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What is the cause and treatment for infertility?

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Posted on Mon, 14 Jul 2014
Question: Hello,

I am 36, mother of a child 8 years old (1st husband) and I am trying to conceive for a year, with no luck so far. My husband (2nd) is abroad and we meet each other once a month, but not always during my fertility period. 7 years ago I had an ectopic (hope I'm using the correct word) and since, I didnt get or tried to get pregnant before. My doctor said that I also have a fibroid, really small though, around 2 cm which obviously makes my effords quite more difficult. He suggested me though to take supplements such as folic acid and fish oils which I do. Folic acid was suggested to me for low hemoglobin levels also. I have stopped folic acid cause I have started taking pregnacare conception pills for almost a montn now. Was trying for 6-7 months for my first child. Please let me know if there is something I could do to conceive soon. Thank you
doctor
Answered by Dr. Shanti Vennam (23 minutes later)
Brief Answer:
Answered below.

Detailed Answer:
Hello,

Thanks for writing to us.

I have noticed certain facts in your history that are significant :
1. You and your husband do not have regular access to each other during the fertile period of every cycle, which in itself reduces the chances of conception.
2. You have had quite some time after your last pregnancy that ended up as an ectopic, before trying to conceive again. This implies that you need to test for tubal function.
3. The small fibroid, can be of significance in leading to difficulty in implantation if it is placed subendometrially. Treatment should be planned prior to conception if deemed. Medical or surgical management is possible.
4. Anemia can be of significance in causing low fertility rates and poor pregnancy outcomes and since you have this, it needs to be corrected. Folic acid and Iron may be needed.

So, in the current scenario, I would ask you to plan carefully taking into consideration your health, age and the access to intercourse. You should see an expert in high risk pregnancies to help you plan your fertile period. The fibroid also may be treated if needed. Ovulation status should be monitored for a couple of cycles to plan accurate timing. Tubal patency should be checked and a trans-vaginal sonogram done to look for any local pathology.

Please continue with the nutritional supplements. Please maintain a healthy weight and a healthy diet.

Hope your query has been answered. Please feel free to contact for further clarifications. I will be happy to help.

regards,
Shanti.V.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Shanti Vennam (15 minutes later)
Forgot to mention that all my cycles are stable. 28 days length. I gave up smoking almost a year ago and Im trying for a healthy diet. Shall I keep taking folic acid (folicil) once a day now that im taking pregnacare conception? (since it contains 400μg). Doctor also prescribed iron (emelin) but I dont take it since the gynecologist asked me not to for a while. Also, what kind of medical treatment can I take for the fibroid? In Cyprus they do only surgical treatments and I dont want to. Could u please advise me of the medical treatment? Thank you again
doctor
Answered by Dr. Shanti Vennam (7 minutes later)
Brief Answer:
Pregnacare would be sufficient.

Detailed Answer:
Hi,

Thanks for writing back.

You would be fertile around the 14th day of your cycle since you have 28-day cycles. This means an intercourse should be planned for a couple of days before to at least one day after this day.

It is good that you quit smoking and please keep on a healthy diet.

As you are taking pregnacare, the folic acid contained should suffice. You can also supplement by taking plenty of greens and milk.

Hope I have answered you. Please get back if you need any more information. I will be ready to help.

regards,
Shanti.V.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Shanti Vennam

OBGYN

Practicing since :1989

Answered : 7626 Questions

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What is the cause and treatment for infertility?

Brief Answer: Answered below. Detailed Answer: Hello, Thanks for writing to us. I have noticed certain facts in your history that are significant : 1. You and your husband do not have regular access to each other during the fertile period of every cycle, which in itself reduces the chances of conception. 2. You have had quite some time after your last pregnancy that ended up as an ectopic, before trying to conceive again. This implies that you need to test for tubal function. 3. The small fibroid, can be of significance in leading to difficulty in implantation if it is placed subendometrially. Treatment should be planned prior to conception if deemed. Medical or surgical management is possible. 4. Anemia can be of significance in causing low fertility rates and poor pregnancy outcomes and since you have this, it needs to be corrected. Folic acid and Iron may be needed. So, in the current scenario, I would ask you to plan carefully taking into consideration your health, age and the access to intercourse. You should see an expert in high risk pregnancies to help you plan your fertile period. The fibroid also may be treated if needed. Ovulation status should be monitored for a couple of cycles to plan accurate timing. Tubal patency should be checked and a trans-vaginal sonogram done to look for any local pathology. Please continue with the nutritional supplements. Please maintain a healthy weight and a healthy diet. Hope your query has been answered. Please feel free to contact for further clarifications. I will be happy to help. regards, Shanti.V.