What causes difficulty in conceiving a baby?
Patient: Hi, my wife is unable to conceive. She was having hypothyroidism and PCOS in right ovary and her periods are also irregular (period cycle is after 2 - 3 months and will last for at least 6 days with heavy bleeding. As consulted by a gyne, she has taken 4 cycles of Herface (contraceptive pills) and she is taking Thyroxin (50mg) for hypothyroidism which has now settled down to normal. Now after 8 months of treatment she is still unable to conceive. Now her doc (gyne) has advised to have an ultrasound of lower abdomen (TVS), below is the report: ULTRA-SOUND LOWER ABDOMEN – TRANSVAGINAL U/S ALSO DONE. Uterus is anteverted normal in size, shape and outline. Uterus measures 53*68*31mm Myometrial and Endometrial abdomen are normal. Cervix is bulky with multiple nabothian cyst of 4mm. Endometrial thickness is 6.1mm Both ovaries are enlarged in size, shape and echopattern. Evdience of irregularly arranged multiple 6 to 10 mm size follicles. Right Ovary volume : 16 ml, left ovary volume :14ml No adnexal mass is seen. There is no fulid in the cul-de-Sac Impression – *Bilateral Multicystic Ovarian Changes. *Chorinic Cervicites. Doc also told for an for ovulation test (i am not sure if i have written the correct test name, she(gyne) asked to visit my wife within 24 hours of periods for the test and told that the report will come after 25 days) but she was unable to perform the test (or she was unable to take the sample from her vagina, she told that my wife has a bifurcated septum inside vagina/ovary). I just wanted to be sure that she (gyne) is going tin the right direction. Now after the US report she is suggesting for another 3 cycles (months) of Herface/Meprate (contraceptive pills) which means for 3 months she wont be able to conceive and i am not sure if after 3 moths will it fix the problem or not. Also she has asked to visit after 3 days of the periods for another test (that i don t know) and also asking to go for the 1st test i mentioned(withing 24 hours of periods). Any kind of advise would be highly appreciated. Doctor: Hello and wecome to healthcare magic.From the information given it seems your wife is suffering from PCOS. In this syndrome the main problem is that mature ovum production is hampered and in absense of that the periods become irregular and infertility is seen.If i would have been your doctor i would have gone for a hysterosalpingogram or saline infusion sonography to see whether the fallopian tubes are patent and also to see if there is any structural abnormality of the uterus. All these tests are for your wife.I would have also asked for your semen analysis.If the above tests were favourable then i would have gone for ovulation inducing drugs and given you a schedule of timed intercourse.I could have given a more detailed answer if i knew few details like you and your wive's age, any past history of conception, number of months or years you have been trying for a baby etc.Please do write back if you have any other questions.