Wednesday, November 7, 2012



Also known as: Tubal pregnancy, Cervical pregnancy or Abdominal pregnancy


An ectopic pregnancy is an abnormal pregnancy that occurs outside the womb (uterus). The baby (fetus) cannot survive, and often does not develop at all in this type of pregnancy.

Causes, incidence, and risk factors

An ectopic pregnancy occurs when a pregnancy starts outside the womb (uterus). The most common site for an ectopic pregnancy is within one of the tubes through which the egg passes from the ovary to the uterus (fallopian tube). However, in rare cases, ectopic pregnancies can occur in the ovary, stomach area, or cervix.
An ectopic pregnancy is often caused by a condition that blocks or slows the movement of a fertilized egg through the fallopian tube to the uterus. This may be caused by a physical blockage in the tube by hormonal factors and by other factors, such as smoking.
Most cases of scarring are caused by:
  • Past ectopic pregnancy
  • Past infection in the fallopian tubes
  • Surgery of the fallopian tubes
Up to 50% of women who have ectopic pregnancies have had swelling (inflammation) of the fallopian tubes (salpingitis) or pelvic inflammatory disease (PID).
Some ectopic pregnancies can be due to:
  • Birth defects of the fallopian tubes
  • Complications of a ruptured appendix
  • Endometriosis
  • Scarring caused by previous pelvic surgery
The following may also increase the risk of ectopic pregnancy:
  • Age over 35
  • Having had many sexual partners
  • In vitro fertilization
In a few cases, the cause is unknown.
Sometimes, a woman will become pregnant after having her tubes tied (tubal sterilization). Ectopic pregnancies are more likely to occur 2 or more years after the procedure, rather than right after it. In the first year after sterilization, only about 6% of pregnancies will be ectopic, but most pregnancies that occur 2 - 3 years after tubal sterilization will be ectopic.
Ectopic pregnancy is also more likely in women who have:
  • Had surgery to reverse tubal sterilization in order to become pregnant
  • Had an intrauterine device (IUD) and became pregnant (very unlikely when IUDs are in place)
Ectopic pregnancies occur in 1 in every 40 to 1 in every 100 pregnancies.


  • Abnormal vaginal bleeding
  • Amenorrhea
  • Breast tenderness
  • Low back pain
  • Mild cramping on one side of the pelvis
  • Nausea
  • Pain in the lower abdomen or pelvic area
If the area of the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include:
  • Feeling faint or actually fainting
  • Intense pressure in the rectum
  • Pain that is felt in the shoulder area
  • Severe, sharp, and sudden pain in the lower abdomen
Internal bleeding due to a rupture may lead to low blood pressure and fainting in around 1 out of 10 women.

Signs and tests

The health care provider will do a pelvic exam, which may show tenderness in the pelvic area.
Tests that may be done include:
  • Culdocentesis
  • Hematocrit
  • Pregnancy test
  • Quantitative HCG blood test
  • Serum progesterone level
  • Transvaginal ultrasound or pregnancy ultrasound
  • White blood count
A rise in quantitative HCG levels may help tell a normal (intrauterine) pregnancy from an ectopic pregnancy. Women with high levels should have a vaginal ultrasound to identify a normal pregnancy.
Other tests may be used to confirm the diagnosis, such as:
  • D and C
  • Laparoscopy
  • Laparotomy


Ectopic pregnancies cannot continue to birth (term). The developing cells must be removed to save the mother's life.
You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to shock, an emergency condition. Treatment for shock may include:
  • Blood transfusion
  • Fluids given through a vein
  • Keeping warm
  • Oxygen
  • Raising the legs
If there is a rupture, surgery (laparotomy) is done to stop blood loss. This surgery is also done to:
  • Confirm an ectopic pregnancy
  • Remove the abnormal pregnancy
  • Repair any tissue damage
In some cases, the doctor may have to remove the fallopian tube.
A minilaparotomy and laparoscopy are the most common surgical treatments for an ectopic pregnancy that has not ruptured. If the doctor does not think a rupture will occur, you may be given a medicine called methotrexate and monitored. You may have blood tests and liver function tests.

