Brief Answer: Detailed advise given Detailed Answer: Hello and welcome to HCM, I am Dr Nilajkumar a consultant gynecologist and I will be helping you in your queries. There is no harm in trying to conceive. There are certain issues that must be taken care of in pregnancy after age 35 years. The chances of spontaneous conception are a bit low after 45 years and some assistance may be needed for implantation and also sustaining the pregnancy after conception. Also chances of abortion are bit higher. Another issue is the incidence of fetal anomalies like Downs syndrome are increased after maternal age more than 35 years. However they can be detected by certain tests [ genetic and blood]. The third issue is the raised blood pressure. It may tend to increase during pregnancy and there is a slightly higher chance of having conditions like preeclampsia and gestational diabetes [ raised blood sugar of pregnancy]. So a bit of extra caution will be needed. Having said all this, I suggest that you try to conceive spontaneously for another 2 cycles preferably using ovulation predicting kits. Since your cycles are regular, the fertile days range from day 12-20 of the cycle. So sexual contact on alternate days during this period is desired for maximum chances of conception. If there is still no result, get an examination by an infertility specialist and check for ovulation as well as endometrial thickness. You may need drugs like clomiphene and progesterone preparations to assist in conception. Most likely you may conceive spontaneously as you have already had a pregnancy and periods are regular. I have seen your reports. You have a low hemoglobin. So start iron and folic acid tablets so that you may build it up before you conceive. Rest of the reports are alright. After conceiving you will need to register at an ANC clinic early and receive HCG and progesterone. A blood test will be needed to rule out downs syndrome and also a genetic amniocentesis will be advisable between 16-18 weeks. A level 3 or 4 ultrasound will be needed to detect fetal well being at 20 weeks. With regular check up and care you should do well. Hope this was helpful. Thanks for using HCM. Feel free to ask any more queries and I am here to answer. Have a good day. Dr Nilajkumar Bagde Consultant Obstetrics and Gynecology

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