Hello,

Thanks for writing to us. I am trying to solve your problem.

First of all, while you are planning for a baby, you need to do unprotected sex without any contraceptive around ovulation time or fertile days to maximize the chance of pregnancy. It should be practiced for 6 months to 1 yr for natural conception before undergoing investigations for primary infertility. You can use ovulation prediction kit (LH kit) to predict ovulation time in mid cycle & prepare for those days.

Secondly, you should take folic acid and vitamin-E supplements for at least 3 months in preconception period.

Now, according to your health problem and age group, some basic health check up & fertility tests are advisable. These include husband semen analysis, pelvic ultrasound scan, thyroid profile, day-21 progesterone assay, blood sugar (FBS & PPBS), check for BP, serial follicular study for proper ovulation, test for tubal blockage, estimation of LH/ FSH/ AMH (for ovarian reserve) etc. You can consult with gynecologist regarding this for proper guidance of the tests.

To regularize cycle & control heavy bleeding, you need to take progesterone medication cyclically for 21 days from D1 to D21 with 7 days gap to get period or 10 days hormonal therapy (like duphaston) from D16 to D25. It also helps to regulate ovulation time.

Some underlying uterine pathology like fibroid/ polyp/ endometrial hyperplasia may cause heavy menstrual bleeding. Supportive treatment is needed according to test report.

Endometrial tissue biopsy following D & C may be required for histopathological examination. Taking tranexamic acid (like Pause) group of drug is quite helpful to reduce heavy bleeding in case of undetermined pathology.

In addition, you should continue anti thyroid medication with proper dosage until delivery of the baby & thereafter. You can consult with endocrinologist regarding this for proper guidance and follow up.

Do the following things for healthy life style:

1) Take healthy diet with vitamin & iron supplements including iron XXXXXXX foodstuffs.
2) Complete avoidance of salty/ fatty/ junk food stuffs. Keep bowel habit regular.
3) Try to avoid stress by yoga/ deep breathing regularly (20-30 times) or meditation.
4) Drink plenty of water/ fluids and eat more green vegetables & fresh fruits.
5) Control body weight by regular physical exercise. Maintain genital hygiene properly.
6) Take sound sleep with complete body relaxation.

Hope I have answered your query. If you have any further questions, I will be happy to help.

For any future query, you can directly ask me by viewing this page WWW.WWWW.WW
Wish your good health & take care yourself.

Regards,
Dr Soumen.

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