Q: I am 36 years old and my wife is 30. We were married 10 years ago and had our first child 2 years later. The delivery was normal (by operation) and our daughter is a perfectly healthy 8 years old child. Now we want a second child and we have been trying for over a year now. While on posting to Saudi Arabia during my assignment, I had consulted a Gynaecologist, who did all the tests including the torch test for my wife to see if there was any blockage in the fallopian tube and the semen analysis for me. The doctor diagnosed that all the tests were normal. In the circumstances, what could be the reason of my wife not being able to conceive? Please advise.

A:What form of contraception have you been using? Patency of the tube had been tested by HSG or did she undergo a diagnostic laparoscopy test. If the tubes are open and the eggs are being released by the ovary monthly and your semen analysis is normal, cervical factor needs to be ruled out. How is the cycle pattern of your wife? If she has undergone a laparoscopy and everything is normal, controlled ovulation induction should be done with intrauterine insemination to bypass a cervical factor.