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What Causes Delayed Ejaculation While On Medication For Prostate Enlargement?
Question: Hi I have used prostate medication for 4 months. Suddenly I am not at all ejecting any sperms.tried 4 days no ejection at all in 4 attemps. Earlier every thing waas fine. Now I am scared as we planned baby. Can you tell me the procedure
Brief Answer:
Probably due to the medications taken for prostate enlargement. Reversible
Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.
Please mention the drug's name.
Assuming that you mean medications for prostate enlargement, I advice the following.
Medications for benign prostatic hypertrophy (BPH) may cause abnormal or dry ejaculation.
This is reversible and can be managed by reducing the frequency of medications without much compromise in therapeutic effects.
I would suggest that you take the medications every alternate day (after confirming with your consulting doctor)
Please mention that you are trying for a baby and they can advice you to take medications to enable ejaculation.
This will take a few days but don't worry, it is reversible
Hope this helps.
Please let me know if there is anything else I can help you with.
Wish you good health,
Regards,
Dr. Shuba Hariprasad
Probably due to the medications taken for prostate enlargement. Reversible
Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.
Please mention the drug's name.
Assuming that you mean medications for prostate enlargement, I advice the following.
Medications for benign prostatic hypertrophy (BPH) may cause abnormal or dry ejaculation.
This is reversible and can be managed by reducing the frequency of medications without much compromise in therapeutic effects.
I would suggest that you take the medications every alternate day (after confirming with your consulting doctor)
Please mention that you are trying for a baby and they can advice you to take medications to enable ejaculation.
This will take a few days but don't worry, it is reversible
Hope this helps.
Please let me know if there is anything else I can help you with.
Wish you good health,
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by :
Dr. Naveen Kumar
I was using afdura for last 4 months. Doctor asked me to change medicine to veltam-f.
My sperm motility is 42%(progressive motility-a) and non progressive motility is 15.
Sperm concentration is 45 per ml and total sperm count is 112 ml for 2.5ml. Normal forms 9%. Are these reports are OK for conceving
My sperm motility is 42%(progressive motility-a) and non progressive motility is 15.
Sperm concentration is 45 per ml and total sperm count is 112 ml for 2.5ml. Normal forms 9%. Are these reports are OK for conceving
Brief Answer:
Semen analysis - fine.
Detailed Answer:
Hello,
Thank you for the follow up.
Veltam-F is usually better tolerated, in terms of systemic effects like dizziness, low blood pressure) in comparison to afdura.
However this may also cause abnormal ejaculation.
Your semen analysis is good. Count and motility is fine. Morphology can be better.
However, one analysis is not enough to give accurate picture. Multiple analysis (2-3) over a period of 10 days. Abstinence of atleast 3days is required before taking the test.
Your analysis is fine and I do not recommend repeat analysis. Quit smoking and alcohol (if you do). Exercise daily and strengthen abdominal, back and pelvic muscles to improve muscle tone and circulation.
Try to time intercourse as far away from the time of medication as possible. Ideally more than 10 hrs
If you still face abnormal ejaculation, see your urologist to ask about reducing the frequency of meds to once every alternate day. The frequency and dosage of the medication will need to be tolerated based on your response.
Each person responds differently to medicines and it will take a while to reach a proper regime with minimal side effects.
Don't worry, it is definitely possible to get pregnant with these results. Just maintain healthy lifestyle and diet.
Hope this helps.
Please let me know is there is anything else I can help you with.
If not, please close this discussion and rate my answer.
Wish you good health and hope you have good news soon
Regards,
Dr. Shuba Hariprasad
Semen analysis - fine.
Detailed Answer:
Hello,
Thank you for the follow up.
Veltam-F is usually better tolerated, in terms of systemic effects like dizziness, low blood pressure) in comparison to afdura.
However this may also cause abnormal ejaculation.
Your semen analysis is good. Count and motility is fine. Morphology can be better.
