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Home > Community > Health  
Health Desk

Ask your doctor

Dr.Smita Lulla  MBBS, M.D, .D.G.O. (Gold Medallist),
Consultant Obstetrician & gynecologist at Qurum Clinic, Muscat since 20 years. Have had advanced training in U.K. in Obstetric & Gynecological Ultrasonography & Infertility.
Click here to ask your questions

Latest questions and answers

A) PCO (Polycystic ovaries)

Question


Dear doctor am 26 i cought into miscarrige by june o7 it is a 50days baby of i got pcod am taking metformin{bigomet 500mg twice\day}for the past one year i reduced 14kgs now iam planning for my pregnancy so am taking fertyl 50mg/5 tablets and susten 200mg from 14th day to 24the day now please tell me about the side effects of all this tablets though iam having fertyl and susten for the past 5months but our planning is by the month of august, i need your thoughts

Answer:You must monitor your ovulation while on fertyl. Have a scan done on day 12 of the period to determine your fertile period and also that your ovaries are not getting unduly enlarged. The side effects of fertyl are multiple pregnancy and ovarian cysts or hyperstimulation. Regarding susten,- like other progesterone medication, it can cause certain abnormalities in the fetus, though this is rare. The risks and benefits of the drug should be discussed with your doctor. All the best !


Question


Dear Doctor, I was diagnosed with PCOS last year. Prior to that I had heavy bleeding for a month, my gynec told me i had thick uterus lining and prescribed me aminor for 6 months. I do not get my periods regularily as well. I changed my gynea and the new one gave me glucophage and duphaston now. I am wondering if I need to take any ovulation inducer to conceive. I also am aware that ovulation predictor kits are not effective for my condition, could you suggest what treatment should I be going in for and how can I know exactly when I ovulate as I am really keen in ovulating. Due to PCOS i am overweight. My last scan showed a small decrease in the cysts. I am also on hunger suppresants. I don't like the idea of having many pills. Thank you

Answer:Firast of all, PCO stays forever, so the decrease in the size of the cysts, would usually not occur. . The size of the cysts may vary depending on the day of the cycle and medication. Have an ultrasound done on day 10 of the cycle to determine whether you are ovulating or not. If not, you may require clomid .Losing weight will help you conceive, so even though it is a difficult job, continue it ! All the best !          


B) INFERTILITY

Question


I am 41 years old and have 1 2 year old boy. I had undergone DNC last year and my husband and I have been trying to get one baby for more than 8 months but todate I still unable to conceive. I just would like to know is it after DNC chances of conceiving is difficult. Furthermore, my period now starting to be irregular, previously my period is 30 days but last month my period came after 19 days after my last period. Could you please me how can I improve my chances of concceiving. Dismayed

Answer:A D&C , by itself, does not increase the chances of conception. You must check whether you are ovulating or not. Since your periods are irregular, have an ultrasound done on day 10 of the cycle. This will determine your fertile period.If you are not ovulating, you might need clomid tablets. Also have your husband's semen checked and also your tubes by hysterosalpingography or laparoscopy.  Also, have your thyroid hormones checked. An abnormality in these can cause irregular  periods. Start taking folic acid tablets. You should be aware that the chances of conception reduce after the age of 35  and also that there is an increase in the incidence of congenital anomalies and miscarriage after that age. You must discuss these with your gynec. All the best !


Question


Hi,I am 26 year old married for 3 years and I have trouble in conceiving.I am getting treated with Dr.Kamini Rao in BACC. I had twice IUI but the result was not postive. Doc has told me that I am suffering from PCOS and one of my tube is little bit bend and endometrial is not progressing. This time when I went she told me to try naturally. And she is prescribed me with Diamet 500mg for whole month, Premarian 0.625 mg from Day 4 to day 18 3 times a day and from 19th day 2 times a day upto 28th day, Foliden 5 mg for whole month, Astymin forte for whole month and lastly duphston 10mg from day 19 ti Day 28. Has she given right prescription for trying naturally.

Answer: The treatment given is perfect. Since you are ovulating, you should conceive. Premarine will take care of the endometrium. Just relax mentally and try IUI for 3-4 cycles. You have not mentioned regarding your husband's semen report. If the count or motility are very low , he might require medication .  If you do not conceive after further 4 cycles of IUI, you may require IVF. All the best !


Question


i'am 33yrs old still i have not conceived, my doc has started usg, i got it done on my 3rd day of my periods & have been called on 24th of this month i.e 10th day, what is this done for. i also have thyroid, & my husbands counts are 30%,will i be preagnent of not,kindly suggest something.regards

Answer:Ultrasound is done to determine whether your follicles ( eggs ) are growing well and what would be your most fertile period. You have only mentioned the sperm motility. What is his count? What is the % of actively motile sperms ? Let me know , so I canadvice you further.Continue taking your medication for thyroid, as it is essential that the levels are normal when you conceive. Also, let me know the size of the follicle seen on day 10 and whether it grew to 20 mm or not. Also, have your tubes been checked ? Are they both OK ?


