Q: I am 26 year old woman with regular periods, which are painful for the first 2 hours. My cycle is about 30-32 days. I am planning to conceive and since past 2 months I am having intercourse during the estimated time of ovulation. But did not conceive. So this month I got my blood tests ANF follicular monitoring done. The Prolactin hormone was around 26.8 so the doctor put me on a tab for a month. On 13th day I had a 18 mm egg in my left ovary. Doctor gave me an injection to ovulate during next 18-36 hours. Then I had intercourse twice. After 48 hours the next scan showed that I have ovulated. Now what are the chances of my becoming pregnant?

A:There is no reason for you to start treatment of infertility, 26 prolactin is not really high; it is just the upper side of normal. Anyway it is very non-specific finding and prolactin levels can increase by various things like stress and anti vomiting pills etc. so a borderline raise prolactin is to be repeated before you make a diagnosis. Also, it is marginally raised in PCOS a much more variable disorder so you need a much more proper diagnosis and the treatment should wait till a firm diagnosis has been made. There is no proof that you are not making a egg. Please first you need to know whether you are making an egg or not which can be seen by whether you ovulate on ultrasound or better still (and more accurately ) by a day 24 Progesterone levels. Once it is established that you are not making an egg on your own you should be taking fertility drugs and again why was injection given to release an egg. You should be releasing it on your own. Ultrasound picks up ovulation only in 80% of the cases and is not an accurate method of diagnosing ovulation (though it is useful to see that you have not had a freak response to the drugs or are not hyperstimulated which is a life threatening condition in response to fertility drugs). If you are taking fertility drugs you do need an ultrasound but you should take these drugs only if you are sure that you are not ovulating on your own and then take medicine after a firm diagnosis. If you treat too much it not only does not improve your chances of conceiving it may actually reduce the chances of conception. In effect you are taking medicines and hormones or interfering with the system too much because of you eagerness to conceive immediately. That is not how nature works. If a man of 25 and a woman of 20 who are both completely normal get married and have sex daily without any contraception only 20% will conceive in one month 40% in three month 60% in six months and 80 percent in one year; meaning thereby that 20% couples in that age group with daily sex will not conceive. Hence only 20 per cent or so couples conceive in a month if everything goes ok. So it is impossible to predict your chances of conception in this cycle but please understand that you have interfered too much without any evidence of it being necessary for example taking a hormone injection(HCG) for release of the ovum may release an unripe ovum which is not very good. So in one word your chance of conception is about 20-25% in each cycle and all treatment you take which is not required reduces this chance. In this cycle your chance is no more than natural cycle, it could be less if the injection forced an unripe follicle to release an egg). So please have patience and do not have unrealistic demands on your system. Just check that you are ovulating by day 24, progesterone if you are ok. Just give nature a chance. Infertility is not like arithmetic if you are not ovulating then you need a proper work up to see what is the cause of not ovulating and treat. Accordingly then certainly you should take medicine to treat.