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

### input:
Hi I am recently married to my husband of four years. I ve been off birth control since October my husband and I were trying at first but nothing ever happened. Recently this is the first time I ve missed 2 periods in a row ever no nausea or cravings but my nipples are constantly hurting and sensitive, white spots have appeared around my areola and discharge has been appearing only when squeezed from my right nipple. I have taken many urine tests and a blood test about two weeks ago and all said negative. Should I be worried?

### output:

Hi, I guess your concern is about reasons for not getting pregnant, right. Firstly I want to tell you that there many reasons or factors which are responsible for not getting pregnancy. These factors can be present in wife or in husband or in both. In most few cases reasons are unknown.in case of female most common reason is ovarian factors like-irregular menses, cystic ovaries etc. Tubal factors like blockage of one or both fallopian tubes, uterine factors like fibroid etc. Sometimes there is a hormonal cause like abnormal thyroid hormones, excessive secretion of prolactin hormone etc. In case of male most common factor is abnormality in sperm or sperm production etc. Secondly let us discuss your problem:- as you told that I missed your period for 2 months, but pregnancy test was negative, and you are having pain, white spot around nipple and on squeezing there is discharge from nipple, right.These problems mostly occurs in case of high prolactin level in the body. It is milk producing hormone which is secreted from pituitary gland. When its level is high in body, it causes irregular menses and milky discharge from the nipple etc. But you have not given information regarding your menses whether it is regular earlier or irregular from the starting, and also you have not told about the character of the nipple discharge. So it is difficult for me to comment on this. With above discussion you can try out my suggestions-1. As you told that you are taking birth control pills. These pills are given for regularization of menses. Once your menses will regular, there is high chances of getting pregnant. So DON'T WORRY.2. Try to do coitus in fertile period (it starts from 10th-16th day of menses) during this period chances of getting pregnant is high). So do coitus as much than possible.3. If you are in hurry then visit nearby infertility specialist. He/ she can help you. I hope the above information is useful, informative and helpful. Let me know if I can assist you further. 