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Trying for baby, no result. Can anybody help?

Mar 2013
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Practicing since : 1998
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In Sep i got my periods on 14th and the flow was there for 9 days and in Oct 2nd I got dark brown spottings till Oct 8 and frm Oct 9 iam getting my periods pain and i think I have started my periods. We are planning for a baby but no result. So please help.
Posted Sun, 27 Oct 2013 in Women's Health
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer:

Detailed Answer:
Thanks for writing to us with your health concern.
Please let me know if your previous menstrual cycles were regular or not.
As is obvious from your medical history, you are overweight, and you need to work on weight loss.
Menstrual irregularities can be commonly caused by obesity, stress, tension, travelling etc.
You are obviously stressed out about conception also.
Furthermore, you could be having conditions like polycystic ovarian syndrome .
In this condition, due to hormonal imbalance, the ovary produces multiple small follicles, but no dominant follicle, and hence there is difficulty in menstruation, ovulation and hence, conception.
Also, there could be endometrial hyperplasia, thickening of the lining of the uterus, due to irregular periods, the lining builds up, and when it sheds off, then heavy periods result. Due to continuous shedding of the lining, pre menstrual spotting occurs for a few days.
Endometriosis is another condition where the lining of the uterus grows in the pelvis in places other than the interior of the uterus.
This is characterized by spotting before the actual periods begin.
However, generally in this condition, there is excessive pain during periods, and extremely painful intercourse / bowel movements etc.
Other possibilities can include polyps in the cervix or uterus, fibroids, ovarian cysts etc.
The first step is - if this is an isolated event, then you can wait and watch ( if this has occurred only this month ).
If it is a pattern, then please see a gynecologist ( this is more advisable as you are having difficulty in conceiving ).
You should have a complete XXXXXXX check up ( per speculum and per vaginum ).
Also, a pelvic ultrasound is a must - this will reveal any of the above conditions if they exist.
Blood tests include basic complete blood count, thyroid hormone estimations, prolactin levels, workup for polycystic ovaries ( FSH, LH, androgens, glucose tolerance test, fasting insulin levels ), AMH ( estimation of ovarian reserve ), documentation of ovulation ( follicular monitoring by serial ultrasound in one cycle ), semen analysis of husband .
These are the first line tests.
If these are normal, and you still do not conceive within another 3 - 6 months, then you should confirm patency of the fallopian tubes by hysteroscopy and laparoscopy.
Take regular folic acid supplements, and try and lose weight to maintain an ideal BMI.
All the best, XXXXXXX
Please feel free to ask for further clarifications or clear any doubts.
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