However, one analysis is not enough to give accurate picture. Multiple analysis (2-3) over a period of 10 days. Abstinence of atleast 3days is required before taking the test.
Your analysis is fine and I do not recommend repeat analysis. Quit smoking and alcohol (if you do). Exercise daily and strengthen abdominal, back and pelvic muscles to improve muscle tone and circulation.
Try to time intercourse as far away from the time of medication as possible. Ideally more than 10 hrs
If you still face abnormal ejaculation, see your urologist to ask about reducing the frequency of meds to once every alternate day. The frequency and dosage of the medication will need to be tolerated based on your response.
Each person responds differently to medicines and it will take a while to reach a proper regime with minimal side effects.
Don't worry, it is definitely possible to get pregnant with these results. Just maintain healthy lifestyle and diet.
Hope this helps.
Please let me know is there is anything else I can help you with.
If not, please close this discussion and rate my answer.
Wish you good health and hope you have good news soon
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by :
Dr. Sonia Raina
Hi my name is XXXX wife of XXXXX
We are married since 2.8 years and trying for pregnency since 2.5 years, i am not getting regular periods till i take pills afer marriage.before marriage my cycle was with 32 days for one cycle and 42 days for my next cycle. i was given conterceptive pills for 7 months. i had pcod for my left ovary. I am done with my SSG on 1st december 2014 with result -Free fluid in pod. .
initally i have under gone 5 cycles with clomefine citrate and hormons with folicular study(size was aprox about 18 - 22mm). They have given me metformin but i could't use it.
took 3 months break(with no medicanes) and started ayurvedic medicine for pcod with clomefine citrate for 4 cycles with their suggestions . Totally i completed 9 cycles of clomefine cirtate.
Now we shifted to banglore and consulted new doctor we are planning to go for IUI, but he said i need to go for HSG once again.
can't we proceed with IUI based on previous SSG.
Do we really need HSG again? can i proceed with IUI without HSG now.
I am getting regular period with clomefine citrate. does it mean that i am ovulating? actully i was given lutigen gold injection on day 14 and they never checked whether ruptured or not.
My LMP was on 3/05/2016. day 3 scan is as follows:
uterus : Ante verted ante flexed
length : 5.6 cm
AP: 3.7 cm
Transverse : 3.1 cm
Endometrial Thickness : 4.6 mm
Right Ovary : 2.0*2.5*1.9 cm- volume -5.0 CC Accessible PV and XXXXXXX , 7 Small GFS
Left Ovary : 2.6*1.3*2.6 cm- volume -4.6 CC Accessible PV and XXXXXXX , 12 Small GFS , PCOM
POD: no free fluid
IMPRESSION: sonologically normal uterus, right overay normal, Left ovary polycystic morphology
Blood Reports: taken on day 5 (6/5/2016)
Hemoglobin - 11.1 g/dl, O+ group.
Glucose -Ramdom (RBS) - 107 mg/dl (Ref 50-150)
THS(Thyroid) - 1.70 uIU/ml (ref 0.35 - 4.94)
you can check my husband's reports in his previous question.
We are married since 2.8 years and trying for pregnency since 2.5 years, i am not getting regular periods till i take pills afer marriage.before marriage my cycle was with 32 days for one cycle and 42 days for my next cycle. i was given conterceptive pills for 7 months. i had pcod for my left ovary. I am done with my SSG on 1st december 2014 with result -Free fluid in pod. .
initally i have under gone 5 cycles with clomefine citrate and hormons with folicular study(size was aprox about 18 - 22mm). They have given me metformin but i could't use it.
took 3 months break(with no medicanes) and started ayurvedic medicine for pcod with clomefine citrate for 4 cycles with their suggestions . Totally i completed 9 cycles of clomefine cirtate.
Now we shifted to banglore and consulted new doctor we are planning to go for IUI, but he said i need to go for HSG once again.
can't we proceed with IUI based on previous SSG.
Do we really need HSG again? can i proceed with IUI without HSG now.
