Infertility/Fertility/pregnancy

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Question
QUESTION: hi,

i am writing from Saudi Arabia, Riyadh
i am 24 years married woman.i got married in january 2012
and still not getting pregnant.
as doctors say i am fat. my height is 5'3 and weight is nearly
82 to 84.
i have irregular periods as the gap is so almost 2 to 3 months.
do help me in this regard.

many thanx,

ANSWER: Hello Happy from Saudi Arabia,

You didn't state a specific question but here are some facts for you to ponder:

1.  It takes the average woman 1 year to achieve pregnancy so until 1 year has passed, you would not be considered to have an infertility probem.
2.  If you have irregular menstrual cycles, then that is an indications that ovulation is not occurring properly.  Something is causing that dysfunction and needs to be evaluated.  That requires some blood tests, epecially for hormones to try to find out why.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate



---------- FOLLOW-UP ----------

QUESTION: hi again,
thanx alot for ur answer

yes i have my clear blood test report.
there is not any  problem shown in the blood .

only doctors say that i am over weight
thats y i dont get pregnent.

my main problem is pregnancy.
sorry i didnt mention it clearly in the last
mail.

only doctors prescribe me a daily walk  and
nothing else .

as my all other tests are clear
hormone + blood tests = clear

do let me know that
if ovulation dysfunctionality is there, then
only a daily walk could give positive
results???

Answer
Hello Again,

If you have irregular menstrual cycles, then that shows that the ovaries are not working properly.  That is an ovulatory dysfunction.  The specific tests that need to be done to evaluate this disorder are done on the second or third day of your period and are FSH, LH, Estradiol, Prolactin, TSH.  This is to rule out hypothalamic, pituitary and thyroid disorders and determine if only the ovary is the problem.  If an ovulation disorder is diagnosed, then the treatment is to use ferility medication to correct ovulation.  This is called "ovulation induction".

However, the body goes through 10 steps to achieve a pregnancy and so if you are not getting pregnant, then all 10 steps need to be evaluated.  This is called an infertility evaluation.  These tests are:
CD#2/3 hormone panel (as mentioned above)
Hysterosalpingogram
Hysteroscopy
Pelvic ultrasound
Semen analysis
Laparoscopy
Mid luteal phase progesterone (CD#20,21 or 22)
End cycle endometrial biopsy (CD#26,27 or 28)

Although walking is healthy, it is not an infertility treatment and does little to help one become pregnant.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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