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Suggest Treatment For Infertility

Posted on Wed, 3 Sep 2014

Question: Hi, I am 29 years old. I have one child of 4 years. i wanted to have second bay. we tried conceiving in May 14. since then i am having irregular periods, pain in lower abdomen. i had my periods on 30/5, 2/7, 24/7, 14/8. my reports are TLC 10700 /cumm; DLC Neutrophil 69%, Lymphocyte 30%, Eosinophil 01%, monocyte, basophil, stab cells, all 0% ;Prolactin 2718 ng/mL; T3 2.15 pg/mL; T4 1.08 ng/dL, TSH 2.708 ulU/ml;,AMH 5.9; MTB detection test by PCR not detected. HSG shows proximal blockage of one tube nad mid level block for other tube. i want to have baby but first i wanted to get treated for irregular periods and pain.

Answered by Dr. Mahesh Koregol (58 minutes later)

Brief Answer:
Prolactin and HSG

Detailed Answer:
Hi,

I read your query and I understand your concerns.

Following is my reply:

1) Serum prolactin should be around 29 ng/ml.

2) Your levels are 2718 ng/ml which is very high.

3) Please repeat the test. If its still high you need to see an endocrinologist immediately.

4) HSG shows block. Hence it is important that this issue is resolved. Please Repeat HSG under anesthesia to make sure its block and not a spasm ( error due to spasm)

5) Other reports seem to be fine. No problem.

Let me know if you have anymore questions.

Regards,
Dr. Mahesh Koregol

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (2 hours later)

hello doctor. thanks a lot for answering the query. i have following remarks and further queries

1. please note that my prolactin is 27.18 ng/ml. sorry for misprinting.
2. i would repeat HSG. but all i wanted to know whether blockage of tubes cause any abdominal pain. i am having regular pain in my lower abdomen.
3. i somewhere read that proximal blockage can be opened without surgery. something called tubal cannulation.
4. the HSG was done under anesthesia only.
5. why my periods are so irregular past 4 months.
thanks

Answered by Dr. Mahesh Koregol (1 hour later)

Brief Answer:
Reply

Detailed Answer:
Hi,

1) 27.18 is normal value. No need to worry.

2) Blockage of tubes dont cause abdomen pain. Get urine tested for UTI.

3) Proximal blockage can be opened by hysteroscopic tubal cannulation.

4) Periods could be irregular because of weight gain or stress. You let me know if there is any change in lifestyle.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (42 hours later)

hello doctor,
1. There is no change in lifestyle. my periods became irregular from may 2014 since i started planning for baby and stopped using protection.

2. As i mentioned in my first query that lmp 14 august, but it didnt turned out into periods. it was only 2-3 spots of brown discharge and cramping in lower abdomen and then it stopped.

3. Can i take dydrogestrone tabs if any possibility of pregnancy is there?

4.Is there any side effect of taking this tablets?

5. If its not pregnancy should i go for laproscopy directly or tubal cannulation.

thanks

Answered by Dr. Mahesh Koregol (5 minutes later)

Brief Answer:
Serum beta hCG blood test

Detailed Answer:
Hi

The spotting you had experienced was probably your period.

Sometimes it is normal to have variations in cycle days and flow.

If suspecting pregnancy get serum beta hCG blood test done to confirm pregnancy. It predicts pregnancy accurately.

If not pregnant go for lapariscopic guided hysteroscopic cannulation.

Regards

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar