If the lady is in the 40s, do seek help if there is no pregnancy within the six months of trying. Be open and avail yourself of assisted reproduction techniques to facilitate a successful pregnancy.

Your job, lifestyle or health history may put you at an increased risk of becoming infected with Hepatitis B. In this case, it is recommend that you be immunised against Hepatitis B, if you have not been before. Not only does the Hepatitis B virus pose a risk for you, but you could pass the virus on to your baby. It is ideal to have your vaccinations up to date before you become pregnant. The Hepatitis B vaccine is also safe for use in pregnancy. 

Please check your hormones. It sounds like you have a hormonal problem which is likely to render you less fertile.

To increase your chances of conception, you can try the missionary position (man on top) as gravity will help the semen be deposited in the vagina. You may want to put a pillow under the buttocks after sex as this will allow semen to stay in the vagina longer. You should also rest in bed for at least half an hour after sex.

Do ensure that you are regularly ovulating by getting a follicular scan done, if you are then you definitely are in a good place to try.

Stillbirth can be due to many causes. Your obstetrician may help you find out the reason. If your cycle is regular, you may try for 3 to 6 months naturally and get the advice of the gynae whether to restart the Clomid.

I presume the D&C was done because of your irregular 
period. Treatment would depend on the results of the D&C, which may indicate that you are not ovulating regularly. There are a number of causes of irregular ovulation, ranging from stress, overweight  and  medical conditions such as polycystic ovarian syndrome (PCOS). Seek medical help as soon as you can so that your doctor can advise further.

Repeated molar pregnancies are rare. If you have had a molar pregnancy, the chance of having a second molar pregnancy is approximately one percent. To check for the problem earlier, you can undergo an ultrasound to check if the pregnancy is normal. Your obstetrician will advise on the appropriate care and follow-up.

An Intrauterine Contraceptive Device (IUCD) is a device which is inserted into the uterus (womb) to prevent pregnancy. Though not common, both abortion and IUCD may cause mild and unnoticeable infection of the womb and the fallopian tube. This complication may affect the chances of conception. If you are above 35 and have been trying for six months without conceiving, please seek medical attention.

There is still no general consensus as to whether a previous abortion will affect the chances of future pregnancies. There are medical studies that say yes and vice versa. However, abortions can have complications such as Asherman’s syndrome where the uterine cavity gets scarred resulting in infertility.

Both husband and wife should seek medical attention. The specialist will conduct tests on both of you to find out why you are not getting pregnant. Once results of tests are reviewed and discussed, a proposed treatment programme will be explained to you.

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