I am getting regular period with clomefine citrate. does it mean that i am ovulating? actully i was given lutigen gold injection on day 14 and they never checked whether ruptured or not.
My LMP was on 3/05/2016. day 3 scan is as follows:
uterus : Ante verted ante flexed
length : 5.6 cm
AP: 3.7 cm
Transverse : 3.1 cm
Endometrial Thickness : 4.6 mm
Right Ovary : 2.0*2.5*1.9 cm- volume -5.0 CC Accessible PV and XXXXXXX , 7 Small GFS
Left Ovary : 2.6*1.3*2.6 cm- volume -4.6 CC Accessible PV and XXXXXXX , 12 Small GFS , PCOM
POD: no free fluid
IMPRESSION: sonologically normal uterus, right overay normal, Left ovary polycystic morphology
Blood Reports: taken on day 5 (6/5/2016)
Hemoglobin - 11.1 g/dl, O+ group.
Glucose -Ramdom (RBS) - 107 mg/dl (Ref 50-150)
THS(Thyroid) - 1.70 uIU/ml (ref 0.35 - 4.94)
you can check my husband's reports in his previous question.
Brief Answer:
IUI first for 3 cycles, then HSG if no Pregnancy
Detailed Answer:
Hello,
Thank you for your query.
I'm sorry that I couldn't reply sooner.
Trying to conceive can be exciting or frustrating and I completely understand your concerns.
I've gone through your query and would appreciate it if you could, please, clarify a few things for me?
1) how old are you? have you had any surgeries in the past?
Any pelvic infections?
2)what is you height and weight?
3) have you tried using the basal body temperature monitoring method to pinpoint your ovulation date (along with ovulation prediction kits - OPK) while using clomiphene?
4)did your doctor say that you have PCOS in only one ovary?
5)your SSG report - free fluid in the Pod. Did it mention the patency of the fallopian tubes? (free fluid can be present even if only on tube is present)
6)any history of PCOD is your family? Mother, sister, first cousins?
7)why couldn't you use metformin?
8)have you ever done a day 2 or day 3 study of your hormones (FSH, LH, estradiol)? Have you checked cholesterol, triglyceride levels?
9)do you have any hair loss, difficulty losing weight, excess facial hair?
10)any other medical issues /medications?
A hysterosalpingogram (HSG) is different from salinesonography( SSG).
Although both are done to check for tubal potency, there are some differences.
Hsg - can show us any partial blockage in the tubes or intra uterine abnormalities whereas SSG shows is if the tubes are patent (partially or fully - doesn't differentiate that)
To answer your queries :
- if both your fallopian tubes were normal and patent, and you have no history of surgeries/pelvic Infections, you can wait for the Hsg.
I recommend that you try ovulation induction with Intrauterine insemination (IUI) for 3 cycles. If no pregnancy occurs, then a Hsg may be required.
-your blood reports show mild anemia. Otherwise normal. I recommend iron rich diet. Take a folic acid supplement daily. (folvite 5mg)
-scan shows normal sized ovaries with a tendency for Polycystic ovaries.
-having regular periods usually means that you ovulate but the only ways of confirming this is either by a follicular study which shows a mature follicle collapsed and free fluid in the pod or a rise in basal body temperature when you monitor this.
I recommend
- moderate exercise and nutritious diet to enable weight loss (if over weight)
-trying ovulation induction with IUI for at least 3 cycles.
If this doesn't help, you may want to consider other modes therapy (laparoscopic ovarian drilling to balance the hormones, in vitro fertilization - IVF)
Your husband semen analysis is fine. Can be better, but it is enough to try for Iui. As mentioned, one analysis alone is not enough to judge sperm quality.
Hope I've answered your queries.
Please let me know if there is anything else I can help you with.
Wish you good health and hope you conceive soon.
Regards,
Dr. Shuba Hariprasad
IUI first for 3 cycles, then HSG if no Pregnancy
Detailed Answer:
Hello,
Thank you for your query.
