Brief Answer:
Good results can be expected with proper plan.

Detailed Answer:
Hi Ms. XXXXXXX

Thanks for trusting us with your health concern.

Firstly, let me tell you that your ages are not a big concern to decide in favor of IVF straightaway. You still have some fruitful time before considering other alternatives.

From the history you have given, I see that the most important obstacle in your family life is the inability to time proper intercourse around the fertile days. Please upload your reports in this query since I cannot access them.

As per your request for lubricants, I would like to say that no lubricant is completely safe for the sperms. You may try K-Y jelly.

To achieve conception, it is essential that you have a proper unprotected sexual intercourse around ovulation at least on alternate days. As the sperms can live up to 5-7 days and the ovum up to 24 hours after release, it is important that you time the intercourse around ovulation. Also, movement should be avoided for 30 minutes subsequent to the intercourse to help ascent of the sperms. If you have a retroverted uterus, you should lie on your stomach, otherwise, you should lie on your back.

Ovulation occurs two weeks prior to the onset of the next menstrual period. To get a better opinion, you can track your cycles for the time of ovulation through follicular studies to help time intercourse better.

Finally, I would like to say that you can opt for other procedures only if you have failed after trying sincerely for at least six months and are deemed to need assistance after complete investigation. Natural pregnancy is always the best thing that can happen and before you lose precious time, both of you should get serious about it.

Hope I have clarified your query. Please feel free to contact for further information. I will be happy to help.

regards,
Shanti.V.

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Brief Answer:
Can take folate supplements.

Detailed Answer:
Hi,

Thanks for writing back.

I have gone through your menstrual calender. You have a cycle span of 21-28 days which has come down to 24-27 days during 2014. As I mentioned earlier, ovulation occurs 14 days prior to the onset of the next period. This means your fertile period is about 20 days prior to your next period until 12 days prior.

For example, you had your last cycle on December 29th and you are likely to have ovulated on 15th of December and this was your fertile period then. Considering the span of your cycles, you should widen the fertile period to cover both the extremes and this means you need to involve in active intercourse from day 7 to day 14 in each cycle, at least on alternate days.

I have seen the reports also. Please make sure you have uploaded several reports because four of your reports are the same. Your blood counts were normal except for the fact that you had some urinary infection at the time and this could be the cause of the raised ESR and ALP. Also, your lipid profile was borderline and if you are overweight, please try to maintain a healthy BMI and go for regular exercise.

Your husband's report suggests some infection and needs further evaluation by a physician. Since this report dates back to August 2014, hope it was done. Also, it would be better if a semenalysis can be done to assess male factor. You can also check for ovulation through follicular studies.

Retroverted uterus can be identified through a clinical exam and a sonogram.

You may take folates as general supplement. Ovulation induction is needed only if natural ovulation fails.

Hope your query has been answered. Please get back if you need any more clarifications. I will be ready to help.

regards,
Shanti.V.

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Brief Answer:
Detailed below.

Detailed Answer:
Hi,

Thanks for writing again.

Your calculation is correct. The most fertile day cannot be predicted so accurately since you have cycle variation every month. Yet, going by the recent changes, it would be between 1st-4th February.

Your BMI should be in the range of 19-25 and more than this, body fat should be lesser. So, you can also try reducing fat and maintaining your weight in the normal range.

If the cycle length is reduced due to shortened pre-ovulatory phase, there is not much harm unless the endometrium is not properly formed. If the post-ovulatory phase is shortened, this could lead to corpus luteum deficiency, which in turn fails to maintain a pregnancy. This can be understood if a cycle is followed through follicular study to see the time period of each phase.

To contact me on this portal, you can post me a direct query. You can see Dr XXXXXXX XXXXXXX in Bengaluru at Milann fertility center in Jayanagar.

Hope your query has been answered. Please contact if you need any more help. I will be glad to oblige.

regards,
Shanti.V.

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