Hello and welcome to Healthcare Magic. Thanks for your query.

From what you have mentioned, I presume that you may have had a problem of adhesions or scar tissue due to a condition called endometriosis - which could have lead to tubal blockage and infertility. However, you say that the problem was sorted out after the surgery in 2007 and that your tubes are open. If you are still having a problem concieving, then you need to be evaluated for other causes which could be causing infertility.

There could be many other factors causing fertility problems, such as anovulatory cycles, hormonal problems or other medical problems. The most important step in the management of infertility is doing a proper evaluation and identifying the correct cause. Only if this is done, further treatment can be initiated (i.e.) treatment will depend on the cause identified. For example, if you are found to have hormonal problems or anovulatory cycles, the appropriate hormonal medication will be needed to normalize your cycles; or if there are any other medical problems, like hypothyroidism, then appropriate treatment of that problem will be essential. So, I would suggest that you see a gynecologist again to have a detailed evaluation - this would include hormonal tests, other blood tests, an ultrasound scan and sometimes, a hystero-salpingogram.

I would also like to give you the following general suggestions to improve your fertility:
- Reduce weight if you are overweight.
- Regular physical exercise is a must.
- Avoid stress as much as possible.
- Avoid smoking or alcohol or any unecessary medication.
- Follow the "fertile period" method: that is calculating your the fertile period (ovulation period) and having plenty of sex during this fertile period maximizes your chances of getting pregnant.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist

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