Expectations (prognosis)

One-third of women who have had one ectopic pregnancy are later able to have a baby. A repeated ectopic pregnancy may occur in one-third of women. Some women do not become pregnant again.
The likelihood of a successful pregnancy depends on:
  • The woman's age
  • Whether she has already had children
  • Why the first ectopic pregnancy occurred
The rate of death due to an ectopic pregnancy in the United States has dropped in the last 30 years to less than 0.1%.


The most common complication is rupture with internal bleeding that leads to shock. Death from rupture is rare.

Calling your health care provider

If you have symptoms of ectopic pregnancy (especially lower abdominal pain or abnormal vaginal bleeding), call your health care provider. You can have an ectopic pregnancy if you are able to get pregnant (fertile) and are sexually active, even if you use birth control.


Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. However, a tubal pregnancy (the most common type of ectopic pregnancy) may be prevented in some cases by avoiding conditions that might scar the fallopian tubes.
The following may reduce your risk:
  • Avoiding risk factors for pelvic inflammatory disease (PID) such as having many sexual partners, having sex without a condom, and getting sexually transmitted diseases (STDs)
  • Early diagnosis and treatment of STDs
  • Early diagnosis and treatment of salpingitis and PID
  • Stopping smoking


Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 176.
Lobo RA. Ectopic pregnancy: Etiology, pathology, diagnosis, management, fertility prognosis. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 17.
Barnhart KT. Ectopic pregnancy. N Engl J Med. 2009;361:379-387.


Dysfunctional uterine bleeding (DUB)

Also known as: Anovulatory bleeding, Bleeding - dysfunctional uterine, DUB, Abnormal uterine bleeding, Menorrhagia - dysfunctional, Polymenorrhea - dysfunctional or Metrorrhagia - dysfunctional


Dysfunctional uterine bleeding (DUB) is abnormal bleeding from the vagina that is due to changes in hormone levels.

Causes, incidence, and risk factors

The menstrual cycle, or period, is not the same for every woman. On average, menstrual flow occurs every 28 days (most women have cycles between 24 and 34 days apart), and lasts 4 - 7 days.
The menstrual cycle of young girls who are just starting to have their periods can range from 21 to 45 days or more apart. Women in their 40s will often notice their menstrual cycles occurring less often.
During a normal menstrual cycle, levels of different female hormones made by your body go up and down. Estrogen and progesterone are two very important hormones.
Ovulation is the part of the normal menstrual cycle when an egg is released from the ovaries. The most common cause of dysfunctional uterine bleeding is when your ovaries do not release an egg. When this occurs, the hormone levels in your body are not the same, causing your period to be later or earlier and heavier than normal.
Other changes in hormones may also cause changes in your period.


A woman with dysfunctional uterine bleeding may notice the following changes in her menstrual cycle:
  • Bleeding or spotting from the vagina occurs between periods
  • Menstrual periods may be less than 28 days (more common) or more than 35 days apart
  • Time between menstrual periods changes with each cycle
  • Bleeding is heavier (passing large clots, needing to change protection during the night, soaking through a sanitary pad or tampon every hour for 2 - 3 hours in a row)
  • Bleeding lasts for more days than normal or for more than 7 days
Other symptoms caused by changes in hormone levels are:
  • Excessive growth of body hair in a male pattern (hirsutism)
  • Hot flashes
  • Mood swings
  • Tenderness and dryness of the vagina
A woman may feel tiredness or fatigue if she is losing too much blood over time and becomes anemic.

