Brief Answer:
Symptomwise approach

Detailed Answer:
Dear
Thanks for contacting Ayurveda with your health concern.

1. To be on the safer side you should see a certified/experienced Acupuncturist with face to face consultation about pros and cons of acupuncture in Menstrual Cycle.

2.If you are thinking of conceiving then first seek an opinion of a Gynecologist or Fertility Treatment Specialist.

3. Although acupuncture is used by many to regulate irregular periods but you should first consult with your attending Acupuncturist/Physician about any secondary disease of reproductive system or hormonal level.

Dr. Munish Sood
Consultant & Physician
Naimittika

---

Brief Answer:
Stress & Fertility

Detailed Answer:
Dear
Thanks for reverting back.

1. Since you are under treatment which means that you are under regular guidance of your doctor who must have ruled out causes of irregular periods with relevant investigations and examination.

PS. As you are in conceiving period thus one cause of irregular period with missed pregnancy can be associated Anxiety/Stress/ Depression which can alter menstrual cycle and Gonadotropin level thus if this is a cause then treat it first.

2. Apart from medicines one should also practice:

. fresh green vegetables/fruits,plenty of fluids,
. avoid caffeine,alcohol,carbohydrates, good sleep, excess physical /mental STRESS.

PS. Do let me know about your weight, since excess weight can be one cause of not conceiving when other parametres are normal.

Dr. Munish
Naimittika

---

Brief Answer:
further clarification and explanations

Detailed Answer:
Dear

Thanks for reverting back and possible explanation and guidance are given below:

A

1. Over weight with BMI 45  [39 age] and wants to down to 30 [currently lost 8lbs] [at your age ideal BMI should be 26.4 which means you are obese] thus check with other health consequences related with overweight/obesity like: abnormal lipid profile, blood sugar level, respiratory problem and any heart disease.

2. Estrogen; 115, LH:1.7, FSH: 5.6 [do let me know the units since they are different in different countries to evaluate the same]

PS. Was any Endocrinologist opinion taken?

3. Cause of irregular periods: [ since most of the examination are normal, STRESS seems to be the culprit at this moment] i.e. stress related hypothalamic dysfunction

4. Are my periods normal: Since your menstrual cycle has been delayed recently, and investigations are normal, one has to say that this might be normal [unless proved otherwise]

5. Is fertility monitor a good diagnosis for monitoring ovulation: is specifically used by women with irregular cycles with studies claiming it to be 98.3% accuracy

6. Can I see conceive naturally: Since main problem of overweight in women is ovulation and affects fertility thus weight loss will definitely help you in conceiving naturally.

PS.  Do let me know about your past and present weight so that management can be discussed accordingly.

7. How can one assess infertility checkup herself:  Infertility check up should be best assessed by your health care provider, thus remain under regular guidance and follow the do’s and don’ts described earlier [since at your age optimal health is required thus healthy diet along with stress reduction techniques are helpful]

8. Why there is change in my cycle: could be perimenopausal changes [unless proved otherwise]

9. HSG was not done as sensitive to iodine, is there any other way to tell if fallopian tubes are blocked: you may ask for HyFoSy [Hystero salpingo – foam – sonography] which uses non- iodinated agent called  ExEm Foam

10. If clear blue fertility monitor shows 3 bars, what does it mean: ovulate/release an egg or conceive naturally? [since I’m not an expert in this test thus your attending physician will be in better position to tell you about the same]

11. Cause of fertility monitor showing ovulation but ovulation strips not: since strips measure only LH, they can only give you either a positive or negative result but not a number, which means they cannot predict whether ovulation is possible or not [they just measure the LH surge with or without release of egg]

 B

1. Since ultrasound report is normal [which means endometrial thickness will be normal also] which means there are good number of eggs present inside which will help you to conceive naturally

2. Since your internal examination [vaginal swab] was also normal thus any infection which may damage the sperms is also ruled out

3. Going by your age [39] although we have studied that, more the age lesser is the quality of egg and more are the chances of genetic disease in children [both in male and females] but have seen numerous cases where females have delivered a healthy baby [talk with your fertility doctor regarding this]

PS. Do check with Amniocentesis to find out any genetic disease in baby, whenever you get pregnant.

4. Repeat serum FSH and LH around 14th day and go with ovulation monitoring by Ultrasonography if there is confusion between fertility monitor and ovulation strips

5. Clear blue will help predict ovulation by hormone levels, and is an INDIRECT method [since it does not provide information regarding size of the follicle] thus ovulation monitoring by Ultrasonography is ideal approach.

6. Do check with your Thyroid level if PCOS is excluded

Dr. Munish

Naimittika

---