Question


Hi Doctor, Iam 24yrs old, i have hypothyroid and also pcos.....,i got married before 3months and i have been adviced by my doctor to take throxin 200ml,glyciphage 500ml and crisanta.My weight is 90kgs and height 5.5inches. Also dark skin is formed at the back of neck,arms and thighs.... please suggest a cream which will be available in India-chennai.Also please suggest me some ways to reduce weight and get concieved.

Answer:Continue your thyroxin, and glyciphage. You must excercise and go on a strict diet , eating only soup or  salads for lunch and at night eat some protein like fish or meat or chicken. If you are a vegetarian, eat daals or soya or sprouted beans at night. Cut down on bread, rice and chapattis. It would be also advisable to meet a dietician  . The darkness of the skin is common with PCO and you should see a dermatologist for that. Have an ultrasound done on day 10 of the period. If you are not ovulating, your doctor  can give you clomid tablets. All the best !


Question


 I am married for an year now and trying for a baby for the past few months. Also consulted a gynec and confirmed that I am ovulating. She advised me to take Duphaston from 16-25 days of my cycle. But she did not check on my medical history. I am slightly asthmatic and take Asthalin inhaler daily. Is it safe to take Duphaston with breathing problem? Also its been 8 days since I have stopped my this months course of Duphaston and yet to get my period. Kindly Advice.

Answer: Duphaston is fine with asthalin inhaler. If you have not yet got a period, do a urine test for pregnancy. All the best !


Question


I am married for 03 yrs now.Last year we were trying to conceive without any success for about 6-7 cycles. A series of tests followed on me and my wife, from A to Z.Finally all my tests(TB, AIDS,THYROID,SPERM COUNT AND CULTURE etc) were normal and endometriosis was detected for my wife. My wife is on inj. lupride for the past 02 cycles now and IVF is planned in the next cycle commencing 29 jun 08.My question is: 1. Is inj. lupride given to stop bleeding during menstrual cycle so that endometriosis doesn't aggravate( as my wife did not bleed during her menses for the last two cycles)? 2. What are the chances of An IVF being successful at this stage.My wife is 29 yrs, has had her menstrual cyccles at a perfect regular interval of 28 days since beginning,all hormone tests i.e. E2, LH, FSH are normal,no TB infection. But one of the fallopian tubes was found to be slightly blocked during hysterolaproscopy done in Mar 08.

Answer: Lupride would help to prevent an increase in the endometriosis. It also cuts down on certain  natural occurring hormones in the body. This would help in regulating the response obtained when injections are given to grow the eggs during the IVF cycle. The success rate of IVF changes from centre to centre and is also dependent on various factors . Since your wife is young and if your semen parameters are absolutely normal, the chances are good - around 25-30 % .. All the best !


Question


hi doctor, me and my huuband is trying to have a secound baby, and tried for 4 month now, and last month we had every alternate days sex but still didnt coneveive can u help me for this?

Answer: You have not mentioned whether you are ovulating or not. Have an ultrasound done on day 11 of the cycle. This will determine whether you are ovulating or not and your fertile period . If you are not ovulating, you may need medication like clomid, which you can discuss with your doctor. Also, have your husband's semen examination done. If you do not conceive in 2-3 months , have your fallopian tubes checked by hysterosalpingography (HSG ) or laparoscopy.  HSG can be done without anaesthesia and does not require hospitalisation.Let me know the results, so I can advice you further.  All the best ! 


Question


Hello Doctor, I am 30 yrs old and we have been trying to conceive for a year naturally. Since the last 2 cycles have taken medical help and have been advised Folic Acid with Becadexamine and Metformin (cause of PCOS). From 3rd day of my cycle took a course of Fertyl and went for regular scanning. On day 13 my Follicle size is LHS 15mm n 16 mm and RHS is 24 mm n 22 mm and ET is 8. I was given an HCG injection on day 13th. IS the treatment on the right track. Last time I ovulated on day 15th with the Follicle size of 18 mm and 12 mm. Please help, Im really worried and need your expert advise.

Answer: You are on the right track. Continue the same medication and follicular scans. You have not mentioned regarding your husband's semen and also whether your tubes have been checked or not. Let me know the results, so I can advice you further. Please mention again at that time that you are taking fertyl, as I will not have any record of your previous question and the questions are sent to me by omanaccess without the person's name for privacy purposes. All the best !


C) PREGNANCY

Question


i am married now for 2 years,im 28 years, and started planning for more than a year now, i have been put on course of 'susten', but i have been told that susten can cause disability in the fetus, is this true.?

Answer: Susten, like other progesterone medication, can cause certain abnormalities in the fetus, though this is rare. The risks and benefits of the drug should be discussed with your doctor.