Signs and tests

The health care provider will do a pelvic examination.
Lab tests may include:
  • CBC
  • Blood clotting profile
  • Hormone tests
    • FSH
    • LH
    • Male hormone (androgen) levels
    • Prolactin
    • Progesterone
  • Serum or urine HCG (to rule out pregnancy)
  • Thyroid function tests
  • Culture to look for infection
The following procedures may be done:
  • Endometrial biopsy may be done to look for infection, precancer, or cancer, or to help decide on hormone treatment.
  • Hysteroscopy is an office procedure in which the doctor inserts a flexible tube with a light and a tiny camera on the end into the uterus through the vagina.
  • Transvaginal ultrasound may be done to look for abnormalities in the uterus or pelvis.


Young women within a few years of their first period are often not treated unless symptoms are very severe, such as heavy blood loss causing anemia.
In other women, the goal of treatment is to control the menstrual cycle.
  • Oral birth control pills or progesterone only pills are often used
  • An intrauterine device (IUD) that releases the hormone progestin can be very helpful for heavy bleeding and pain
The health care provider may recommend iron supplements for women with anemia.
If you want to get pregnant, you may be given medication to stimulate ovulation.
Women whose symptoms are severe and do not respond to medical therapy may need surgical treatments including:
  • Endometrial ablation or resection - destroying (cauterizing) or removing the lning of the uterus will often stop or reduce the amount of menstrual bleeding
  • Hysterectomy - performed less often than in the past
  • D and C - for diagnosis and to remove polyps

Expectations (prognosis)

Hormone therapy usually relieves symptoms. As long as there is no problem with anemia (low blood count), no treatment is needed.


  • Infertility from lack of ovulation
  • Severe anemia from prolonged or heavy menstrual bleeding
  • Buildup of the uterine lining without enough menstrual bleeding (a possible factor in the development of endometrial cancer)

Calling your health care provider

Call your health care provider if you have unusual vaginal bleeding.


Lobo RA. Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 37.
Kaunitz AM, Meredith S, Inki P, Kubba A, Sanchez-Ramos L. Levonorgestrel-releasing intrauterine system and endometrial ablation in heavy menstrual bleeding: a systematic review and meta-analysis. Obstet Gynecol. 2009;113:1104-1116.
Casablanca Y. Management of dysfunctional uterine bleeding. Obstet Gynecol Clin North Am. 2008;35:219-234.
Damlo S. ACOG guidelines on endometrial ablation. Am Fam Physician. 2008;77:545-549.


Reference from A.D.A.M.

Alternative Names

Irregular menstruation; Heavy, prolonged, or irregular periods; Menorrhagia; Polymenorrhea; Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleeding


The menstrual cycle is not the same for every woman. On average, menstrual flow occurs every 28 days (with most women having cycles between 24 and 34 days), and lasts about 4-7 days.
However, there is a wide variation in timing and duration that is still considered normal, especially if your periods began within the last few years.
A small percentage of women have periods more often than every 21 days or less often than every 35 days. These variations may be normal.
Some examples of abnormal bleeding include:
  • Bleeding or spotting between periods
  • Bleeding after sex
  • Bleeding more heavily (passing large clots, needing to change protection during the night, soaking through a sanitary pad or tampon every hour for 2 - 3 hours in a row)
  • Bleeding for more days than normal or for more than 7 days
  • Menstrual cycle less than 28 days (more common) or more than 35 days apart
  • Bleeding after you have gone through menopause
Often, if you are bleeding from the rectum or there is blood in your urine, you may think the blood is coming from the vagina. To know for certain, insert a tampon into the vagina to confirm that it's the source of your bleeding.


