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Delayed periods during infertility treatment - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Infertility Problem
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1770 Questions
Doctor :   hi
Doctor :  
how can i help u?
User :   hello doctor
User :   i have a query regarding my menstural cycle
Doctor :  
ok
Doctor :   proceed

User :   I am a few days late in this cycle; I had fever for about a week this month
Doctor :  
ok
User :   do u think the delay is due to fever or should i consider pregnency as a possibility
Doctor :  
when was your last menstrual period?
User :   Last period was on Oct 21st
User :   I am undergoing some infertility treatment also
Doctor :  
ok and before that when was it?
Doctor :  
ok
Doctor :  
what treatment are you taking?
User :   ok .. normally my cycle used to be 32/33 days. But last 2 times after the tablets the cycle was around 30 days
User :   I am taking some pills, monitoring the folicular growth using ultrasound, and doctor recommends the timed intercourse
Doctor :  
ok
Doctor :  
what medications are you taking?
User :   just a min...
Doctor :  
sure
User :   It is tablet Letoval from day 3 to 7 of cycle
Doctor :  
ok
Doctor :  
anything else that you are taking?
Doctor :  
what was your scan report?
User :   i am taking thyroid medication; folic acid
User :   scan report was normal;
Doctor :   ok
Doctor :  
did you do your thyrpid test?
User :   this month ovulation was detected in ultrasound on day 15; but last 2 months on day 12
User :   now it is almost 6 months since my thyroid test
Doctor :  
was any other hormonal test was done for you?
User :   yes, some other hormonal tests were done and the study was normal. do u need more details?
Doctor :   in a 30 day cycle ovulation can occur anywhere between 10-16ths day of the cycle
User :   ok... regarding harnonal test FSH level was 8.42 mlU/ml
Doctor :  
it would be better if you give the details of the hormone tests done for you along with the scan reports
Doctor :   ok
User :   & LH was 3.15 mlU/ml
User :   Now I giving details of scan report: Doctor :  
sure, go ahead
Doctor :  
was Prolactin levels done for you?
User :   uterus: normal in size, contour and parenchymal echopattern. No distinct focal lesion. endometrial echoes are normal. Ut measures: 6.7 cms, AP: 3.1 cms, transverse diameter: 3.9 cms, endometrial thickness 7mm
Doctor :  
ok
User :   yes, prolactin level was 10.42 ng/ml
Doctor :  
ok
User :   continuing with scan report...
User :   adnexa: both ovaries appear normal. no adnexal mass; RO meas: 3.5 * 1.9 cms; LP meas: 4.0 * 2.3 cms
Doctor :  
ok
User :   and lastly P.O.D: clear
Doctor :  
ok
User :   doctor impression was: normal pelvic studt
Doctor :  
your scan report seems to be fine.
Doctor :  
is the endometrial thickness mentioned anywhere in the report?
Doctor :   ok
Doctor :  
sorry i jsu reviewd
Doctor :  
and saw that you have mentioned it
User :   yes, on day 10 it was 7mm, and grows after that
Doctor :  
fine
Doctor :  
so now you are having a 30 day cycle since you are on the Letoval
User :   yes
Doctor :  
and the follicular study showed ovulation on 15th day of the cycle
User :   yes doc; but previous cycle it was on 12th day (when cycle was 30 days) so i am not sure if this month i should expect 30 or 33 day cycle
Doctor :  
so the scan done for ovulation confirmation was on 4th NOV
User :   yes; on 4th nov it is ruptured
Doctor :  
Yes Viday i understand your concern. in a 30 day cycle ovulation can occur anywhere between 10-16ths day of the cycle
Doctor :   so you can have ovulation on the 15th day also
User :   ok... thanks
Doctor :  
since you have a history of fever, the ovulation might have got delayed a bit
User :   fever was after ovulation
Doctor :  
ok
Doctor :  
fever after ovulation was a high fever or just a little raised temperature?
User :   it was around 100 C;
Doctor :  
ok
Doctor :  
did you have the intercourse during your ovulation time?
User :   yes, i did.
