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Q. Why cannot we get pregnant though our ovulation and semen analysis are normal?

Answered by
Dr. Monica Mathur
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Oct 22, 2021

Hello doctor,

I am a 34-year-old female. I have been married for 11 months. I have hypothyroidism, and I am obese. I had hyperprolactinemia in the past. But now, my prolactin is normal. After that, I have a regular cycle of 33 days, and we are trying to conceive. My husband did a semen analysis, and everything was normal. Our doctor prescribed him tablet ACC 600 mg for a month. Though I ovulate every month, we did not get pregnant after all these efforts.

Do we need fertility treatments?

Kindly help.

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#

Hello,

Welcome to icliniq.com.

I have seen the sperm report of your husband, and it is expected (attachments removed to protect the patient’s identity). I suggest you do an abdominal ultrasound to check for any abnormalities in the fallopian tubes. You should also know about the most fertile period in your menstrual cycle. As your cycle is of 33 days, the most fertile period comes out to be between days 12 and 19.

Secondly, you can take tablet Clomiphene 150 mg once a day for five days starting from the second day of your cycle. I have seen many cases conceiving after taking this drug.

Thirdly, start taking Folic acid 150mg once a day for one month.

Take care.

Thank you doctor,

I will soon plan for the ultrasound and other investigations.

#

Hi,

Welcome back to icliniq.com.

Thanks for using icliniq. Sorry for the delay. I think by this time, your follicle size will have reached to ovulatory level. Please share the latest size for interpretation. Progesterone supplementary is a must on seeing your previous history.

Thank you doctor,

Thank you for the reply doctor. The follicular size as of day 17 is still 10. mm on both the ovaries and I was told to start Duphaston and advised to report on day 2 of my cycle. I have a doubt about my cycle days 14 and 15. Though my opk test came out positive, why my follicles are not growing? How I got LH surge? If my eggs are not ruptured, how come I get periods in 29 to 33 days? What should I do to increase the growth of the follicle? Please guide me.

#

Hi,

Welcome back to icliniq.com.

The follicles which have not reached the size would lead to the rupture of the ovum so that fertilization can occur. There are medicines that can increase the size of the follicles. There are certain cycles in which ovulation does not occur but still, the menstrual cycles come regularly every month. So, I would like to know was there a mature follicle that has ruptured releasing ovum or not? In other words, whether your cycles are ovulatory or not associated with ovulation? This step is very important for conceiving a pregnancy. As far as your concern for your next cycle, I can suggest you take tablet Clomiphene 100 mg once for five days starting from the second day of your menstrual cycle. Feel free to ask a query.


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