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Miscarriage due to blighted ovum. Have ovarian cyst and burning urination. Reason of not getting pregnant?

Mar 2013
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Practicing since : 1998
Answered : 5602 Questions

I am 29 yrs and 4 months old and my husband is 35.
We are married for 4 years now. I became pregnant after 1.5 years of our marriage. But i had a miscarriage when i was 1.5 months pregnant (Reason: Blighted ovum)

It is almost 2 years 4 months since i had miscarriage.
We are trying to concieve for 2 years now without any success.

My husband had his semen analysis done, and he is diagnoised with low motility rate, which he is being treated for. He has shown improvements in his motility rates.
During the same time, i had all the tests done - pelvic scan, fallopian tube test and series of blood tests.
My fallopian tube did not have any issues.
My ovulation is normal which usually occurs around 14th-16th day.It was confirmed with follicular scans.
My thyroid, hemoglobin, serology reports are normal.

But my pelvic scan report showed right ovarian cyst measuring 10mm.
The scan was done on 4th day of my period. The reports are attached. My gynic said that everything is normal and nothing to worry. She said that due to low motility rate, our conception is getting delayed and I do not have any issues.

But from past 9 months, i am experiencing light to medium cramps one week before my periods.
It starts around 21st day of my period and increases until my period occurs.After my periods, all these cramps are gone!
It starts with light shooting pains in my left vaginal area, and then slowly spreads to the lower pelvic area.
The cramps occur once in an hour, most of the times it is mild, but one or two times a day i feel it like period like cramps.
From past 2 months, I have also observed that the cramps also vanish one day before my period starts.

After 10 days of my period, i am also experiencing burning sensation while urinating.
The burning sensation occurs mostly during nights, and there is an urge to pass urine frequently when the burning sensation occurs. This happens only once during a day either in afternoon or during night. I do drink lot of water but the issue persists.
This is happening from almost an year.

Are these cramps caused because of the cyst. Is the cyst reported in the scan a matter of concern. Does burning sensation during urination has any effect on me getting the cramps?

Does the below have any impact on me getting pregnant.
(1)     The burning sensation during urination,
(2)     cramps before periods and
(3)     cyst

Should I consult a neurologist?

If i get these cramps, does it mean that i have not concieved for that month?

Kindly guide me on how to go about this?

Posted Sat, 23 Feb 2013 in Women's Health
Answered by Dr. Aarti Abraham 1 hour later
Thanks for trusting us with your health query.
I have gone through your question in detail.
I would like to firstly guide you for your inability to conceive, since that is your major concern.

1. You are almost 30 years old now, and have been trying to conceive unsuccessfully for almost 2 and a half years. Please consult an Infertility Specialist in your city at the earliest. Almost 30 % of cases of infertility are cases of unexplained infertility, where no specific cause can be pinpointed, and ART ( assisted reproductive technology ) definitely helps such cases.

2. Your husband's decreased sperm motility could definitely be a reason, but as you have not attached the report, it is difficult to be specific about this. However, if the sperm motility is low, you should go in for procedures like IUI ( intra uterine insemination ) which will magnify your chances of conception.

3. You mentioned that fallopian tube testing was done. Could you please provide the details for the same ? As you previously had a miscarriage, chances of tubal damage are high. Also the cramping and problems you mention pre menstrually could indicate a possibility of endometriosis ( a disease where there is functioning uterine tissue outside the uterus - leading to pain, cramps, difficulty in urination or passing motions, painful intercourse etc ). This condition is diagnosed by a clinical check up by a gynecologist, and by ultrasound, and sometimes, a laparoscopy is required to confirm the diagnosis. In fact, I would recommend a laparoscopy and hysteroscopy to you anyways, because you require assessment of fallopian tubes and ovaries, which is best done by a laparoscopy. If the laparoscopy is fine, you can then proceed with treatment modalities like IUI, as I suggested.

4. The cyst is nothing to worry about at all. The report is almost one year old, and a cyst of this size ( 10 mm ) is called a follicular cyst / retention cyst. This happens when there is leftover cyst from one of the follicles ( eggs ) formed during the previous cycle. Nothing needs to be done for such a cyst, and it disappears on its own within a month or two. The cyst has no impact on fertility, and definitely would not cause cramps. It has no related with the burning urination also. I would advise you to go for a repeat pelvic ultrasound, which I am sure, would indicate no such cyst at present.

5. At certain phases in a womans menstrual cycle, the environment of the vagina predisposes to infections, and if you are experiencing burning micturition every month mid cycle, it could point to a mild urinary tract infection. Drink adequate fluids, get a urine microscopy and culture done, and maintain meticulous local hygiene during these days.

