Hello,

Thanks for writing to us. I am trying to solve your problem.

Can you please upload all recent investigations including ultrasound report that you have done??

It will help me to assist you better and I will discuss everything in follow up section.

Waiting for your response and all reports.

Regards,
Dr soumen

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Hello XXXXXXX

Thanks for uploading your ultrasound report. Now, I am trying to discuss all things one by one.

A) As per information, you are suffering from irregular period for last 2 months. There are certain underlying pathology with you like ovarian cyst (20 mm) in left ovary, hypothyroidism (treated with eltroxin), presence of two small posterior uterine fibroid. Other co-existence factors are stress/ anxiety/ mental upset/ depression, irregular diet habit, high prolactin level, over weight or extreme loss etc.

Here, you need to take all prescribed medication (like eltroxin, meprate) with correct doses as per your doctor recommendation. If 10 days progesterone pill fails to regulate your cycle, then you may need to take cyclic hormonal therapy with progesterone ( 3 weeks on for 21 tabs and 1 week off to get period).

Some other general measures need to be taken:

1) Take balanced diet with folic acid & vitamin supplements. Drink more water or fluids. Eat more carotene based vegetables & fresh fruits.
2) Foods to be avoided in thyroid deficiency like cabbage, cauliflower, mustard, soy milk, soybean oil, radishes, broccoli, brussels’ sprouts, kohlrabi etc.
3) Control body weight by regular physical exercise. It helps to improve body circulation and fertility.
4) Try to avoid stress by regular yoga and XXXXXXX breathing exercise.
5) Maintain personal hygiene & take a sound sleep with complete relaxation.

B) Now, we come to CA 125 level & endometrial thickness (ET). It seems to normal ET at 9.8 mm, corresponding with proliferative phase of cycle.

CA-125 level at 52.10 U/ml is slight higher than normal level. Though, blood level of CA-125 is thought as a best marker for early detection of ovarian carcinoma, its fluctuation or slight increased level can be seen in some benign condition also like endometriosis, ovarian disease, menstruation, pelvic inflammatory disease (PID), diabetes etc. CA-125 test has limited specificity with low sensitivity in detection of Ca Ovary.

Palpable solid ovarian mass with raised level of CA-125 more than 65 U/ml or twice/ thrice of upper level of normal value gives some indication of ovarian carcinoma. Histopathological examination of ovarian tissue can confirm the same. In this age group (35 years), it is unlikely but you need to get examined by your consulting gynecologist and do other relevant investigation if necessary.

C) You are married for 8-9 years and without any pregnancy. Here, I want to suggest you to consult with infertility specialist regarding this.

In my opinion, it is better to undergo assisted reproductive technology (ART) without wasting any time for natural method of conception as your age is almost 35 years.

For this, you have to fulfill some criteria like 1) production of healthy ovum and proper ovulation. You may need ovulation inducer medication and here, serial follicular study is mandatory to get healthy ovum. 2) Healthy sperm from your husband- here normal semen analysis is mandatory. otherwise, sperm aspiration technique is applied to get healthy sperm.

ART includes- IVF (In Vitro Fertilization) where fertilization of healthy ovum & sperm take place outside the uterus in laboratory and embryo is implanted within your uterine cavity. Success rate is 35-40% in India and depends on acceptance of the uterus.

Other option is surrogate pregnancy (in case of failed IVF) which is widely acceptable as best modality of treatment for infertile couple. Here, fertilization takes place out side the uterine cavity with your own healthy ovum & sperm and embryo is transferred to uterine cavity of surrogate mother (other than you).

In case of unhealthy sperm/ ovum, you have to collect donor sperm/ ovum to make healthy pregnancy.

Hope, above information is very much sufficient and useful to you. If you have any other query, you feel free to ask.

You can directly consult with me by visiting my profile on WWW.WWWW.WW and press the button "ask me a question".

Wish your good health and have a good luck.

Regards,
Dr Soumen

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Hello,

Thanks for follow up query.

IUI or Intra Uterine Insemination is an alternative procedure of sexual intercourse or natural insemination. It is generally done in case of male infertility like

1) Abnormal low sperm count and poor quality sperm.
2) Husband with erectile dysfunction or Impotence / failure to deposit semen inside vagina.
3) Presence of anti sperm antibody etc.

Women having cervical mucus hostility and mild endometriosis are also the ideal candidate for IUI. It has success rate near about 15-20% per cycle.

In my opinion, you should consult with your infertility specialist at the earliest to make decision of the ART procedure after checking all your current reports & husband semen analysis report.

Please consult with our XXXXXXX support team for suitable doctor and hospital name or you can search doctor's profile according to your location & specialty (infertility/ reproductive medicine) in the home page.

If you do not have any clarifications, you can close the discussion and rate the answer.

Be well & stay healthy. Take care yourself.

Regards,
Dr Soumen

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