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

### input:
Yes, my husband and I are trying to conceive. We conceived in 2008 & lost the baby at 14 weeks with a miscarriage. Since then, we have tried to get pregnant and learned April this year, I have premature ovarian failure with very little egg reserve left. Also, I just turned 40. All those factors are working against us.  Ive been on clomid for 3 cyles, and the last 2 months had mature follicles. Both times did not get pregnant. We decided to have my husband do a seamen analysis to see if things were ok in that area. He took 2 tests one month apart. There are 2 factors less than the desired level. My question is, could these 2 things be contributing to us not getting pregnant. His concentration was 6.2 out of desired 15 , and the motility was 33 out of desired 40.

### output:

Hallow Dear, At the age past 40, the fertility does go down; however, with proper monitoring and scientific approach, pregnancy is not impossible. Now let us start from the end of your query. Though a couple of parameters in your husbands' semen report are somewhat substandard, they do not rule out the possibility of conception. You may have to go for some assisted reproduction technology like intrauterine insemination of so. I am more concerned about your ovarian reserve. On what basis you have been declared a case of premature ovarian failure; and if so how is it that are responding to camphene citrate by ovulation? Anyway, your ovarian reserve seems to be very poor. Hence, I would advise you to monitor ovulation by ultrasonography. This will help to assess the endometrial growth also. Ovulation from the follicle between 18 mm to 21 mm gives best results. The endometrial thickness between 9 mm to 14 mm at the time of ovulation (thus indirectly conception and implantation) is very conducive for successful implantation and pregnancy. So at the time of ovulation with such conditions, you may get intrauterine insemination done to increase the possibility of pregnancy. You may try this for 3 months (considering your age and ovarian condition) after which you might seriously think of in vitro fertilization and embryo transfer. In this advice, I am presuming that you have tested the patency of your tubes, and they are patent. If you have not tested, please get Hysterosalpingography and/or Laparoscopy done for the tubal assessment before you take any active intervention step. I hope this clarifies your doubts. 