<s>[INST] hello sir i m 27 yr old male married since last year . we hv been trying for a child but are still not successfull. my wife is 26 yr old and her TSH levels are slightly elevated. she also has galactorrhoea since last 4 years. her prolactin levels are about 25 units. she had been started on thyroxine 25 mcg OD daily and tab cabergoline 0.25 mg once weekly recently along with tab oflox-oz 1 bd & tab fluconazole 150 mg stat . my semen analysis was normal except for 8-10 pus cells. what does it indicate. what investigations should i undergo? is this the right treatment we are taking? is cabergoline better then bromocriptine if we desire pregnancy? sir plz reply . we would be highly obliged [/INST] Hello dear, I understand your concern. In my opinion you are on correct line of treatment. Your wife has problems of hypothyroidism and galactorrhea both are the cause of female infertility. They might cause hormonal imbalance leading to irregular ovulation and irregular cycles. Cabgoline is better than bromicriptine and increases the conception chances. Cabgoline is given as tapering dose and the prolactin level is repeated after the course. The prolactin level is only mildly elevated.(up to 20 ng/ml is taken as normal). But both the problems are correctable and once the level becomes normal the conception becomes successful. Presence of pus cells in semen indicate infection, and it needs a course of antibiotics to be taken. Nothing to worry. Avoid stress. As both your and your partners problems are correctable and reversible. There are good chances of pregnancy once they are corrected. Hope this helps. Best regards.... </s>