instruction: hi doctor I was diagnosed with endometriosis and had surgery last year now we are married for four years and I am not getting pregnant my age is 40 and my husband is 42 please suggest
output: hello I understand it has been a year since your endometriosis surgery I am not clear if you have taken any treatment following that to enable conception from the limited information you have given me and assuming that your partner parameters are normal as you have not mentioned anything about it I will try to make my suggestions as age advances the maternal ovarian reserve comes down which means the number of eggs a female has come down endometriosis is a disease that not only affects the ovaries but later causes adhesions which also hamper your chance for pregnancy it is also notorious to recur putting all these together the chances of a natural pregnancy comes down though definitely not impossible but the medical advice here and the ideal thing would be not to lose too much time and go in for art procedures like if in vitro fertilization because once the maternal ovarian reserve becomes too low the chances of pregnancy in an if cycle also becomes less so it would be ideal not to waste time and think of approaching any of the if centers also I would like to add that this couid time is not the right time to start an if treatment though I hope this helps