### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi...we have been trying to get pregnant for the past few months and have not been able to....I had an ultrasound done last September and i am wondering if my results may be why i have not been able to get pregnant. Im not really understanding my findings. I am 40 years old. My findings are: Transabdominal and endovaginal static images of the pelvis were acquired. The uterus is anteverted and measures 9.2 x 4.6 x 5.1 cm for a total volume of 115 mL. No focal uterine Ieiornyomas are seen. Uterine myometyrial heterogeneity could represent difihise fibroid change or adenomyosis . If imaging support for adenomyosis is clinically required, pelvic MRI could be considered. The encloinetriel stripe measures 0.5 cm. Nabothian cysts are seen at the level of the cervix . Small pelvic free fluid could be physiologic. The right ovary measures 3.4 x 1.6 x 1.7 cm for a total volume of 4.7 mL. The left ovary measures 3.0 x 1.3 x 1.7 cm for a total volume of 3.4 mL. Physiologic follicles and power Doppler flow at both ovaries are seen. No ovarian or pelvic masses are identified. Please let me know if my findings is what is keeping me from getting pregnant? Thank you.

### output:

HelloThanks for your query. You seem to be having fibroid or adenomyosis. In both these cases, the wall of the uterus gets thickened, and is not able to support a pregnancy.Also, your age is 40, at which ovarian aging starts. Please consult an Infertility Specialist for ovarian reserve testing, and assessment of uterine cavity via laparoscopy and hysteroscopy. You might require ART (assisted reproductive technology) in order to conceive. All the best.