Hi, thanks for using healthcare magic

For pregnancy to occur there must be: (1) release of a normal egg from the ovaries (2) the production of adequate sperm
(3)normal transport of the egg and sperm to a particular part of fallopian tube where fertilisation occurs
(4)transport along the tubes to the uterus for the embryo (young fetus ) to implant in the womb


Irregular periods due to PCOS would mean that there may be a problems with the release of an egg. PCOS is treated with lifestyle changes (if there is excess weight , weight loss can cause PCOS to improve) and medication.
The medications commonly used are metformin (this decreases the insulin resistance that goes along with PCOS and also improves the chances to conceive) and also the siphene that you are using that helps the eggs to be released.

If the use of the siphene is not effective then other hormonal treatments may be needed.

In terms of the tubes, this would not occur as a result of miscarriage unless it was an ectopic pregnancy which is a pregnancy not in the right place such as the tubes.

The causes of blockage of the tubes are:(1) infection( the fact that she is giving you antibiotics may mean that she thinks it is related to infection)
(2)previous surgery in the tubes
(3)previous infection in the abdomen that results in scar tissue around the tubes like appendicitis
(4) a condition called endometriosis where endometrial tissue that is normally found in the lining of the uterus is found in other places

If the blockage is related to infection , the use of antibiotics may help.

In some cases, it is necessary to reconstruct the tubes or remove any blockage seen by surgery. This can be done by open surgery or by laproscopy.
In laproscopy a small tube is used.

Your doctor may consider other hormonal treatment that is used if the siphene faills before opting for surgery.

In this present age that we live where there are so many treatment options available, you have good chance of conceiving because all of these obstacles are correctable and treatable

I hope this helps, feel free to ask any other questions

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Hi

It is not recommended to go above the dose of siphene you are presently on.

This medication is normally used for 6 cycles or up to 6 months.
The use with metformin may increase its effectiveness. If the siphene does not work there are other hormonal medications that can be used as well as procedures such as intrauterine insemination or invitro insemination.

There is a chance to conceive with one tube functioning the exact figure or chance is not known but it is definitely possible

In terms of determining if it unblocks with the antibiotics your doctor may either assess through ability to conceive or repeat the HSG

Laproscopy involves making small incisions about 1 to 3 cm , using a scope to do surgery.
This can be done to correct the tubes or your doctor can choose laprotomy which means making a larger cut.

Please feel free to ask anything else

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Hi

Lifestyle changes means changes in diet and increase in physical activity to try lose any excess weight .
Increase weight can decrease the chance of conception

There have been medical studies on women with PCOS who have been placed on a low carb diet who have loss weight and conceived.

Low carb diets involve reducing your use of carbohydrates because the carbohydrates cause the body to release insulin .Insulin stops fat from breaking down.

Low diets involve reducing the use of rice/pasta/potatoes/bread/biscuits/ some breakfast cereals.

It would involve using as much protein as you wish along with low carb vegetables.
It would also require using water instead of sodas or fruit juices.

There is a wealth of information available on it , you can decide if it is something you are able to do.

Please feel free to ask any additional questions

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