A change in hormone levels is a common cause of abnormal menstrual bleeding. This is called dysfunctional uterine bleeding.
Other causes of abnormal menstrual bleeding include:
  • Endometrial hyperplasia (thickening/build-up of the lining of the uterus)
  • Cancer of the uterus
  • Uterine fibroids, uterine polyps (small noncancerous growths in the lining of the uterus), adenomyosis
  • Medical conditions such as thyroid and pituitary disorders, diabetes, cirrhosis of the liver, and systemic lupus erythematosus
  • Pregnancy complications -- such as miscarriage or ectopic pregnancy (when a fertilized egg implants somewhere other than the uterus)
  • Changes in birth control pills or estrogens that you take
  • Use of certain drugs such as steroids or blood thinners (for example, warfarin or Coumadin)
  • Use of an intrauterine device (IUD) for birth control
  • Recent trauma, surgery, or other uterine procedure
  • Infection in the uterus (pelvic inflammatory disease)
  • Bleeding disorders such as Von Willebrand disease
  • Polycystic ovary syndrome
  • Stress, change in diet or exercise routine, recent weight loss or weight gain, travel, or illness

Home Care

Keep a record of your menstrual cycles and any other bleeding, including:
  • When menstruation begins and ends
  • How much flow you have (count numbers of pads and tampons used, noting whether they are soaked)
  • Bleeding between periods and after sex
  • Any other symptoms you experience
Tampons should be changed at least twice a day to avoid infection.
Because aspirin may prolong bleeding, it should be avoided. Ibuprofen is usually more effective than aspirin for relieving menstrual cramps. It also may reduce the amount of blood you lose during a period.
If you think you are or could be pregnant, talk to your doctor.

When to Contact a Medical Professional

Call your doctor if:
  • You have soaked through a pad or tampon every hour for 2 - 3 hours.
  • Your bleeding has lasted longer than 1 week.
  • You are pregnant or could be pregnant.
  • You have severe pain, especially if you also have pain when not menstruating.
  • Your periods have been heavy or prolonged for three or more cycles, compared to what is normal for you.
  • You have a fever or abnormal vaginal discharge, especially if it has an odor.
  • You have bleeding or spotting after menopause.
  • You have bleeding or spotting between periods.
  • You have nipple discharge, excessive hair growth, deepening voice, unintentional weight loss or gain, or new acne.

What to Expect at Your Office Visit

Your doctor will perform a physical examination, including a pelvic exam. Your doctor will ask questions like the following to determine the history of this symptom:
  • What is your age?
  • Have your last three menstrual periods been normal in timing and amount for you?
  • How long do your periods usually last?
  • How many days are there usually between your menstrual periods?
  • How did this cycle (and others) differ from your usual menstruation?
  • Have you passed blood clots?
  • How many days has the bleeding lasted with these different or abnormal menstrual periods?
  • How heavy have they been? How many pads and tampons have you been using per day?
  • When was your last menstrual period?
  • How old were you when had your first menstrual period?
  • Do you use birth control pills? Do you use an IUD for birth control?
  • Do you take an estrogen supplement?
  • Do you take aspirin more than once per week?
  • Do you take Coumadin, heparin, or other anticoagulants?
  • Have you recently given birth, had surgery, or experienced trauma on or near the vagina or uterus?
  • Have you recently had a vaginal or uterine infection?
  • What other symptoms do you have? Abdominal or pelvic pain?
  • Do you have nausea or vomiting?
  • Are you pregnant or could you be pregnant?
  • Have you noticed a growth, lump, or lesion on the genitals?
  • Have you had blood in your stools?
  • Do you bleed easily?
Diagnostic tests that may be performed include:
  • Pap smear
  • Endometrial biopsy
  • Pelvic ultrasound
  • Lab tests such as thyroid function tests, CBC, pregnancy test, and serum ferritin

Tuesday, November 6, 2012


Digunakan diseluruh tubuh terutama digosok ke paha dan bontot yg berselulit, pangkal tangan iaitu antara lengan dan permulaan bahu, perut, pinggang,pinggul dan mana-mana bahagian yg berlemak, besar dan menggeleber. Penting juga digosok kepada bahagian berparut , celah kekotoran degil , badan berjerawat batu dan berbiji akibat lemak keras dan kesan luka.