I'm sorry that I couldn't reply sooner.
Trying to conceive can be exciting or frustrating and I completely understand your concerns.
I've gone through your query and would appreciate it if you could, please, clarify a few things for me?
1) how old are you? have you had any surgeries in the past?
Any pelvic infections?
2)what is you height and weight?
3) have you tried using the basal body temperature monitoring method to pinpoint your ovulation date (along with ovulation prediction kits - OPK) while using clomiphene?
4)did your doctor say that you have PCOS in only one ovary?
5)your SSG report - free fluid in the Pod. Did it mention the patency of the fallopian tubes? (free fluid can be present even if only on tube is present)
6)any history of PCOD is your family? Mother, sister, first cousins?
7)why couldn't you use metformin?
8)have you ever done a day 2 or day 3 study of your hormones (FSH, LH, estradiol)? Have you checked cholesterol, triglyceride levels?
9)do you have any hair loss, difficulty losing weight, excess facial hair?
10)any other medical issues /medications?
A hysterosalpingogram (HSG) is different from salinesonography( SSG).
Although both are done to check for tubal potency, there are some differences.
Hsg - can show us any partial blockage in the tubes or intra uterine abnormalities whereas SSG shows is if the tubes are patent (partially or fully - doesn't differentiate that)
To answer your queries :
- if both your fallopian tubes were normal and patent, and you have no history of surgeries/pelvic Infections, you can wait for the Hsg.
I recommend that you try ovulation induction with Intrauterine insemination (IUI) for 3 cycles. If no pregnancy occurs, then a Hsg may be required.
-your blood reports show mild anemia. Otherwise normal. I recommend iron rich diet. Take a folic acid supplement daily. (folvite 5mg)
-scan shows normal sized ovaries with a tendency for Polycystic ovaries.
-having regular periods usually means that you ovulate but the only ways of confirming this is either by a follicular study which shows a mature follicle collapsed and free fluid in the pod or a rise in basal body temperature when you monitor this.
I recommend
- moderate exercise and nutritious diet to enable weight loss (if over weight)
-trying ovulation induction with IUI for at least 3 cycles.
If this doesn't help, you may want to consider other modes therapy (laparoscopic ovarian drilling to balance the hormones, in vitro fertilization - IVF)
Your husband semen analysis is fine. Can be better, but it is enough to try for Iui. As mentioned, one analysis alone is not enough to judge sperm quality.
Hope I've answered your queries.
Please let me know if there is anything else I can help you with.
Wish you good health and hope you conceive soon.
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by :
Dr. Prasad
Thank u very much for ypur valuble suggestions, Here are my details u asked for...
i also have some doubts i mentioned below please have a look at them.
1) i am 26 years old, No surgeries, No pelvic infections
HIV 1 & 2 - 4th Generation, p24 Ag & Abcombination assay,
HBsAg,
Anti HCV antibody
are all non -reactive to me and my husband.
2) Height - 154 cm, weight - 47.3kgs, BP Normal, BMI 19.9.
at present i look slim only i became some what fat when i was given harmones((clomefine, humog, lutezen gold, duphaston for 4 cycles) but my weight was around 47 all time since marriage
before marriage i used to be 40 to 43 kgs. i asked them to stop humog and see whether i get size they did and stopped humog for remaining cycles. right side folicule got 20 mm for first cycle and left side got 20 to 22 mm for all remaining 3 cycles.
3) NO i did'nt, try using the basal body temperature monitoring method to pinpoint
ovulation date (along with ovulation prediction kits - OPK) while using clomiphene.
no one suggested me to do so.
4) my Pcos report is not same all the time some times it is bilateral and some times like the above.
5) i was not given any report for SSG they said every thing is normal and wrote "Free fluid in pod" and said its normal for everyone.
6) My family members never tested for PCOD my mom has 3 chlidren she didnt test and my sister has regular periods she is not married young girl.
but 3 of us have facial hair.