Doctor :  
ok
Doctor :  
if we consider it to be a 30 days cycle then you are late by 8 days this month
User :   ok
Doctor :  
and if we consider it to be a 33 day cycle then you are late by 5 days
Doctor :  
i would suggest you to wait for another 5 days more
Doctor :  
and then if you still dint get your periods
Doctor :  
then check a urine home pregnancy test
Doctor :  
to see if you are pregnant
Doctor :  
and if it does come negative, do not get disheartened,
User :   ok doctor. are these test kits are avialble in medical stores?
Doctor :  
but go and check a blood HCG level
User :   ok... doctor
Doctor :  
which will give a more confirmed results
Doctor :   yes these kits are available in medical stores
User :   ok.. thank u doctor. so i will wait one more week
Doctor :  
Few brands include Dr.Reddy's laboratories, or Organon labs
Doctor :  
these are the trusted brands you can ask your gynac for these prescriptions
User :   ok doctor.
Doctor :  
sometimes if the HCG levels in urine are less, then these tests can show a negative results
User :   i forgot to mention that i got a HCG injection on day 13 of cycle this month
Doctor :  
report back to your Gynac, and get a blood HCG levels done in case you face this problem
User :   ok... sure
Doctor :  
also after Dec 4th you can also opt for a transvaginal scan which will show the presence of gestational ring in the uterus which is the most trusted confirmation that you are preganant
Doctor :  
and in that case if the HCG levels are low
Doctor :  
you will need supplimentation of progesterone hormones to continue the pregnancy safely
Doctor :  
so if you have got the injection once, you might need to continue tablets for next 2-3 months
Doctor :  
until the placenta takes over the function
Doctor :  
have you followed what i have said?
User :   ok...doctor. these tablets can be started only if pregnancy is confirmed. correct? i mean there is no need to have it now
Doctor :   no, no need to have them now, only after the confirmation you might need to start
Doctor :  
that too wil depend on the condition at that time.
User :   ok.. thank u.
Doctor :   I have just told you the precautionary measures
Doctor :  
such that you can continue the pregnancy safely
User :   ok. i understand.
Doctor :  
and loser the precious baby that you are going to have
Doctor :  
be careful also in your daily works now
Doctor :  
do not lift anything heavy, do nor wear heeled chappals, do not climb stairs
User :   yes, i have reduced in last 1 week since the delay started; i am doing very mild excercise only now
Doctor :  
do not walk fast or run
Doctor :  
do not do any activity that can put pressure on the abdomen and pelvis
User :   ok... i have been going to gym; i will stop completely until further tests are done or my period starts
Doctor :   take ample of green leafy vegetables to rteduce chances of constipation'drink aboout 10-12 glasses of water per day
Doctor :  
also take a fruit juice, preferably musambi or orange juice to keep your body cool and provide energy for the bodily changes that will slowly take place
Doctor :  
sleep well for atleast 6-7 hours daily
Doctor :   and avoid all stressful conditions, practice relaxation techniques in case you find yourself getting into any kind of stress
Doctor :  
have you followed what i have said?
User :   yes doctor. thanks. I will do these from today
Doctor :  
avoid the use of sesame seeds, sesame oil, papaya, brinjal and all other such foods that are labeled as hot foods
Doctor :  
Is there any thing else I can help you with?
User :   ok thank u doc. my questions are answered now;
Doctor :   in case you continue to have intercourse now, be sure to be in your comfort level and avoid any rough or rashness
User :   ok.. i understand.
Doctor :  
until the pregnancy is confirmed
Doctor :  
and if it does get confirmed, continue to practice these measures for next three months and again in the last two months
User :   ok doc; in case the pregnancy is negative should i meet my gynecologist?
Doctor :  
yes , you should meet your gyynac
Doctor :  
and get a blood HCG level done
User :   ok. thanks.
Doctor :  
and a trnsvaginal scan done
Doctor :  
if both come negative, you will have to follow another cycle, and if both come positive then well, congrats in advance.
Doctor :  
do not worry for anything
Doctor :  
wait for 5 more days
Doctor :  
and get a pregnancy test done, if you still dint get your periods by that time
User :   ok doctor; i understand. thanks
Doctor :   Please fill the feedback form and comment box, say done when done.
User :   done
Doctor :  
Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
User :   thanks doctor. bye
Doctor :   Bye
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