Semasa penggunaan kulit akan berasa segar dan naturally dingin. Liang-liang kulit akan terbuka dan ini membantu penyerapan oleh satu bahan pelembab yang boleh melarutkan air dan lemak dibawah lapisan kulit . Penggunaan tumbuhan, buahan dan sayuran membantu melancarkan peredaran darah dan sebagai satu bahan anti bakteria dan kulat. Penggelupasan perlahan dan penggantian kulit semulajadi serta menghasilkan kulit tubuh yang cantik, tegang , licin dan lembap serta membantu menghilangkan kesan parut seperti rekahan selepas beranak , kekotoran seperti kerak dan daki yang terpendam .
Lebih effektif digunakan setiap kali mandi untuk shape dan kulit yang anda ingini.
Harga RM36 lulus KKM dan selamat digunakan

Monday, November 5, 2012


InsyaAllah jamu pengantin dara (JPD) akan restok minggu depan (12/11/12)... saya harap anda yang beli JPD paham kenapa nak guna JPD, bagaimana nak guna JPD, siapa yang boleh guna JPD, siapa yang tak boleh guna JPD, apa pantang larang JPD..saya takmau ada sebarang komplikasi atas kecuaian anda dan ketaksabaran anda untuk guna JPD.. ye, saya tau, anda semua tak sabar2 nak tengok apa hasilnya nnt,apa yang kuar, berkesan ke tak, ketat balik ke tak, masalah selesai ke tak, apa en husband akan cakap lepas ehem2 ;p, lekat benih ke tak dan lain-lain..

kesannya bergantung kepada individu, sp saya harap anda semua paham dan patuh kepada pantang larang untuk guna JPD.

1- JPD hanya boleh digunakan oleh wanita yang pernah melakukan hubungan kelamin sahaja.

2- JPD hanya boleh digunakan oleh wanita yang mempunyai masalah di bahagian sulit mereka, antaranya keputihan terok, bau busuk, ada discharge, dah longgar, rahim kembang, period tak lancar, dah beranak, pernah terlanjur tapi berusaha membina kehidupan baru and of course nak bagi yang terbaik untuk suaminya nanti, gatal2 tak tertahan dll lagi.. (name it)

3- jika ada makan jamu/herba/ubat diet/minuman diet/sebarang yang berkaitan dengan diet-----> wajib berenti selama sebulan sebelum guna JPD.. yes, saya tau ada yang cakap stop 2-3 minggu pon dah boleh start guna JPD tapi anda harus ingat, lain orang, lain antibodi--> yakin ke anda cukup kuat? karang mampos di tengah jalan.. (best tak ayat?;p )... jadi sila stop selama sebulan ye..

4- jika anda ada amik apa2 suppliment/ubat selain herba contohnya vit c, vit e, ubat hospital, pil perancang dan segala yang takde kaitan dengan herba, sila jarakkan selama 2 jam.

5- pengguna IUCD yang kurang dari setahun tak boleh guna JPD.. wajib genap setahun baru boleh buat pembersihan guna JPD..

6- anak dara dilarang paling keras insert JPD

7- yang dah terlanjur tapi dah insaf dan nak baiki hidup pon boleh pakai JPD... tapi kalo anda saja nak menggatal dengan mana2 lelaki, mintak maaf ye, saya tak jual..

8- pengguna JPD wajib pantang minuman sejuk, ais, air kelapa, durian, madu, minuman bergas, alkohol. WAJIB YE!

