failure to conceive

I have been trying to conceive for the past two years without any success. I have also been suffering from painful periods. Please suggest a way out.

In order to get pregnant you need to produce healthy eggs, you must have well-functioning fallopian tubes (either of the two tubes along which eggs travel from the ovaries to the uterus) and your husband’s semen should have normal sperms. However, on rare occasions women have difficulty even if all these conditions are fulfiled. This is called unexplained infertility which may be associated with a disease called endome-triosis. To determine the problem in your case first ask your husband to get his semen analysed. Then you undergo blood tests and a ultrasonograph (USG) check-up to examine if your ovulation (egg formation and discharge) has any problem. The condition of the tubes can be assessed by an x-ray or a laparoscopic examination. Since you have painful periods, it is better to undergo a laparoscopy to look for endometriosis as well. The results of the tests will decide the mode of treatment.

pregnancy blues

I am a 34-year-old married woman. I have been suffering from diabetes for the past four years. I have to take several medicines to keep blood sugar under control. Do you think I will be able to conceive'

Pregnancy in diabetic women carries some risks, which include congenital abnormalities in the baby, growth problems inside the uterus and so on. However, the risks can be cut down if you conceive when diabetes is under control. Blood sugar needs to be monitored carefully throughout the pregnancy. You should consult a gynaecologist and a diabetologist for pre-pregnancy counselling. In fact, you’ll need a team of doctors (comprising a gynaecologist, a diabetologist, a paediatrician and a radiologist) to look after you during pregnancy.

ovarian cyst

I am 28. Last week an ultrasonograph test detected cysts in my ovaries during a routine check up. A doctor suggested me to get them removed through a surgical operation. Is it the only way to get rid of the problem'

It depends on the nature and the size of the cysts. It seems you do not have any symptom of pain or discomfort. Small water-filled cysts are common at your age and they tend to resolve on their own. These are called functional cysts or simple cysts. If the cysts appear to contain clear fluid and are less than five cm in diametre, a repeat ultrasonograph should be done after six-eight weeks. However, if the cysts are six cm or more in size, or if they contains solid areas or blood (complex cyst), or if they cause pain, then they need to be removed. This is usually done by laparoscopy, although very large cysts or twisted cysts may need open surgery.

hormone therapy

I am 47. My periods stopped six months ago. Still I am experiencing severe hot flushes. Can I take hormone replacement therapy (HRT)' Isn’t it associated with serious side-effects'

Some recent studies indicate certain risks associated with HRT. However, these risks are linked to long-term HRT in older women. Current international consensus is that HRT may be used safely for a short period for relief of symptoms during menopausal transition. You need to see a gynaecologist as HRT should be monitored by a specialist. Or else there will be complications later. Also, it cannot be used in some conditions in which less effective non-hormonal alternatives are useful.

irregular periods

My 17-year-old daughter has irregular periods. She has also developed facial hair. What could be the problem'

Your daughter is probably suffering from polycystic ovarian disease (PCOD). In this condition, there are multiple tiny cysts in the ovary which cause a hormonal imbalance. She will need some blood tests and a USG, following which she should be on hormonal medication. You need to take your daughter to a gynaecologist.