We have been trying to conceive for 2 years. How to achieve conception?

Question

Hi doctor,

I have been trying to conceive for about 2 years now. My prolactin is 31.8 ng/mL, progesterone is 4.1ng/mL, not opacified left fallopian tube and no free peritoneal spillage of contrast noted. My partner has varicocele. I had a shot of progesterone. Please provide some advice on how we can achieve conception.

Answer 1

Hello,

Welcome to icliniq.com.

It is evident from HSG (hysterosalpingogram) that you have a left tubal block and only the right tube is patent. Secondly, considering that your partner has varicocele, it is important to get his semen analysis done to check for sperm count and quality if it is adequate or not. Thirdly, your prolactin levels are high making you hyperprolactinemic, and your progesterone levels are low indicating progesterone deficiency. So in your case, firstly hyperprolactinemia has to be controlled with dopamine antagonists and progesterone deficiency to be tackled with cyclical progesterone therapy for three months. A single patent tube is not a deterrent for conception, but the prolactin and progesterone are also most important. It is your partner's semen sperm count and quality, which would be mandatory to predict the possible conception after analysis. Please keep the follow up.