9- wanita yang dah menopous tak boleh guna JPD.. pakai intim gel, feminin wash dan masker sahaja untuk penjagaan intim anda

10-wanita yang kering bila bersama en asben sampaikan setiap kali nak bersama wajib ada pelincir luar pon tak boleh guna JPD.. sila guna intim gel dulu

11 - wanita hamil laaaaaaaaaaaagi la haram guna JPD ni.. sebab tu sila guna JPD lepas anda period, sebab kalo sebelom period, risau anda tak tau anda dah mengandung. sebab JPD boleh tarik janin, boleh tergugur... jangan pula ada yang order JPD sebab nak gugurkan kandungan ye

12- wanita yang dah bersalin, sila tunggu lepas pantang baru boleh guna JPD.. kalo takut baby panas, sila tunggu lepas 6 bulan bersalin baru guna JPD sebab masa tu lidah baby dah banyak merasa makanan selain susu ibu. selingan- jangan sesekali bagi makanan tambahan kepada baby anda selagi tak cukup 6 bulan sebab sistem penghadaman mereka belom sempurna. tak kira la kalo anda nampak macam baby tu lapar sangat pon, bagi susu je.

sila betolkan minda anda ya, JPD bukan berfungsi untuk mengetat semata-mata sebab JPD ni bukan ubat seks.. tapi JPD berfungsi untuk serap dan buang segala mak nenek yang tak patut ada dalam salur vagina anda.. dan bila serap dan buang, secara tak langsung salur anda akan bersih dan sempit.. air mazi pon senang nak turun jika anda ghairah.. maka takde lah masalah kekeringan lagi tu.. maka takde lah lagi masalah bau busuk,keputihan dll.

kesan semasa guna JPD adalah berlainan bergantung kepada individu..ada yang sihat walafiat, ada yang demam, ada yang senggugut, ada yang sakit perot tak tertahan, ada yang banyak kali kencing, ada yang bentan dll.... so sangat diharapkan ikut segala pantang larang.. air suam kena minum banyak2... dan sila bersabar sementara proses pembersihan dijalankan..

hasil yang anda dapat lepas pakai JPD pon berlainan bergantung kepada tahap kekotoran/kebersihan salur vagina.. ada yang kuar banyak, ada yang kuar sikit je..jangan pula sedih bila hasilnya sikit, sepatutnya happy la sebab tak kotor sangat salur tu..

Cara penggunaan JPD:
hari pertama - sambil mencangkung, masukkan 2 biji JPD dalam miss V (1 kanan, 1 kiri) sebelum tidur dan makan 4 biji disusuli minum air yang banyak (herba panas dan kuat).
hari kedua - makan 2 biji sebelum tidur.
hari ketiga - makan 2 biji sebelum tidur.
so ngam2 10 biji untuk kegunaan 3 ari..

* boleh bersama encik asben selepas 24jam insert.. maknanya start ari kedua baru boleh bersama..ari pertama tak boleh bersama ye sebab nak bagi masa kat rempah JPD untuk berfungsi dengan baik..

* kalo badan rasa panas, sila minum air putih banyak2..

* simptom berbeza semasa proses pembersihan dijalankan.. ada yang sihat walafiat, ada yang sakit kat bahagian ari2, ada yang demam, ada yang bentan.. so harap bersabar ya..

* selepas 72jam, sambil mencangkung, korek keluar rempah dan sisa dalam miss V (wajib!).. jika kotoran tu terlampau besar, jangan paksa diri untuk korek.. biarkan dulu dan sapu minyak masak kat salur vagina supaya kotoran senang nak keluar. pengguna akan rasa sangat berbeza jika kesemua kotoran dah keluar habis..

* JPD bekerja dengan lebih baik kat vagina yang basah, lecak.. iAllah lepas pakai JPD, anda tidak akan rasa basah, lecak dan keputihan pon hilang..

* lain-lain kebaikan JPD, sila tanya encik asben ;p


Thursday, November 1, 2012


Oleh:Dr Hamid Arshat, pakar kesuburan.
Polycystic ovary syndrome (PCOS)

PCOS sukar dirawat
Penyakit ini menjadi salah satu punca utama kemandulan.

Mengapa sukar merawat PCOS ?

