Hello XXXXXXX

Thanks for writing to us. I am trying to solve your problem.

First of all, I want to interpret with blood test report. Fasting plasma glucose (114 mg%) is slightly higher than normal range (70-110 mg%). It indicates hyperglycemia or prone to diabetics (mainly type 2). Though repeat plasma glucose test (both fasting & postprandial) is required to confirm the same. In your thyroid profile, T3 & T4 levels are normal but TSH level (6.28 mIU/L) is slight higher than normal range (0.5-5 mIU/L). It indicates hypothyroid state still now.

Now we come to causes of missed period for 3 months. I can assume that you have excluded pregnancy. Reasons are PCOS or ovarian cyst (most common)- associated with hyperglycemia or insulin resistance with co-existence of stress/ anxiety/ emotional upset, hormonal imbalance, irregular eating habit, overweight, hypothyroidism, psychological factor etc.

The possibilities can be narrowed by several tests such as ultrasound scan of lower abdomen, monitoring of LH / FSH level, blood estrogen & progesterone levels, repeat thyroid profile, repeat blood sugar test, blood prolactin & testosterone level etc.

Fertomid is an ovulation induction drug and used to treat anovulatory cycle. Deviry is progesterone medication and given in deficiency of the same. In follicular study report, follicle size 16 mm on D12 indicates preovulatory stage and it is normal in that sense. Normal range of follicle size is around 19-20 mm on ovulation time. You may use ovulation prediction kit (OPK) or can repeat follicular study to predict or confirm ovulation.

Both the prescribed medication are used to treat irregular delayed period and your doctor is treating you in right way.

Basically pregnancy depends on proper timing of ovulation & unprotected sex with ejaculation. If you do not want to conceive right now or want to wait 7-8 months, you can use oral contraceptive pill which can treat your problem with regularize your period and prevent from unwanted pregnancy. So please consult with your gynecologist regarding this to take appropriate medication.

Please do the following things that can be helpful to improve your condition:

1) Control body weight by regular physical exercise by jogging/ running/ treadmill or you may join into XXXXXXX for daily work out.
2) Take healthy diet with iron supplements with avoidance of junk/ fatty/fast food.
3) Drink plenty of fluids/water and eat more vegetables & fresh fruits.
4) Avoid stress by doing yoga/deep breathing regularly (20-30 times)
5) Maintain personal hygiene and need adequate sleeping.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish your good health in future & take care yourself.

Regards,
Dr Soumen.

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hello XXXXXXX

Thanks for follow up query and giving me some extra information regarding your problem.

It is better to use only injection. As depot shot may cause prolonged infertility after discontinuation. In this context, OCP is very much useful in regularize your period and prevention of unwanted pregnancy. You can plan your pregnancy after 2-3 months of stop taking OCP.

I suggest you to proceed for further investigation like complete hormone assay, thyroid profile etc as I have described in my previous reply to rule out other possible causes of irregular delayed period.

Please consult with your gynecologist for suggestive medication according to your test report. You need to undergo follicular study also on D14 to monitor ovulation.

In addition, you must follow measures for healthy lifestyle that I told you on last portion of earlier reply.

If you do not need any further clarification, you can close the discussion and rate the answer.

Be well and stay healthy.

Regards,
Dr Soumen

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