Q: After first baby in 1991, when we wanted to have a second one, I developed the following problems due to which I did not become pregnant. 1) I always have painful periods and on other days too I get lower abdomen pain. 2) I suffer from 'unruptured follicle syndrome' and only one of my tubes is patent, the other being blocked. 3) Tests on my husband were carried out and he is normal. 40 I was advised laproscopy after failure of medical treatment (2 years - during which sonography was done several times and later, an HSG. 5) After that I was diagnosed to have ‘endometriosis’ for which I am taking Danogen for three months. This medicine stops the periods slowly. Why do they want to stop my periods; is it true that periods will re-start after 3 months. Kindly explain clearly what is the treatment and how long will it take to become ready to conceive. Is there any chance that periods may not start again ? I want a second child, what are the treatments I have to take.

A:Yours is a case of endometriosis. This can prevent pregnancy in several ways. One is unruptured lutenised follicle where the egg is not released from the ovary and the other is the disturbance in the function of the follicle tube so that egg is not transfered properly. The tube can also become blocked because of adhesion in the region of the tube ovary. If you desire a pregnancy the initial treatment is induction of ovulation with fertility drugs and monitoring the develoment of eggs, as usual regularly. The egg is released from patent tubes then you either try to have nromal intercourse or your husband's semen is processed and good sperms are injected in the womb of the uterus. You can try four cycles of this treatment and if it is not successful, then you should go in for IVF. Dangogen is given for relief of symptoms of pain. This is the current advise for achieving pregnancy.