6. At times, with age, the incidence of premenstrual symptoms increases. The cramping and pain that you experience just before your periods could be plain pre menstrual symptoms also. To differentiate this, you require a thorough check up , ultrasound, and as recommended, a laparoscopy is ideal.

7. If you get these cramps before your periods, by no means does it mean that you have not conceived. The only reliable way to detect a pregnancy is a pregnancy test/ultrasound. Sometimes, even after implantation / conception, you might experience mild cramps.

8. Unless endometriosis is responsible for the cramps and urination problems, these two factors are not of concern for your fertility.

To summarize, Please proceed ahead as follows :
Please get your basic hormonal tests done ( complete blood count, blood group, Day 2 hormonal assays, AMH for ovarian reserve, Blood glucose and thyroid hormone testing ), a fresh semen analysis should be done. Also go for a repeat transvaginal ultrasound. I hope the ovulation has been confirmed by follicular monitoring already. Consult a gynecologist who specializes in Infertility and ART, get a laparoscopy done if not done already, and then quickly proceed to IUI / IVF as advised without losing time further.

Meanwhile, please take folic acid while you are trying to conceive, maintain an ideal body weight, take regular exercise and a healthy diet, and please try to eliminate stress and anxiety, as these negatively affect the reproductive hormonal axis.

Please DO NOT WORRY about the cyst at all, as it is insignificant, and the cramps and the urinary problems are also minor ones, which would not interfere with fertility.

Please feel free to ask for further clarifications anytime, I hope I have been able to clear your doubts.

I wish you all the best in your attempt .
Take care.
Above answer was peer-reviewed by
Follow-up: Miscarriage due to blighted ovum. Have ovarian cyst and burning urination. Reason of not getting pregnant? 1 hour later

Thanks very much for your inputs.

here is what i see from fallopian tube report.



UTERUS: Normal

Normal HSG study.

Also, i donot experience any pain during intercourse.

One more point i would like to add is - the cramps and burning sensation during urination was not there even after 1.2 years after my abortion. It has only started from past 8-9 months.

Kindly share me your inputs on the fallopian tube testing report and if i should still go for laproscopy?

I have also heard that, after 30 years, it would be difficult for women to get pregnant.
Can IUI/IVF give positive results even when done after 30 years of age??

Answered by Dr. Aarti Abraham 4 hours later
Hi again XXXXXXX,
Your HSG report is essentially normal.
However, the HSG is not completely sensitive or specific for tubal disease.
A laparoscopy would be more detailed and reliable.
However, since you have already undergone HSG, you can go in for one or two cycles of ovarian induction with IUI, and then go for laparoscopy before deciding further course of action.
The results of IUI/IVF do depend on age, but more on the ovarian reserve ( capacity of the ovaries to produce mature eggs ), semen analysis and other complicating factors.
It DOES give positive results to women after 30 years of age.
Ovarian reserve is tested by AFC ( antral follicle count ) - already mentioned in your past USG report, and it is good, and by a blood test called AMH ( anti mullerian hormone ).
Plus, endometriosis etc can be diagnosed by laparoscopy.
So, if one or two cycles of IUI do not give you a positive result, you can proceed for laparoscopy.
Take care.
Above answer was peer-reviewed by
Follow-up: Miscarriage due to blighted ovum. Have ovarian cyst and burning urination. Reason of not getting pregnant? 48 hours later
Thanks again. Can you please suggest me to good gynic in bangalore.
And good infertility clinic in bangalore.
Few generic clarifications.
How long should i lie stay in the same positon after the intercourse?.
Sometimes semen flows out fast. Is there any remedy for semen overflowing?.
Does riding a two wheeler after 20 days of period cause any impact while concieving?
We stay in first floor and i will climb the stairs approximately 5 to 6 times a day. Does this have any impact while concieving.

No one has given me convincing answers for these generic questions. Please clarify my confusions.
It was very nice interacting with u Dr XXXXXXX Thank u very much for your valuable suggestions
Answered by Dr. Aarti Abraham 59 minutes later
Hello again XXXXXXX,
Its nice hearing from you, and thank you for your appreciation.

I would recommend a few names to you for Infertility consultation -

Dr. XXXXXXX XXXXXXX Jayanagar, Bangalore
Dr. XXXXXXX XXXXXXX JP Nagar Bangalore
Fortis IVF centre
Dr XXXXXXX Aggarwal

You would find the details and contact numbers of all these doctors easily on the internet.