7) i can't use "metformin" because i feel sore taste in my mouth, stomach full XXXXXXX no hunger, absence of mind, unable to do any work not even exercise
skin becomes black, looks some what fat and ugly but weight is constant 47.
8)yes, day 2 on 18/3/2015.
FSH is 5.46 IU/Ml
LH is 4.6 mlU/ml
estradiol day 2 was not checked but had one random value when i was in due of period for about 2.5 months it is 50.01pg/mL
Not checked cholesterol, triglyceride levels.
9)yes i have more hair loss, excess facial hair i do upper lip threading once in a month my mother, sister,cousins and my grandmother also has the same problem.
I used to be 40kgs to 43kgs before marriage and now i am around 47kgs....whether i look fat or slim my weight 47 is constant these days.
10)no other medical issues /medications other than fertility drugs.
i have few more questions
1)Can u tell me the procedure to monitor the temperature i will check it when i go for ovulation induction through IUI.
2) Can u tell me, what could be the cases and the reasons for not conseving naturally and in my 9 cycles of clomefine citrate?
actually my husbands seman analyis was not checked for first 5 folicular study test and OI.
my husband's motility was 18% when tested after that.
and the remain 4 cycles where take by ayurvedic doc suggestion no scan monitoring with mine.
my husband husbands motility got improved to 42% with some medications.
can u suggest us what should be our next genune step.
I can go for HSG before IUI if required. Do i get any infections with this procedure for doing 2 times?.
actually when i was done folicular study and OI with harmones(clomefine, humog, lutezen gold, duphaston for 4 cycles).
i became like a person that dosent look like me actually( black, fatty, dull).
will it be same with IUI????
I also had a question,
MY LMP was 03/05/2016, the bleeding was heavy on 5th and 6th. it lasted till 8th 6 days this time and today is day 10 i am still getting brown thread like discharge 2 to 3 times a day with some mild cramps in my abdomen (probably left side)
shall i go to doctor now regarding this problen or it is normal??? days 3 scan for this cycle is mentioned in the previous message.
usually i have 5 days period ( with 1,2 days lite, 3,4 heavy and 5th day lite period then stop). i didnt take clomefine for this cycle.
i also have some doubts i mentioned below please have a look at them.
1) i am 26 years old, No surgeries, No pelvic infections
HIV 1 & 2 - 4th Generation, p24 Ag & Abcombination assay,
HBsAg,
Anti HCV antibody
are all non -reactive to me and my husband.
2) Height - 154 cm, weight - 47.3kgs, BP Normal, BMI 19.9.
at present i look slim only i became some what fat when i was given harmones((clomefine, humog, lutezen gold, duphaston for 4 cycles) but my weight was around 47 all time since marriage
before marriage i used to be 40 to 43 kgs. i asked them to stop humog and see whether i get size they did and stopped humog for remaining cycles. right side folicule got 20 mm for first cycle and left side got 20 to 22 mm for all remaining 3 cycles.
3) NO i did'nt, try using the basal body temperature monitoring method to pinpoint
ovulation date (along with ovulation prediction kits - OPK) while using clomiphene.
no one suggested me to do so.
4) my Pcos report is not same all the time some times it is bilateral and some times like the above.
5) i was not given any report for SSG they said every thing is normal and wrote "Free fluid in pod" and said its normal for everyone.
6) My family members never tested for PCOD my mom has 3 chlidren she didnt test and my sister has regular periods she is not married young girl.
but 3 of us have facial hair.
7) i can't use "metformin" because i feel sore taste in my mouth, stomach full XXXXXXX no hunger, absence of mind, unable to do any work not even exercise
skin becomes black, looks some what fat and ugly but weight is constant 47.
8)yes, day 2 on 18/3/2015.
FSH is 5.46 IU/Ml
LH is 4.6 mlU/ml
estradiol day 2 was not checked but had one random value when i was in due of period for about 2.5 months it is 50.01pg/mL
Not checked cholesterol, triglyceride levels.
