31 yrs old patient secondary infertility want to concieve . her reports she brought along. hsg normsl nd even husband semen analysis. what further advises nd steps be taken in this case for her conception ?

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start antidiabetic drug.do USG for ovary and any endometrial pathology.FSH,LH,prolactine to be done.evaluation h/o d&c,mtp,TB,PID,CU-T,Treatment in past of any STD.Once do diagnostic hysteroscopy and laparoscopy.if any disturb tuboovarian relationship is their correct it.take Endometrial biopsy.what is her menstrual pattern?

First of all rule out PCOS and hypothyroidism. If her cycles are regular, go for follicular studies without inducing with C.C... Then SOS induce with C.C as per the dose needed.. U can add Tab.Metformin 500mg BD just before meals.. It would give very good results in higher ppbs as well in PCOS..

get an ogtt with 75 gms glucose done to rule out dm.. if her periods are regular and as the reports show, all is normal, then you can start with metformin and ovulation induction with clomiphene 50 mg... first two cycles with timed intercourse and subsequently with iui

I agreed with Dr. Ankur shah .... Just do an USG to rule out PCOS ..
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*first thing try to detect tha actual cause for failure of conception,, Do. usg whole abdomen manage sugar leve+ thyroid * do use on 14day from Last manstrul period for seeing proper OVULATION is occur or not * chek hormonal caus FSH,, LH * see for sperm mortality in man semen Do Test- TORCH for any othee problems advised proper coitus position lower head + buttock up

PPBS is high right! Is she obese?? Get done with HbA1C. Get done with USG Abdomen, KUB, FSH, LH. R/O PCOS Start on Metformin 500mg SR anyways

she is anaemic and pre diabetic obase?? controll consult obstretition for follow up further tt

I'm her obstetrician nd infertility specialist too
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Start metformin do usg ovulation investigation unprotected sex check amh if no result try IVF

Dear Dr chintan as PT age is 31 plz do AMH to know ovarian reserve also do fresh FSH LH and PRL put PT on cc and look on follicular monitoring Thank you

Very true
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Control diabetes.

Hello Dr.Chaudhary, very interesting. I have succeeded 36 cases of primary and secondary infertility cases, which includes due to hypothyroidism & failed IVF for 3 times. Many cases of infertility results pregnancy within 1yr of treatment with homoeopathic medication. For infertility, I treat both the partners, to avoid incordination. Cases must be studied well. At least for routine sake, she can take Nat.mur.0/3, bds & Saraca.India.Q/20 drops bds. Report after 1 month.

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