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I am unable to conceive

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Hello Doctor, I am 29 years old. I was married 5 years ago. Me and my husband decided to have children 3 years ago but we couldn't. I was diagnosed with PCOD two years ago and am still on treatment. I was given oral contraceptive pills for a few months and also some anti diabetic drug, it was metformin twice daily. I have been using these medicines from about 2 years, there is no difference I am unable to conceive. Please help me and guide me what to do?

Category: Sexologist

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Category: Family Physician-GP
Dr. John Monheit is online now

Expert:  Dr. John Monheit replied 4 Days.

Hello, Thanks for writing to us

Poly cystic ovarian disease is a condition where there are disturbances in the ovulation, often followed by cyst formation In the ovaries. There could be some problem with fertility as in your case. Usually this condition is seen in association with obesity or overweight. There is hormonal disturbance and an increase in male hormones like testosterone. Because of excess fatty tissue, there is increased peripheral conversion of oestrogen to androgen. Also there is insulin resistance over a period of time further accentuating the imbalance in the hormonal status and so on, it is a vicious cycle.

Oral contraceptive pills are used to regularise the periods so that fertility can be regained. Metformin helps in treating obesity. But the best way to break this vicious cycle is to lose weight. Also a regular lab work must be done in your case like ultra sonogram abdomen and pelvis to find out ovarian condition, to know if there are any new cysts or increase in the pre existing cyst size. In poly cystic ovarian disease there is usually a decrease in FSH (follicle stimulating hormone), increase in LH (leutinizing hormone), oestrogen and testosterone.

There is an equal chance that your husband might be infertile. Assuming that your husband doesn't have any medical condition pertaining to the scrotum and testicles, I would like to advise that you get your husband's semen analysis done.

Hope this helps.

Dr. John Monheit
Category: Family Physician-GP
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
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