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

### input:
Hello,I am a 34 yr old women with 2 children, 5 and 3.I was diagnosed with PCOS 6 years ago when trying for 2 yrs to fall pregnent with my 5yr old. Fortunately i was able to fall pregnent with no medical assistance. and again after about 8 months of trying with my 3 yrs old. i have been trying for  the past 12 months to fall pregnant again with no luck.I have Hypothyroidism and taking 10o micrograms daily since i was about 12yrs old. i have been taking my temp and checking the position of my cervix as i find it very difficult to know when im ovulating. i have very painful cramps around when i think im ovulating, but often not backed up with egg white mucous. my periods have been regular 28 day cycles since my 3 year old was born, up until the past 3 months, which have started to be out by a 4-7 days late. this month i didnt get my period for 48 days. i had had intercouse a week before i got period on day 41 and had severe pain to the point i was going to go to the hospital. it did subside the next day after taking some pain killers.i saw my GP who sent me for an ultrasound. the results were: uterus is in anteverted position with bulky appearance, measuring 95cc. Myometrium is heterogeneous. Endometrium appears unremarkable, measuring 12mm. Right ovary, there is a 1.8 x 1.7cm thick walled hypoechoic structure with internal echoes. no abnormal vascularity demonstrated. left ovary appears in remarkable, measuring 7cc, right ovary measures 12cc.I have had all the usual blood test, ChatDoctor, prolactin, progesterone, testosterone, thyroid, shg. all have come back within normal range.I am unsure what this all means. Will this make it harder for me to fall pregnant? should i even try? would this cause complications if i was to fall pregnant? Regards Lisa

### output:

Hi there, I have understood your concern. I will suggest you the best possible treatment options. First do not panic. Please consider that you have already been able to get pregnant twice.  Please keep taking your thyroid treatment meticulously, monitor TSH levels every 3 months. For your PCs, I will suggest you to opt for a healthy diet and regular exercise regimen. Try to have optimum weight, with body mass index OD 23. Avoid deep-fried foods, bakery products and refined sugars. Avoid substance abuse if any. Start on Folic acid, vitamin B 12 and Omega-3 supplements at least 3 months before you plan to get pregnant. This helps to prevent many problems during pregnancy and delivery. As your remaining reports are normal, you need not worry about getting pregnant. You can simply get USG done for follicle study, to know the day of ovulation. Accordingly you can have unprotected sex act, or GUI on the day of ovulation. I hope this answer helps you. Thanks. 