9)yes i have more hair loss, excess facial hair i do upper lip threading once in a month my mother, sister,cousins and my grandmother also has the same problem.
I used to be 40kgs to 43kgs before marriage and now i am around 47kgs....whether i look fat or slim my weight 47 is constant these days.
10)no other medical issues /medications other than fertility drugs.
i have few more questions
1)Can u tell me the procedure to monitor the temperature i will check it when i go for ovulation induction through IUI.
2) Can u tell me, what could be the cases and the reasons for not conseving naturally and in my 9 cycles of clomefine citrate?
actually my husbands seman analyis was not checked for first 5 folicular study test and OI.
my husband's motility was 18% when tested after that.
and the remain 4 cycles where take by ayurvedic doc suggestion no scan monitoring with mine.
my husband husbands motility got improved to 42% with some medications.
can u suggest us what should be our next genune step.
I can go for HSG before IUI if required. Do i get any infections with this procedure for doing 2 times?.
actually when i was done folicular study and OI with harmones(clomefine, humog, lutezen gold, duphaston for 4 cycles).
i became like a person that dosent look like me actually( black, fatty, dull).
will it be same with IUI????
I also had a question,
MY LMP was 03/05/2016, the bleeding was heavy on 5th and 6th. it lasted till 8th 6 days this time and today is day 10 i am still getting brown thread like discharge 2 to 3 times a day with some mild cramps in my abdomen (probably left side)
shall i go to doctor now regarding this problen or it is normal??? days 3 scan for this cycle is mentioned in the previous message.
usually i have 5 days period ( with 1,2 days lite, 3,4 heavy and 5th day lite period then stop). i didnt take clomefine for this cycle.
Brief Answer:
Iui is safe
Detailed Answer:
Hello,
Thank you for the follow up & clarifications.
To address your concerns :
1) buy a. Digital thermometer with one decimal point, withe Celsius or in Fahrenheit.
Take your temperature first thing in the morning at the same time every day (half hour +/- is ok). Record this on a graph. There are online sites available (fertility friend) which helps you do this.
They also have tutorials and pictures which help you understand better)
At the end of the month, you should notice a slight elevation of temperature after you ovulate. It will be a biphasic chart- lower temperatures before and higher after ovulation. This helps to pinpoint date of ovulation. This rise is due to progesterone and will rise even if you take supplements (progesterone). Doing this for a couple of cycles without progesterone supplements will give you an idea of when you ovulate.
Using OPK helps to identify when this day is near. When the OPK is positive, ovulation usually occurs within 24-36 hrs. This helps by alerting you to the fertile period. Having intercourse during the day of ovulation and three days prior gives you the best chance of conceiving.
2) reasons could include-
-irregular intercourse
- too much of androgen in the body
-not ovulating
-semen quality
-clomiphen itself can produce too many cysts and have a negative effect on the endometrium that doesn't favor implantation.
Your FSH, LH, estrogen levels are perfect.
3)my recommendation
-check testosterone levels on day 2 of your cycle.
- letrozol instead of clomiphen for ovulation induction
-follicular study to check for follicle growth and to check rupture (ovulation)
-time intercourse from when your follicle is abt 18 mm till 2 days after it ruptures. At least once in 2.days. Note: some good scan centers follicular study as well (if your doctor is unavailable).
- don't use progesterone supplements for the first two cycles of the above.
-if not pregnant - next the same above with Iui on the day of ovulation. Iui does not have hormonal effect. They just put good quality sperm into your uterus directly. Takes just 5 minutes.
Ovulation induction medications or hormone injections may have some of the side-effects you mentioned.
I advice only letrozol with timed intercourse, then letrozol with IUI, and if that too doesn't work injections with Iui, and progesterone supplements after ovulation is confirmed.
HSG - to be done if no pregnancy results after trying two cycles of IUI.
