Suggest treatment to conceive after failed pregnancies
Patient: i have been trying to conceive since last 3 months but is unable to, was on clomid for last 2 months but this also failed, I have a four year old son, and have a history of  a miscarriage (feb 2005), ectopic pregnancy and ovarian cyst (jul 2009) treated last year.......what should i do wait for another few months or get myself treated for infertility? my doc put me on pyricontin when i refused to take any more clomid! what is the best for me? Doctor: Hi How are you doing ? Let me start on a positive note , if you have had one pregnancy then you will have a second for sure. 100% sure.You have proved your capability !!!Kindly see if the following checklist of investigations is doneHusband- Semen analysis at least 2-  done 4 weeks apart preferably in an infertility center ( examination done by andrologist), Blood sugarsWife - Blood Sugars, Thyroid profile Ultrasound scans to evaluate Uterus , Ovaries & adnexa          Confirm tubal patency- most important- Tube is the connection           between uterus & ovaries( the bridge where sperm meets the egg &           forms a baby) this is size of hair follicle & cannot be seen on scans.           Being such a small opening tube can get blocked easily,            So check with HSG( Xray with dye), or SSG ( Scan with dye) or            LaparoscopyIf all this done & found normal , nothing can stop a pregnancy with God's willWith that history of tubal pregnancy, I would suggest tubal testing before anything ,I bet there is some problem in the tube. If unfortunately both tubes have problem IVF is the only option. Even if both tubes are open & you don't get pregnant after 3-4 months, think of IVF , as if tube is possibly damaged leading to ectopic pregnancy. Tube may be physically open , but not functionally- the ciliary process inside tube needed to push egg , sperm & embryo may be damaged !!  Hope I have cleared your queryAll the bestDr.Balakrishnan