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Suggest Treatment For Infertility

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Posted on Tue, 30 Dec 2014
Question: Hi, I am xxx,31, height 157 cm, weight 61 kg,married in dec,2010. got pregnant in jun,2011 , however got this pregnancy terminated medically. second time got pregnant in may,2013, however that was a missed abortion after 11 weeks in july,2013. as advised by doc to refrain from conceiving for next six months, started TTC after march,2014.am living with husband regularly.all blood tests and seimen analysis of hubby are ok with respect to tests done in oct,2014. HSG was done in nov,2014 which showed cervical stenosis. after one week laparoscopy and hysteroscopy was done along with endometric biopsy (TB-PCR, real time, reported positive).doc says my case is of secondary infertility. while left tube is patent, uterus is ok, but right tube is infected. stenosis is removed now.I have been suggested to go on AKT-4 for next 6 months and then only can i start TTC. I want to know; (a) if the line of treatment is correct, (b)when can i start trying to conceive, (c) are there any side effects of undergoing this treatment on my fertility prospects.
doctor
Answered by Dr. Aarti Abraham (7 minutes later)
Brief Answer:
PLEASE PROVIDE MORE DETAILS

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Before guiding you further, I would request for clarifications / elaboration on a few points -
1. Please upload all the blood tests and semen analysis etc that you mention were done in Oct. 2014.
2. Please upload the report of the HSG done in Nov. 2014.
3. Please upload the TB - PCR report also.
4. Most importantly, please upload the report of the hystero - laparoscopy . Also clarify if the right tube is patent or not. ( infection does not mean it is blocked completely ).
5. You mention that stenosis is removed now. On what basis do you say that ?
6. When you had a missed abortion in May 2013, was a D and C done ? If yes, was the aborted tissue sent for chromosomal analysis. If yes, please upload that report.
7. Are your cycles regular ?
Please get back with these details, as it is essential for me to evaluate them before proceeding with my opinion.
Looking forward to hearing from you.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (50 minutes later)
As i am being treated in a company hospital, reports are shown to the patient and preserved in database. however the data available with me as part of medical book and reports that have been discussed are as in the point to point order:
1.blood groups of mine and hubby: b+, seimen : 70 million and 80% motile, tsh=3.84,acl (igG , igM)= negative, apl( igG, igM)=negative, LA=negative, hb=12.5, no sugar as from tests
2.doc writes very hard to push, needs to dilate
3.this report says: MTB: detected, MOTT: not detected on real time basis for endometric curettage sample.
4.report says underwent lap XXXXXXX test. findings: uterus: MPS/RIV XXXXXXX free from fibroids, Os-cervical stenosis, very hard to dilate, lap XXXXXXX test: right side no spillage noted, cesnual black, left tube patent,
5.doc said that the area under stenosis has been dilated.
6.yes dnc was done.biopsy was done in the lab and reported ok.
7.it used to be normally 28 days for 2-3 days with average plus flow,however, since july, 2014, flow has reduced drastically, and delayed by more than 1 week. scanty flow, in sep, 2014 mid period flow also. pls be informed that i was put on med bigomet during july and aug, 2014.2 folliculimetry also done in july and aug, while in july, both sides showed results, in august, nothing was observed on folliculimetry.

this much i cud share.
doctor
Answered by Dr. Aarti Abraham (1 hour later)
Brief Answer:
PLEASE UPLOAD REPORTS, DO NOT TYPE

Detailed Answer:
Please upload the exact reports.
Typing these out is of no use, as various labs have various ranges of normal and abnormal.
There are spellings mistakes in what you write.
I need the exact reports.
I realize it might be an effort, but it is worth it , if you want an honest evaluation.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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Suggest Treatment For Infertility

Brief Answer: PLEASE PROVIDE MORE DETAILS Detailed Answer: Hello Thanks for writing to us with your health concern. Before guiding you further, I would request for clarifications / elaboration on a few points - 1. Please upload all the blood tests and semen analysis etc that you mention were done in Oct. 2014. 2. Please upload the report of the HSG done in Nov. 2014. 3. Please upload the TB - PCR report also. 4. Most importantly, please upload the report of the hystero - laparoscopy . Also clarify if the right tube is patent or not. ( infection does not mean it is blocked completely ). 5. You mention that stenosis is removed now. On what basis do you say that ? 6. When you had a missed abortion in May 2013, was a D and C done ? If yes, was the aborted tissue sent for chromosomal analysis. If yes, please upload that report. 7. Are your cycles regular ? Please get back with these details, as it is essential for me to evaluate them before proceeding with my opinion. Looking forward to hearing from you. Take care.