Question


i took a blood test possitive but faint another day later it was a 5 took another one neg doc done sona gram did not see nothing also oral exam still could not tell me if iam preg or not help

Answer:The best method would be to determine the actual level of hcg in the blood. If it is below 5 , you are not pregnant. Let me know that result, so I can advice you further. All the best !


Question


I am 35 weeks pregnant and i am having the last couple of days a very dark discharge and i am worried what it is about, because like 2 months before i had a vaginal swab and had UTI and was treated, i have no itchiness nothing and the discharge this time is darker and i am having really really painful braxton hicks. so i want to know what this discharge could be

Answer:if the discharge is brown, it could be blood. See your obstetricain to determine that you are not having premature labour pains.


Question


hi i have a simple quesition,i m pregnant now almost 22 weeks i m very fat can i do diet and excercices 2 lose some kl like 10 kg or it ll afect the baby pls i m waiting 4 ur answer. Thanks

Answer:You have to put on 10-15 kilos during pregnancy and now at a rate of 1 kg every 15 days, so that your baby grows well. Use low fat milk, yoghufrt and avoid high fat foods like chocolate, ice creams etc. Have a lot of protein. If you were overweight before pregnancy, you have to lose weight only after you deliver.


Question


Is it safe to take ecospring 75 during 2-3 month? Doctor suggested to my wife. He said because of one miscariiage it is advicable to take it. We dont know the reason of first miscourrage. pl guide us.

Answer:Ecosprin 75  is safe in pregnancy and often helps to prevent a miscarriage/ All the best for this pregnancy!


Question


Dear Sir/Mam, I am undergoing treatment for thyroid and am two months pregnant weighing 75 kgs. Pls help me with some diet tips to maintain my weight and take good care of my child in womb? Awaiting for your help and advice. Regards Kavitha

Answer:You must ensure that your thyroid levels remain normal during pregnancy, by taking the correct dose of your medication.Ensure that you eat a lot of protein and salads. Avoid fats and sweets , so that you do not put on excess weight. You should put on 1 kg every 15 days now and only in the last 4 weeks 1 kg every week.  


D) OTHERS

Question


hi. i had my first period when i was 10 and ever since then i can't remember having a regular monthly period. at age 19, i was given diane to regulate my periods but still no regular pattern. i'm now 25 and is planning to have a baby soon. i was told by my doctor recently to take duphaston but since i was kinda pre-ocupied then i didn't understand how to take it, could you give me a clear instructions about the drug? thanks.

Answer: Duphaston can be given for various conditions and in different doses . Usually it is given twice a day for 5 days to induce a period. Now , since you are planning a pregnancy, determine whether you are ovulating or not. Have an ultrasound done on day 11 of the cycle. This will determine the size of the follicle ( egg) and also whether you have PCO ( polycystic ovaries ) which maybe giving  rise to the irregular periods. If you are not ovulating , you may require clomid tablets, which you must discuss with your doctor regarding the dosage and follow- up.


Question


I am 29 years old. i am married but never get pragnent.last 2 years i have got milk sicretion from my best without any reason. i want to no why.

Answer:Have your prolactin hormone checked. A high level can give rise to milk secretion and even prevent conception. If it is high, take medication like dostinexor parlodel


Question


hi there, im 3days delayed on menstruation, last month i had mens on May 7th but up until now i still dont have,then i have some slight but can handle the pain on my left side of abdomen. sometimes i feel back pain on the lower left side of my back while sitting or lying bed. am i pregnant? is it signs of pregnancy? i already experience 2 preganancies and i felt same slight pain on my left side of abdomen. thanks and i hope u can help me out.

Answer: If you still have not got a period, check your urine for pregnancy. If you have got a period,have an ultrasound done to determine whether you have an ovarian cyst or a fibroid which is giving you this pain.


Question


Dear sir/ Madam I got this mail id from net, Iam undergoing treatment for infertility (irregular menstruration, mensus on eprate), I am suffering from PCOS and Fibroid, 3 months back we did laparoscopy treatment to punture the pcos and also removed the fibroid. Dr advised me to wait for atleast 4 months to conceive a baby, and also advised us to have protected sex from the second month from the date of operation.But we are not using condems instead he will remove when he reach the climax but i have a doubt if 1 or 2 drops get inside or not. Now it is almost 3 months over I didnt get periods so she suggested me to take susten 300 - 5Nos each day 1 tablet tablets continously for 5 days for getting the periods, I have taken 4 and forget to take the last one, one week passed still I didnt get my periods so i have a doubt whether i am pregnant or i can wait for some more time or any otherlelse due to forget of last tablet. Kindly suggest Deepa

Answer: you must have got your period by now or you maybe pregnant. If you have not checked for pregnancy, do a urine test to confirm that. If still negative and no period, take duphaston tablets 2 tablets twice a day for 5 days to get a period. You should get a period within 7 to 10 days of stopping the duphaston.


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