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Suggest treatment for infertility - Online Doctor Chats

Date : 01-Mar-2014
User rating for this question
Very Good Posted in: Infertility Problem
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2305 Questions

We are trying to have a baby since last 10-12 months but no success.
We consulted a gynecologist for my wife and she mentioned some tests like TSH, Ultra sound of ovaries and other related areas and reports were normal.
Can you help us in this?

Doctor:Dr. XXXXXXX here
Doctor:How can I help you?
User:We are trying to have a baby since last 10-12 months but no success. We consulted a gynecologist for my wife and she mentioned some tests like TSH, Ultra sound of ovaries and other related areas and reports were normal.Can you help us in this?
Doctor:Was a semen analysis also done.
Doctor:Is your wife's period regular?
User:Is this your profile: WWW.WWWW.WW
User:Sorry, I want to know with whom I am consulting
Doctor:Yes; that's my profile.
User:ok thanks
User:Yes, my wife's period is regular. But, usually here and there by 1-2 days. Is that fine?
User:Yes, I got the SA test
User:Here is the report.
User:Actually, I believe that while giving the sample for test I was very nervous and not feeling very well. So I was not able to do it at the best. That's what I believe. But, I may be wrong.
User:Does this hold any validity?
User:Hello, are you there?
User:Hello, are you online? I am waiting for your reply.
Doctor:There seems to be some technical problem.
Doctor:I am unable to send my messages.
Doctor:Can I call you to discuss the issues?
User:I got your message just now
User:I am in office now and dont want to discuss now.
User:We can chat here.
User:You can share your contact details so that I can contact you when I am free
Doctor:I think its fine now.
User:Actually, I believe that while giving the sample for test I was very nervous and not feeling very well. So I was not able to do it at the best. That's what I believe. But, I may be wrong. Does this hold any validity?
Doctor:I don't see your semen analysis report here.
User:I have not sent yet. Before that I have the above question.
User:Can you please reply?
Doctor:Nervousness at the time of giving a sample doesn't alter semen analysis report too much.
Doctor:i would like to know the report if you have them with you.
User:OK thanks. SA report:
User:Volume : 2.5 ml Total Count: 25 Million/ml Mobility: Active: 25 Sluggish: 15 Non Motile: 60 Morphology: Normal: 60 Anbormal: 40
Doctor:The motility is slightly low; however with 25 million sperms the values are acceptable.
Doctor:Have you consulted an infertility specialist?
Doctor:Are you there?
User:No, I didnt went to any infertility specialist as such but consulted a urologist who also have specialization in Andrology
Doctor:Let me brief you.
Doctor:Pregnancy and conception is dependent on different factors.
Doctor:The reports that you have submitted seems ok; but there are multiple other factors.
Doctor:You said your wife had ultrasound scan of ovaries which was normal.
Doctor:However there are few other tests that is done to understand the ovarian reserve, quality of ovum produced and so on.
User:Can you suggest that please?
Doctor:Besides that the doctor also need to exclude patency of uterine cavity.
User:I remember Gynecologist also prescribed some urine culture tests also which was normal
Doctor:The tests are timed at particular interval of her menstrual cycles and that is important to analyse the report.
Doctor:Without complete details of all tests that is done, when it was performed it would be extremely hard for me or any other doctor
Doctor:to give you a solution.
Doctor:I think it is best to consult an infertility specialist.
Doctor:He/she will order for other tests such as AMH level, prolactin level, FSH level
Doctor:along with hysteroscopy.
Doctor:These tests would be besides the test that is already done yet.
User:But, can she take any medicines which are common supplements to boost conception
Doctor:If every thing is in order and if you are still unable to parent a child
User:Urologist has prescribed me: 1) LYCOMEGA twice a day. 2) COQ 300 - once a day 3) CARNISURE 500- Thrice a day Is this treatment correct? Can healty sperm count can be increased?
Doctor:he/she would suggest for assisted fertilizations.
Doctor:The medicines are routinely prescribed to improve sperm quality and quantity.
Doctor:You can take them as recommended.
User:Thanks. CARNISURE 500- Thrice a day. Is this dosage alright?
User:Hello, are your there?
Doctor:It is a supplement with almost no side effects or toxicity. The dosage prescribed are varied; however there is no clear cut
User:can she take any medicines/supplements which are common supplements to boost conception ?
Doctor:dosage / frequency schedule.
Doctor:Since there is no dosage and frequency schedule, I am ok with this schedule.
Doctor:At this point of time, my opinion is that she gets evaluated completely.
Doctor:It is impossible to give a right schedule of treatment especially with conception with piece meal laboratory data.
Doctor:Consulting an infertility specialist or discussing about all those parameters that I mentioned on the chat would be ideal.
Doctor:Hope you understand me.
User:Should I consult an infertility specialist on healthcaremagic? What do you suggest? Or can you refer some good infertility doctors/clinic in Delhi?
User:I am taking consultation from Holy Family Private OPD doctors at this point in time for both XXXXXXX & Gynae
Doctor:I am unaware of a doctor at Delhi, but if you are ok with Gurgaon, there is Dr. XXXXXXX XXXXXXX
User:I am taking consultation from Holy Family Hospital Private OPD doctors at this point in time for both XXXXXXX & Gynae .
Doctor:She is again a Gynecologist with good experience in treating fertility expert.
Doctor:She practices at the cradle of Apollo, Gurgaon.
Doctor:You might visit her.
Doctor:If Gurgaon isn't ok
User:You must be aware of that there are many fancy clinic and centers who do a lot of publicity and no good treatment. So please suggest a good place
User:So please suggest a good clinic/doctor/hospital
