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

### input:
i am 42 years old and only have a daughter who is currently eight years old. I have been tryin hard in vain to conceive. According to various doctors reports i have multiple fibroids inside my uterus . But despite this I managed to get pregnant even with fibroids and gave birth to my daughter through a normal delivery. I am desperate to have a baby or babies. Three days ago i was advised to use fertility pills which i should finish by saturday, and then proceed to using ovacare, kindly advice.

### output:

Hi there, After going through your question, I am of the opinion that:1) Fibroid do cause infertility, especially as age increases as well as size of fibroid increases.2) The reason that fibroid cause infertility are: a) They distort the uterine cavity and prevent implantation. b) Hormonal changes are caused which can prevent ovulation. c) Sometimes, they obstruct sperm transport and fertilization. d) They can cause miscarriages due to poor plantation.3) My suggestion is that you keep trying to conceive, but in case the pills do not work, you might need to get your fibroid removed by mastectomy and then plan for pregnancy.4) As it is, your age is also a factor in reduced fertility. As we grow older, our follicles reduce and there are a lot of hormonal changes too. A woman of 34 and of 42 are completely different. You should get evaluated for your hormonal profile too with tests like FSH, LH, AMH, Sr. testosterone and estradiol, TSH, T3, T4 and blood sugar and Sr. insulin. I wish you all the best. Chat Doctor. 