Pregnancy Issue - help me

Patient

Q: We are trying to conceive but no results I had my period on 26th De 2014 and We tried to conceive in Jan 2015 a few times around my O but took 2 home tests which came negative L but I missed my period for almost 6 weeks(thought I would be pregnant) but got relaxed by seeing few members discussions in babycentre.com that even they got negative results they got +ve pregnancy later on so got relaxed .I had few symptoms even like missed periods, lower hips pain, severe back pain, too much gas,no tender breasts ,spotting and morning sickness. But my results showed negative which is really a bad sign of trying for the first time. But on 4th Jan I am spotting a little brown colour I thought it was implantation bleeding as it was for 3 consecutive days . But I had red colour bleeding on 7th Jan and still 11th Jan I am still bleeding without any cramps . Is it my mc or any other problem I could not understand . I am really worried a lot.



Today I had severe cramping in my lower left and central abdomen (not like my period cramps) , it is very sharp and I couldnt even sit or stand or even sleep . so iwas trying to sleep only on my left side so that the pain is not severe so whats happening with me I couldnt understand . I have thyroid around 11 which I last checked 2-3 months back and I do have a small cyst in left side ovary and 3 years back my endometric thickness is also very thick around 18 but doctor suggested few medications at that time but I dont know whats happening with me and my health .Will I able to get pregnancy with theses 3 problems and when will my periods stop (but earlier my periods are regular).Me and my husband love kids a lot in this world so looking out for our baby so please kindly help

Symptoms:  Bleeding,cramps ,sharp pain in lower and central abdomen ,pcos,thyroid,endometriosis,failed in conceive,-ve pregnancy ,
Doctor

A:   Hello, RIOSIS ,
Thanks for the query to ATD,
As it is seen that you are suffering from PCOS, THYROID AND ENDOMETRIOSIS, all three together , you treatment has to be approached one by one. Firstly you have to be really patient during the whole course of treatment. Irregular bleeding and then amenorhoea for 6 months ( likely cause hypothyroidism and pcos together), pain while menstruationg ( due to endometriosis), prolonged menses ( pcos ) , irregular shedding ( due to progesterone deficiency or luteal phase defect). All have to be addressed in a phased manner .
Firstly, bleeding has to be stopped with a therapeutic endometrial curettage and subjecting the sample to histopathological examination to rule out any hyperplasia or prolifeartive endometrium during secretory phase, to ascertain and rule out progesterone deficiency.
Nextly, hypothyroidism has to be controlled with exogenous thyroxine to bring theTSH levels below 5. Then PCOS has to be controlled with reduction in weight , daily exercises and being placed progestrone only pills for 6 months which shall prevent menses and help treating pcos , and even endometriosis.
Following the course of treatment and weight reduction, a repeat hormonal profile can be done and then the next cycle can be chosen for either natural conception based on follicular monitoring ( to understand the growth of follicles during the cycle) or if required ovulation induction may be done to help grow follicles.
The details have to be discussed with your physician in detail so that you understand the process and are able to take an informed decision. I have outlined a guideline as to what to expect.
I hope i have addressed your concerns in detail,
wishing you good health,
regards

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