What Does This Semen Analysis And Ultrasound Report Indicate?

Posted on Wed, 10 Dec 2014

Question: I am 35 years old and my wife is 33 years old. We have a child aged about ten years. Now, we want another child but my wife is not conceiving. We met a doctor who advised us for some tests and we undergone that tests. Now, I want to understand that reports and the medicines to be advised according to the reports. Please explain our reports and prescribe medicines. Also give certain advice in this regard. I am sending my semen analysis report and the reports of my wife of ultrasound and other blood tests, thyroid, urine tests etc. The period of my wife remains for only one and half days or two days only for few months. Before that it was remaining for 3 to 4 days. What is the cause for this.

Answered by Dr. Aarti Abraham (29 minutes later)

Brief Answer:
PLEASE PROVIDE FEW MORE DETAILS

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Please provide me with a few details firs t-
1. What is her height and weight ?
2. Since how long are you trying to conceive ?
3. What contraception has been used ?
4. Any problems while conceiving the first child ?
5. Any miscarriages ?
6. Does she have regular cycles ?
7. Apart from blood tests and ultrasound, has any other treatment been given so far ?
Looking forward to hearing from you.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (4 hours later)

Her height is about 5 ft and weight is about 49 kg., we are trying to conceive for about one year. No contraceptive pill or any other method has been used only condom has been used as a precautionary measure. There was no problem either in conceiving or delivering the first child and the delivery was normal. No miscarriage ever took place. In some months her period delayed for about seven, eight or ten days with symptoms of pregnancy but the pregnancy checking kit showed the test negative. She has a regular cycle on time but this month for the first time her cycle came five days before, perhaps taking the aforementioned medicines could have the reason I do not know. Apart from blood tests, ultrasound and urine test no other test or treatment has been given so far. Four about six months earlier e.coli was detected in her urine which was treated and cured. It has been noticed by us that for the last few months her period comes late by 5, 8 or ten days with pregnancy symptoms but the pregnancy kit shows it negative.

Answered by Dr. Aarti Abraham (11 hours later)

Brief Answer:
STEPS SUGGESTED.

Detailed Answer:
Hello
You need to have a complete workup as outlined below -
1. Complete internal exam by a gynecologist.
2. Hormonal levels - FSH, LH, TSH, Prolactin, DHEAS, Serum estradiol, OGTT.
3. Follicular monitoring. Siphene is a tablet given to induce ovulation, follicular monitoring uses serial ultrasound scanning to check the growth of the egg. It is important to check if she ovulated naturally or in response to clomiphene .
4. Your semen analysis should be done.
5. If 3 - 6 cycles of follicular monitoring show good ovulation, but no conception, then please go for a laproscopy to check if the fallopian tubes are open or not.
6. If there is no ovulation, higher dosages of injections / medications need to be given for stimulation.
Please go through the above mentioned workup and then revert.
I can see that the semen analysis and some hormonal workup has been done.
Am not able to make out the dates on any of the reports.
If the workup has been more than 6 months back, please repeat it, particularly the Serum Prolactin level, as it is borderline raised.
Take care.

Above answer was peer-reviewed by : Dr. Prasad