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Ans: PCOS is a condition of the ovary that one is born with. You can optimize the hormonal imbalances in PCO, but the condition never factually reverses because it is a type of theory. So, lifestyle modifications and medication are sometimes necessary to ensure that regular ovulation happens with PCO. Lifestyle modification in terms of diet control, exercise, medication like metformin, MYO inositol. In exceptional cases, cyclical contraceptive pills, etc., may be needed to regulate cycles and ensure hormonal imbalances in PCO, PCOS with androgen excess, men need medication like spironolactone and aldactone to optimize their hormonal imbalances. Weight loss often helps to optimize the condition and resume ovulation in cases of PCOS. Since you weigh 64 kilos, it might be a good idea to lose around 7 to 8 kgs of weight, which will help further improve the cycles.

Ans: "If your mother is around 51 years old and has endometrial hyperplasia, the thickness is usually considered high for her age. However, it depends on the part of the menstrual cycle during which the thickness is measured. Therefore, it is appropriate to see a gynecologist who can assess whether the thickness is appropriate for that stage of the menstrual cycle. If the thickness is thicker than expected, possibly around 13 millimeters, a hysteroscopic guided DNC or biopsy may be appropriate to rule out any abnormalities. This is also a good time to plan a pap smear for your mother if it hasn't been done already."

Ans: "It is fairly common to have a miscarriage in the first pregnancy, so that shouldn't be a cause for concern. It's not necessary to assume that if you've had one miscarriage, you will have problems in the second pregnancy as well. However, considering your wife's age, it is always a good idea to seek the supervision and advice of a good gynecologist who can monitor the current pregnancy and ensure that it progresses smoothly. Additionally, it is appropriate to start folic acid supplementation and aspirin prior to conception to reduce the incidence of miscarriage. If you haven't had a chance to evaluate possible reasons for the miscarriage, it might be a good idea to see your gynecologist who can determine if there are any underlying issues and correct them before you plan your next pregnancy."

Ans: "Yes, it is possible for having children and getting pregnant with varicose veins to be very costly. During pregnancy, it's important to be careful, stay active, and wear stockings to ensure that the varicose veins don't worsen. However, there is no contraindication for having a pregnancy with varicosity if your wife is 35. It's important to ensure the chromosomal or carrier health of the baby. For this reason, your wife's pregnancy should be carried out under the supervision of a gynecologist, and appropriate testing should be done during the first and second trimesters."

Ans: "I think the compelling reason to have a second child should be to complete your family and provide a sibling for your existing child. At age 38, it is important to be under supervision and undergo appropriate genetic investigations to determine the possibility of abnormalities in the baby. Once these investigations are complete and everything is normal, you can proceed with the pregnancy.

Your reasons for having a baby, such as not being able to find a good maid, fear of tampering, or your daughter's education, don't seem very logical. Instead, it is important to economize your funds and channel them appropriately to be able to generate resources for both your children."

Ans: If your wife is 48 years not getting periods, there could be multiple reasons, but the communist reason could be either perimenopause or menopause itself. It could be also associated hormonal imbalances in a very rare instance of pregnancy also needs to be ruled out.
Please do a pregnancy test in home kit. If it is negative, which it should really be at this age, then consult a gynecologist and get an ultrasound done to see further possible reasons. But the communist reason at this point should be menopause.

Ans: Thick menstrual flow is usually not a cause for concern heavy flow if your periods last for more than 7 days or if they come at very short intervals, or if you need to use more than 3 to 4 pads in a day and is accompanied by clothing. And there is a fall in hemoglobin, then the menstrual flow needs to be regulated. There are several medications which can be used to regulate the menstrual flow. Tranexamic acid along with mefenamic acid can help both in menstrual pain and in decreasing the blood flow, and the use of progesterone and contraceptive pills can also help in regulating the cycles and decreasing the flow. But this is only to be taken under supervision and if it is really needed.

Ans: Menstrual irregularity at age 15. It is very common to have irregular paid periods in the initial years of menopause anarchy, so having irregular periods. For the first 2 or 3 years, when the period when monarchy begins is quite common. If the ultrasound of the pelvis is fine and the hormonal assessment is normal, like thyroid, prolactin levels, insulin levels are all fine and the FSH, LH levels are fine, it should not be a cause of concern. I do not think regulating the menses menses at such an early age is recommended. However, since she is 53 and ways 66 kilos, maybe optimising her weight by about 2 or 3 kilos might be helpful. Other than that, lifestyle modification, regular exercise, eating a judiciously avoiding junk food, or decreasing the amount of sweets and junk Maida. Potatoes, sugar, rice, EC may help, and increasing proteins in the diet may be helpful. Other than that, if the hemoglobin levels and hormonal profile is normal, I don't think it's a huge cause for concern.

Ans: Hormone Replacement Therapy (HRT) subsequent to pre or peri menopausal symptoms may be appropriate for some people. HRT has to be tailored as per the persons need and requirement and also has to be given under supervision. So before you actually embark on HRT as a treatment option, it might be useful to consider lifestyle modification. Exercise, yoga, meditation and adding on basic things like evening primrose oil, vitamin E to your daily supplementation, starting some form of exercise may be useful. Before you actually resort to considering HRT. I think you have to see a gynecologist or a physician to ensure that it is the right choice for you at this time, usually in the perimenopausal HRT may not be needed, and other forms of treatment may be quite useful.

Ans: 31 seems to be an appropriate age for sure to plan the next baby. Since you are beyond 30 years of age, it would be worth while doing a basic health checkup around your hormones and basic sugar levels, vitamin D B12 and hemoglobin levels before planning the pregnancy starting folic acid supplementation. Would be appropriate. Stopping any kind of recreational drugs, smoking or alcohol and bit of lifestyle optimization like increasing proteins, fresh fruits, green vegetables, nuts, seeds and berries and the diet and starting some form of exercise would be useful. To ensure a smooth pregnancy.
Anti-mullerian hormone or AMH levels prior to planning a pregnancy will be helpful in discerning the fertility, the probability of getting pregnant and also. Appropriate or good image levels usually ensure a healthy pregnancy during pregnancy screening of the baby with a Nuchal translucency and nasal bone or level one scan bit around 12 weeks, a double marker subsequent to the scan if need be. A NIPT screening and a level 2 ultrasound usually, or level 2 ultrasound or an anomaly scan usually ensure that the fetus is more or less normal. If any other advanced investigation is needed, that too can be done during pregnancy. To ensure the the health of the baby.

Ans: The decision to procreate or have a child should be a mutual decision between the couple and I don't think any either of the partners can force their decision on the other. However, the owners on when to plan the family and how to plan the family should obviously be on the female partner as she is going to carry the baby. I think it is just appropriate to tell your husband that you have been on the pill. Stop the pill immediately and start trying naturally, which will obviously result in a pregnancy fall as well.

Ans: Infertility or sub fertility basically means that a couple who's been living together having regular sexual intercourse and not using any contraception for a period of one year and they do not have a pregnancy or the conception. By definition, this would be infertility or sub fertility. The reasons are many like- there could be male factor or female factor, female factors involved blocked fallopian tubes, Polycystic Ovarian disease and ovulation, premature ovarian, failure genital tuberculosis, hormonal imbalances, fibroid uterus, severe endometriosis, uterine shape abnormalities and in rare cases in autoimmunity or rejection of the conception and low anti mullerian hormone or extremes of maternal age, In men or male factor, It is usually low or absent sperm counts or ejaculatory dysfunction.