Doctor:As you would have known, I am from Bangalore. I do not have any personal reference of infertility specialist from there.
Doctor:Dr. XXXXXXX XXXXXXX has been a doctor helping out infertility queries on healthcaremagic for sometime.
Doctor:Hence I put her name across to you.
Doctor:If you are looking for a doctor in Delhi,
Doctor:I shall try my part by searching on the web and providing you the information.
Doctor:Hope that is fine with you.
User:Sure. Thanks a lot. Appreciate you
Doctor:Do you mind if I send the details by mail to you.
Doctor:since it might take some time for me to do the searching.
Doctor:If it's ok, please share your email details?
Doctor:Are you there?
Doctor:I have to close the chat as you are not responding.
Doctor:You can chat with us 24/7 if you have any other query.
User:Dr XXXXXXX there?
Doctor:Yes, Dr. XXXXXXX here
Doctor:Do you have any more questions?
User:yes please
User:I was out for 2-3 minutes and hence could not reply
Doctor:No problem; is there any other query?
User:Doctor has prescribed me the medicines mentioned above for 1 month and then redo the SA test
User:I dont want to delay any more.
Doctor:I am sorry I did not ask your age and your wife's age in the first instant.
Doctor:May I know both your and your wife
User:Should I wait for few more months after completing the complete medicine course and try for pregnancy or should I consult a gynae parallely?
User:My: 33
User:Wife: 30
Doctor:As I said in the beginning, pregnancy and conception has many factorial influence.
Doctor:Your sperm count was good; more than average. But the motility was bit low.
Doctor:Since motility is a percentage, I am ok with the number of motile sperms.
Doctor:The medicines given to you is to improve the motile sperm content.
Doctor:As you correct this factor, it is important that you wife also corrects if any of her factors are abnormal.
Doctor:Based on the details you provided, I am not very sure what factors have been looked at yet.
Doctor:The minimum things that need to be looked at are
Doctor:1. Her ovarian reserve - FSH and AMH are two hormones that are tested.
Doctor:2. If she is ovulation are fine. Doctor needs to perform follicular scan to assess the size and quality of ovul.
Doctor:3. Is the uterine cavity patent. it is tested by HSG or hysteroscopy.
Doctor:Besides these test, thyroid and prolactin levels are also checked by doctors.
Doctor:You should discuss about these with the treating doctor.
Doctor:As you follow your medicines, you need to simultaneously discuss about this with the gynecologist or infertility specialist.
Doctor:Hope it is clear now.
Doctor:Do you have any more questions?
User:Just want to add that I also did my Semen, FSH/LSH, Testerone
User:and Testis doppler tests. And they are all normal
Doctor:I am glad the tests are normal. Please take the medicines prescribed.
User:Is there any more tests required for me?
User:I have an appointment with XXXXXXX after 10 days and he has told to come back with SA test.
Doctor:The tests that are done on you are additional tests. The most important one was semen analysis.
Doctor:As I have been discussing, I am very happy with the sperm count, however your motility is slightly on the lower side; though not seriously concerning.
Doctor:You can repeat the semen analysis, if things are not better
Doctor:and all your wife's parameter are normal
Doctor:we still can make a decision to use assisted techniques such as simple intrauterine insemination
User:Alright. So I would take medicines as prescribed and also consult a Gynae probably if no success.
Doctor:where the actively motile ones are concentrated and picked up to improve the chances of conception.
Doctor:Yes, I can tell that your semen parameters are fairly ok
User:Is there any exercise to assist me in increasing motilty besides medicines?
Doctor:Discuss about the female parameters and take an informed decision.
User:Any other life style, habit changes?
Doctor:Stop smoking or drinking alcohol if any.
Doctor:Eat plenty of fruits and vegetables.
User:I dnt - smoking or drinking alcoho
Doctor:Do not wear tight undergarments.
User:I am in IT so need to sit long hours on laptaps
User:what should I do?
Doctor:General exercise such as brisk wallking or jogging are added for benefits.
User:I reach home back around 7:30 pm and leave early at 7 AM
Doctor:You can always choose alternatives at work.
User:alternatives ?
Doctor:You need not always sit and work. I don't think your boss would object if you stood up for couple of minutes during work. Will he?
User:I get time to jog only on Saturday & Sundays? I believe I have to increase it
User::) Yes, got it
User:I am already doing that
User:Any specific exercises for pelvic, abdomin area?
Doctor:Exercise has various benefits. Do make time even if it is 15-20 minutes for it.
Doctor:No other specific exercise that i recommend.
Doctor:Do you have any more questions?
User:Sure. Will do it. I usually do full abdomen exercise for 30 minutes and some dumbell exercise on weekends
User:I guess I have to increase it
Doctor:Avoid unnecessary supplements or medicines if you are on any.
Doctor:And keep your mind fresh.
User:No, I dont take any medicines without consultation
Doctor:Let the doctors do the work on taking care of your fertility issues. Do not stress up.
User:That the issue.
User:There is a lot of mental stress in my life
Doctor:if your semen analysis doesn't improve and if there are no female factors, intrauterine insemination where handpicked sperms are injected into her will improve the chances of conception.
Doctor:I hope this information suffices for today.
User:Due to family issues - same daughter in law- parents issue. :(
Doctor:Is there any thing else that you wish to discuss now?
User:That's it.
User:Realy appreciate your advice.
Doctor:Thanks for consulting me.
Doctor:Bye for now.
User:How I can reach you again?
Doctor:I will be available on chat between 9-4 on week days.
Doctor:Is there any thing else?
User:ok. Cool Thanks a lot.
Doctor:Good day!!!
Doctor:Bye for now.
User:Same to you
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