After intercourse, if you are trying to conceive, do not immediately get up or use the washroom. Also avoid use of lubricants, vaginal gels or any medicated chemicals or products for cleansing of the private parts for both partners. Semen takes maximum a few minutes to ascend into the vaginal and cervical canal, however, try lifting your knees to your chest, and stay in this position after intercourse for atleast 15 - 20 minutes, before cleaning yourself.

It is natural for women / men to feel that semen flows out of the vaginal canal fast after intercourse. If your husband has no problems with ejaculation, do not worry. A few drops of semen is all that is required for conception, and once semen liquifies after a few minutes, you will feel it gushing out of the vagina. That is normal, and do not worry.

Riding a two wheeler has NO impact on conception.

Climbing stairs or any form of exercise in fact increases health benefits , which ultimately benefits all the body systems, including reproductive ones. It does not interfere at all with conceiving.

Please feel free to ask any further questions, and all the best with your attempts.
Above answer was peer-reviewed by
Follow-up: Miscarriage due to blighted ovum. Have ovarian cyst and burning urination. Reason of not getting pregnant? 15 hours later
Am again back with few more questions. I know i have flooded you with loads if questions. Pardon me for this.

(1) Both me and my husband have considerable amount belly fat near the lower abdominal area, does the belly fat cause any impact on the penetration during intercourse and subsequently on conceiving?
(2) I usually have 27 day or 28 or 29 day cycle, which days would be critical and help in achieving the conception. How many of gap do you suggest between 2 intercourse?
(3) Does exercising every day, improve sperm motility rates? Does it also aid in good quality egg creation? Does a 30-45 min brisk walk serve the purpose?
(4) We are pure vegetarians; my husband is non-smoker and non-alchoholic.
Can you please suggest specific fruit/vegetable(or anything) which would improve my husbands motility rates? Also, please suggest me also specific item which would help in good quality egg creation.
(5) How long does a egg stay active once it is released. How long does it take for a sperm to reach the already released egg?
(6) Are ovulation kits effective in predicting when I am ovulating? Do you suggest me to use them?

Please give us tips on how do we prepare both mentally and physically before we opt for assisted reproduction.

Thank you very much for your time.

Answered by Dr. Aarti Abraham 37 minutes later
Flooding me with questions is a compliment for me :)
Please go ahead, anytime, XXXXXXX.
As for your queries,

1. Increased belly fat , unless in grotesque amounts, does not interfere with penetration or intercourse. You would know best if you both achieve orgasm and satisfactory sexual activity. Regarding conception, yes, increased body fat in both males and females affects fertility, reproductive hormone secretion, ovarian function etc. You should aim at ideal BMI for both of you.

2. In a 28 day cycle, ovulation normally occurs around day 14. Being regularly sexually active ( daily or alternate day ) after Day 10 of period , for the next 10 days, ensures maximum chances of conception. Also, ovulation varies from month to month, so ideally I would advise regular ( alternate day ) sexual activity during the cycle.
3. Exercising daily definitely improves reproductive function in both males and females. The amount of exercise required depends on your current body weight and targetted body weight. A dietician would guide you better regarding the number of calories you need to burn per day, and hence the exercise form should be chosen based on that.
4. No specific fruit/vegetable/food is 100 % reliable to improve reproductive ability. A diet XXXXXXX in antioxidants ( XXXXXXX leafy vegetables/nuts/legumes/fresh fruits/whole grain cereals ), fibre, proteins ( yoghurt/dahi/paneer ) is helpful. Avoid starchy , fatty foods, carbohydrates, increased consumption of sugar, salt,ghee, maida , oil etc. Use olive oil/ sunflower oil for cooking and that too in minimum amounts. Increase intake of salads and XXXXXXX leafy vegetables, while reducing that of starch, rice, potatoes, sweets, snacks, packaged and processed foods. Have lots of fluids ( coconut water, lemon tea, XXXXXXX tea, home made soups and juices ). Avoid eating outside. Avoid binge eating. Eat small frequent meals at home, freshly made.
Take folic acid supplements.
5. An egg has a life span of 24 hours, while sperm can survive upto 3 - 5 days, and hence fertilization can occur anytime right from ejaculation ( sperm takes a few minutes to ascend into the vaginal canal ), upto 3- 5 days ( provided ovulation has freshly occurred. )
6. Ovulation kits are reasonably effective in predicting ovulation. However, you should rely on follicular monitoring to provide the most objective evidence of ovulation.

It is most important to stay stress free, exercise regularly, and follow the advice of a reputed Infertility specialist in your city.

All the best dear.
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