Several recent studies show that before you consult an infertility doctor to help you become pregnant, you should be given antibiotics to treat a possible hidden infection. Many other studies show that the most common cause of infertility is a uterine infection. Of women being evaluated for infertility, 40 percent are infected with chlamydia, mycoplasma or ureaplasma, as are 36 percent of those with a previous history of uterine infection and 50 percent of those with tubal blockage. More than 60 percent had evidence of a past infection.

The more partners you have, the more likely you are to be infected, although you can be infected by one contact. An infection can prevent pregnancy by blocking the uterine tubes. It can damage sperm, so they can't swim toward the egg, and it can cause miscarriage, premature birth or low birth weight. Infected people may have burning on urination, discomfort when the bladder is full or an urgency to void. Women may have only spotting between periods. Or there may be no symptoms at all.

Infection with chlamydia is the most common cause of blocked Fallopian tubes that cause infertility. First, chlamydia paralyzes the cilia so the egg

Men and women can be infected with mycoplasma or ureaplasma, even though all available tests can't find them and they may have no symptoms. Before infertile couples spend between $10,000 and $150,000 for infertility evaluations and treatments, they should ask their gynecologist to treat them with newer erythomycins, Zithromax (250 mg once a day for 8 days) or Biaxin (500 mg BID for 10 days), for chlamydia and mycoplasma infections.

EVALUATION OF INFERTILITY: Blood tests: Female: FSH (menopause), TSH (thyroid disease), Prolactin (brain tumor), Progesterone (7 days after expected ovulation, around 21 days after start of menstruation), HSG (to check if uterine tubes are open). If masculinization: testosterone, DHEAS, 17-oh progesterone, sonogram of ovaries. Male: semen analysis.

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in four specialties, including sports medicine. Read or listen to hundreds of his fitness and health reports at http://www.DrMirkin.com

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Journal references on infertility: http://www.drmirkin.com/women/W128.htm

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