1. Salah satu punca penyakit PCOS adalah cacat baka / genetic - dimana gene yang mengawal hormon subur adalah cacat sejak lahir. Tidak ada rawatan untuk membetulkan kecacatan genetic ini. Kita bergantung dengan usaha mengubah faktor2 lain sahaja , ini pun banyak bergantung kepada azam dan kesungguhan pesakit PCOS.

2. Kegemokkan / obesity adalah faktur kedua pentingnya dalam kejadian PCOS. PCOS sering dikaitkan dengan penyakit diabetes dalam keluarga. Begitu juga obesity juga dikaitkan dengan diabetes dan baka. Usaha untuk mengurangkan berat badan memang sangat sukar, mudah untuk naik berat badan , tapi hendak turun memang perlu azam dan ketabahan. Penurunan berat badan merupakan rawatan yang terpenting bagi meningkatkan kesuburan dikalangan pesakit2 PCOS. Cara2 yang paling berkesan ialah dengan DIET, iaitu mengurangkan makanan carbohydrate dan gula, dan exercise untuk membakar lebihan gula dan lemak dalam badan.
.Program kuruskan badan

3. Tiada ubat khusus untuk PCOS, kerana ia rangkaian berbagai masalah termasuk, insulin resistance, hormone imbalance antara FSH / LH, hormon testosterone tinggi, estrogen tinggi, progesterone rendah, Akhirnya sel2 benih/telor tidak dapat dimatangkan.
Seringkali ubat subur clomid dengan dose tertinggi diperlukan (200 - 250 mg), dan jika gagal ubat gonadotrophin secara suntikan diperlukan dan ubat ini sangat mahal harganya, sedang kadar kejayaan hanya 30% sahaja.

4. Kegunaan ubat2 supplement bolih membantu untuk kurangkan berat badan, kurangkan insulin resistance seterusnya mengurangkan gula dalam badan, mengurangkan hormon testosterone. Saya sering beri pesakit2 ubat adipex, metformin, dan saw palmetto.Perlu diingat pesakit2 PCOS tidak bolih bergantung kepada ubat2 tersebut terlalu lama, munkin antara 3-6 bulan sahaja.

5. Saya nasihatkan makan banyak buah2 dan sayuran serta ulam2. Makanan yang banyak mengadungi bahan2 pengawet, perisa dan pemanis perlu dijauhkan termasuk fast dan junk foods. Segala kebaikkan saperti vitamins, antioxidants, logam dll adlah terkandung dalam buah2, sayur2 dan ulam2.

6. Jangan mudah putus asa, teruskan usaha sampai hamil.Perubahan dalam caragaya hidup sangat penting terutama tabiat makan dan pilihan jenis makanan yang berzat dan berkhasiat. Pilih makanan yang segar/fresh tanpa diperoses, tanpa pengawet, perisa dan pemanis. Lakukan gerak tubuh/exercise , munkin buat jogging 30 minit sehari. Lakukan breathing exercise/yoga untuk relxation, hilangkan stress dengan baca quran dan berzikir.

7. Cuba buat IUI apabila ada telor matang selepas makan clomid dos tinggi, ini munkim bolih menambah peluang untuk hamil. Biasanya jika ada pematangan telor kehamilan akan berlaku secara spontan tanpa memerlukan IUI.

8. Laparoscopic ovarian drilling , ia itu satu kaedah pembedahan untuk menyuburkan ovary perlu dilakukan jika tiada pematangan telor walaupun dengan clomid dos tinggi. Rawatan ini dapat menurunkan tahap hormon testosterone yang sering menganggu pematangan telor. Selepas ovarian drilling ubat subur clomid dos tinggi masih diteruskan selama 3 pusingan haid. Peluang hamil lepas rawatan ini 40-50 %.

9. Bayi tabung uji atau IVF munkin bolih dicuba sebagai langkah terakhir, itu pun kalau berjaya merangsang pematangan telor.

Daftar Agen JSD