How can infertility be treated?
Patient: Hallo dr I have been married for 8 months... My inlaws are very eager for me to conceive After marriage I had regular periods for 5 months After that i missed period for one month Since then i am having irregular bleeding For 15 to 16 days and then after a week or two again i am having bleeding I got an ultrasound done..and it says pco And horseshoe kidneys Actually after 3 months of my marriage i had taken duphaston for 3 months and clomid for five days My husband stays abroad So he was coming for 15 days I took clomid right after my periods stopped. then i wasnt feeling much well So after medical examination i came to know that i dint have proper intercourse Now i have stomach cramps and headaches all the time And my periods wont stop Its 17th day today I was undergoing unani treatment from a certain dr But it wasnt effective Then last week i met a gynacologist and shes giving me herbal treatment..still periods dint stop So she is suggesting me duoleton Which i am scared of taking after all this What should i do Please help Doctor: Hello,First of all, I would like to reassure you that you should not feel disheartened about it. It is important for you to understand that at the peak of her fertility, any healthy woman around thirty years of age has approximately 1 in 5 to 6 chance of becoming pregnant during the fertile period of her cycle. This chance may become less due to a number of factors - increasing age, timing, and frequency of intercourse etcetera. In your case, the fact that you are not staying with your husband regularly and he is based abroad reduces your chance of becoming pregnant. Besides your marriage is very recent. A guiding principle for starting to investigate for sub-fertility is when a woman has not conceived for twelve months of having regular sex with her partner. This criterion has not been met in your case. However, given your health concerns - diagnosis of horseshoe kidney and PCO, it is important to start an investigation and plan for the conception. Horseshoe kidney is a condition that is there from birth and can occur together with malformations and problems linked to the reproductive parts. It may be worth getting imaging done for the kidneys, ureters, bladders as well as for the uterus, tubes and varied. The blood tests for a renal function should be done and review of results with a Urologist or Gynaecologist may be useful. Please get your blood pressure checked as sometimes this can occur with this condition.PCO or polycystic ovaries is a condition that is common, occurring in one out of three women. Sometimes it resolves with correction of weight, lifestyle changes, Sometimes medications may be necessary. Giving combined pills for 3-6 months is sometimes offered to manage irregular periods if fertility is not much of a concern. Doulton is a contraceptive pill, so it might not be the preferred method in your case. Clomid and Duphaston might be a better alternative, however, the intercourse has to be properly consummated, timed to the fertile period of your cycle and occur every two days to maximize the chances of conception.I would like to emphasize that for any investigation and management to deal with conception and pregnancy, it is important to include and involve the partner as well.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sabina Hussain