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.

Experience

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.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

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

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

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