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Have problem with pregnancy. Have taken medication prescribed. Tests done. What is the reason for not getting pregnant.

I got married in dec'2010, I have mentural cycle in 28 days regularly. 6 months later from my marriage period got extend 3 days, i done urine card test it shows positive on morning but i got period on same day evening (that day i didnt take rest did some bending activity) so i thought due to bending activity only pregnancy got disturbed. In the next 2 months again my period got extend checked with doctor , in the urine test it shows only weekly positive. 2 days later again i got periods. Consulted with doctor did thyroid test - Normal , Blood Test - Normal , Scan Normal. Seman test also done for my husband - normal. Dosctor advised me for tablets in 3-7 days & 11-16 days(app) continued for 1 month only - no positive result.
then after a year again period got extend - urine test shows negative but Blood test confirmed pregnancy. After a week bleeding noted i consult with doctor , scan made it shows heart beet of baby is only 90. Doctor provide me injection for improvement & waited for 2 days then scaned again no improvement in heart beet. so doctor provided me tablet to abort (baby not formed properly).
After 6 months i consult doctor 25.03.13 1st day of period , provide tablet for d3-d7 , 10th day started follicular study did upto 20th day , left side ovulation started but not rupture even on 20th day also.
Doctor told me to come again after the period started to improve hormone.
Any problem with me to get pregnant. If any problem with me can rectify? Already my age is 31 & working in chemical industry. Pls suggest me how to rectify this?
Asked On : Thu, 18 Apr 2013
Answers:  3 Views:  36
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OBGYN 's  Response
Mar 2013
Thanks for your query.
you are suffering from repeated miscarriages as per your history.
There could be various reasons for this.
Please do not go for further fertility treatment till you are completely investigated.
Genetic causes are the leading reasons for abortions.
Ideally, products of D and C should be sent for analysis.
Intrauterine infections, abnormalities in size and shape of uterus and cervix are all reasons.
Hormonal imbalance and autoimmune conditions could be another cause.
You need to have complete evaluation.
If your follicular study is showing problems, you need help of clomiphene or injections like gonadotropins to help with regular ovulation.
You can consider IUI ( intra uterine insemination ), if your fallopian tubes are patent on laparoscopy.
Please consult an Infertility specialist.
Take care.
Answered: Thu, 18 Apr 2013
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General & Family Physician Dr. S. Jegadeesan's  Response
You must understand few facts. I need not repeat your results. Both of you are clinically and investigations wise normal. A few things are there for you to understand. Your cycle is 28 days regular. So approximately 11th day to 17th day from the first day of your periods are important days to have the contact to get pregnant. Secondly even though you have 2 ovaries and 2 falloppian tubes only one ova will be released from either one of the ovary in each cycle. For ova to get released the follicles which are surrounding the uterus should get enlarged and ruptured approximately around the 14th day to release the ova. The follicles will start enlargement approximately from the 9th day and reaches its full dilatation around the 14th day (mid day of cycle). In your case the follicles are not dilated up to the level to get ruptured (it is assumed as your dr has suggested hormone treatment). The dr. has said she will give hormones to increase the size. Hormones are available in tabs or inj. which should be started from 2nd day of your LMP for 5 days and USG to be started from the 9th day. The sonologist can come to a conclusion on the 12 th day itself whether in this cycle your follicle will reach full blown growth or not. if your follicles attain full growth and ovum is released around the mid day of the cycle there is nothing to worry. If tab fails you can try with inj. Further management depends as per result of your follicular study. Pregnancy test is to be done after 40th day of your last LMP to get correct report
Best wishes
Answered: Thu, 18 Apr 2013
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OBGYN Dr. Ahmed Bahaa's  Response
My dear vgomathi,
You do not have any problem to get pregnant, you actually got pregnant several times.
The problem is that these pregnancies do not continue.
You are a case of recurrent pregnancy loss, which affects 1 in 300 couples.
The good thing is that after several pregnancy losses, the chance of having a viable birth is greater than having another pregnancy loss, even without treatment. Also the prognosis may improve dramatically if diagnose and treat the underlying cause.
There is a big list of investigations and examinations to diagnose the definitive etiology, though sometimes we don't reach the diagnosis and give imperical treatment.
At first we should exclude paternal chromosomal abnormalities and anti phospholipid antibody syndrome, then we search for endocrine and anatomical abnormalities.
In the event of pregnancy loss, tissues should be obtained for karyotyping.
If there is difficulty doing all this, I recommend the following:
- Folic acid 4mg supplement daily.
- Low dose aspirin 81 mg daily once there is a positive pregnancy test.
- heparin 5000 I.U subcutaneously every 12 hours once there is a positive pregnancy test.
- progesterone support either intramuscular or subcutaneous.
I hope these words be usefull to you and I wish you the best of luck.
Dr. Ahmed Bahaa.
Answered: Thu, 18 Apr 2013
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