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Ask Dr Arun

Question: My husband and I have been trying to get pregnant for over a year, the problem is that I only ovulate at the most 3-4 times a year. Every time I take a test on our ovulation kit it comes back positive even though I take the tests at different times of the month. Still the pregnancy test's come back negative. I don't know what to do anymore can you please help us?

Answer:
For over a year you are trying and not getting pregnant.
The reasons for not getting pregnant are of three categories.
1 – either the fault is with the woman.
2 – or the fault is with the man.
3 – or both the partners are perfectly normal and still the pregnancy is eluding the couple. We call this condition as ‘GOK’! (God Only Knows!)

In your case you have not written anything about your partner’s status and I take it to be normal.

You use the ovulation kit and you get a positive result even though you take the test at different times of the month. Ideally it should not be the case, you must get the positive result only at the time of ovulation and that is just once a month.
Ovulation kit basically detects the level of LH in your body. LH means Luteinizing Hormone and its surge is the cause behind ovulation.
Ovulation is the process where the ovary throws out a mature ripe ovum in abdominal cavity where it is picked up by the floating end of a fallopian tube.
Once the mature ripe egg (ovum) is in fallopian tube it waits there for 48 to 72 hours to hug the moving sperm, which has painstakingly traveled all the way up from vagina moving its tiny tail in search of his beloved ovum.
Once these two meet the conception occurs.

The very fact that you get positive result with ovulation kit at any time in the month suggests that there is no LH surge in you but a constantly elevated level of LH.
That is why you ovulate at the most 3 – 4 times a year as against 12 to 15 times a year as expected normally.

These findings are suggestive of PCOS.
PCOS is Polycystic Ovary Syndrome.
The very word polycystic denotes that rather than getting one or two eggs developed fully in a monthly cycle your ovaries produce many ova at a time and they grow very large in size but still do not get expelled out. The moving sperm has no one to greet in the fallopian tube.

The science, the technology and the medicines have advanced very much and there is a lot a fertility specialist can do for you.
I know it may be expensive but advancing age is the most significant obstacle in success. As the woman advances in her age the success rate of getting pregnant drops with any kind of treatment module.
So I think it is prudent for you to see your OB/Gyn and discuss the possibility of a referral to a fertility specialist near to your home.

Best wishes and prayers,
Dr Arun

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