If done properly, procedure itself doesn't pose risk of infection. XXXXXXX allergies are rare. Please inform your doctor if you have any allergies.
If your androgen levels are high, that needs to be treated prior to conceiving. If medications are prescribed, you should not try for a baby till the course is over.
Ovarian drilling may help alternatively. This depends on what you treating doctor chooses.
4)bleeding can occur. If the pain doesn't worsen and no fresh blood recurs, nothing to worry.
If your pain worsens or you have bright red blood gushing out, see your doctor immediately.
Fertility treatments are known to cause abnormal patterns of bleeding.
Try to have intercourse every alternate day from today - 11th day. Check your temperatures as mentioned above.
Do regular exercise. Avoid refined grains, too much red meat. Be healthy.
Hope to hear good news soon.
Hope I've answered your queries.
Please let me know if there is anything else I can help you with.
Regards,
Dr. Shuba Hariprasad
Iui is safe
Detailed Answer:
Hello,
Thank you for the follow up & clarifications.
To address your concerns :
1) buy a. Digital thermometer with one decimal point, withe Celsius or in Fahrenheit.
Take your temperature first thing in the morning at the same time every day (half hour +/- is ok). Record this on a graph. There are online sites available (fertility friend) which helps you do this.
They also have tutorials and pictures which help you understand better)
At the end of the month, you should notice a slight elevation of temperature after you ovulate. It will be a biphasic chart- lower temperatures before and higher after ovulation. This helps to pinpoint date of ovulation. This rise is due to progesterone and will rise even if you take supplements (progesterone). Doing this for a couple of cycles without progesterone supplements will give you an idea of when you ovulate.
Using OPK helps to identify when this day is near. When the OPK is positive, ovulation usually occurs within 24-36 hrs. This helps by alerting you to the fertile period. Having intercourse during the day of ovulation and three days prior gives you the best chance of conceiving.
2) reasons could include-
-irregular intercourse
- too much of androgen in the body
-not ovulating
-semen quality
-clomiphen itself can produce too many cysts and have a negative effect on the endometrium that doesn't favor implantation.
Your FSH, LH, estrogen levels are perfect.
3)my recommendation
-check testosterone levels on day 2 of your cycle.
- letrozol instead of clomiphen for ovulation induction
-follicular study to check for follicle growth and to check rupture (ovulation)
-time intercourse from when your follicle is abt 18 mm till 2 days after it ruptures. At least once in 2.days. Note: some good scan centers follicular study as well (if your doctor is unavailable).
- don't use progesterone supplements for the first two cycles of the above.
-if not pregnant - next the same above with Iui on the day of ovulation. Iui does not have hormonal effect. They just put good quality sperm into your uterus directly. Takes just 5 minutes.
Ovulation induction medications or hormone injections may have some of the side-effects you mentioned.
I advice only letrozol with timed intercourse, then letrozol with IUI, and if that too doesn't work injections with Iui, and progesterone supplements after ovulation is confirmed.
HSG - to be done if no pregnancy results after trying two cycles of IUI.
If done properly, procedure itself doesn't pose risk of infection. XXXXXXX allergies are rare. Please inform your doctor if you have any allergies.
If your androgen levels are high, that needs to be treated prior to conceiving. If medications are prescribed, you should not try for a baby till the course is over.
Ovarian drilling may help alternatively. This depends on what you treating doctor chooses.
4)bleeding can occur. If the pain doesn't worsen and no fresh blood recurs, nothing to worry.
If your pain worsens or you have bright red blood gushing out, see your doctor immediately.
Fertility treatments are known to cause abnormal patterns of bleeding.
Try to have intercourse every alternate day from today - 11th day. Check your temperatures as mentioned above.
Do regular exercise. Avoid refined grains, too much red meat. Be healthy.
Hope to hear good news soon.
Hope I've answered your queries.
Please let me know if there is anything else I can help you with.
Regards,
Dr. Shuba Hariprasad
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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