Brief Answer: Kindly reply few questions. Detailed Answer: Hello XXXXXXX Kindly reply few questions so that I can come to a conclusion: How are your menstrual cycles? are they regular or irregular? please mention its frequency and duration of flow. Do you have painful menstruation/ periods? Do you have pain during intercourse? Have you undergone blood investigations, serum LH (leutinizing) FSH(follicular stimulating hormone) , serum prolactin and thyroid function tests ? How many cycles you have been put on ovulation induction tablets like ubiphene? Have you ever undergone laparoscopy ? or Hysterosapingography for checking fallopian tube patency? Kindly mention about the size of endometriotic cysts? Give details regarding your husbands semen analysis, if it has been done? Does your husband has any coital problems? ejaculatory or erectile dysfunction? Please ask if you have more questions, and do write back with the answers so that I can guide you further. Awaiting your response. Regards Arif

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Brief Answer: Your husband needs evaluation first. Detailed Answer: Hi XXXXXXX Thank you and I appreciate for the detailed reply. I can understand your concerns XXXXXXX Coming back to your questions, after analyzing all the reports you have little hormonal imbalance which needs to be corrected first. First of all before we start giving any ovulation induction drugs (clomiphene) for females it is very important to check the SEMEN ANALYSIS first. It is very very important. If the semen report is normal then only further treatment is planned. In infertility treatment both husband and wife should be involved. As you are having PCOS and endometriotic cyst I suggest you to undergo Diagnostic laparoscopy . This is because by laparoscopy we can tackle 4 things in your situation: 1)Removing endometriotic cysts (which are important part of infertility treatment) 2)removal of pelvic adhesions in between the fallopian tubes, which might affect the OVUM PICKUP (which is quite possible in your case) 3)Ovarian drilling, which is again a treatment option for PCOS 4)checking fallopian tube patency. After all evaluation you can be given treatment with ovulation induction. I am not in favor of what treatment you are getting now. Also your TSH level are high, kindly get evaluated for hypothyroidism, you might require Thyroid hormone supplementation. Please ask if you have more questions. If you are satisfied, please make sure that your ACCEPT my answer so that I receive credit. Good luck!!

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Brief Answer: Antioxidents are helpful to improve semen function Detailed Answer: Hello XXXXXXX I apologize for the late response; I was away from my computer due to unavoidable reasons. Coming back to your question, your husband needs to continue the medicines prescribed to him. Both these drugs are antioxidants (coenzyme Q , arginineand L carnitine) which have shown to be helpful in improving the semen parameters. I have analyzed the semen report of your husband, what I conclude from the semen report is there is normal count and motility, but there is problem with forms, which gets alright with antioxidants. The present method used for the analysis is computerized, which needs to be confirmed by repeating the manual method after 2 months of treatment. Along with this medication your husband needs clinical evaluation (if not done earlier) to rule out any other pathologies like hypogonadism, varicocele and hydrocele. The present medicines are sufficient for your husband. I personally feel for better results you need to undergo IUI (intrauterine insemination) and other treatment plans (kindly refer my previous answers) in present scenario, kindly discuss with your doctor regarding this. Please ask if you have more questions. If you are satisfied, please make sure that your ACCEPT my answer so that I receive credit. Good luck!!

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