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Should I Take Duphaston For Delayed Period?
Question: Hello Doctor(s),
My wife is 38, and she had her first miscarriage at the age of 20 – then 2 other miscarriages and finally last year (After 5 years of the last miscarriage) we had an induced abortion at 14 weeks because the heart of the baby stopped beating. We were on Duphston (not to mention that we stopped Duphaston at 12 weeks as well).
We did all medical checkups which came back normal except for 2 genetic mutations which are:
Beta – Fibrinogen G455A Heterozygous mutant & MTHFR A1298C Heterozygous mutant.
She has hepatitis C caused by a tattoo she placed back in 2000, diagnosed after a full checkup in late of 2014.
We’ve been trying to conceive since February without luck – her last pregnancy didn’t take any effort! It was one shot that got her pregnant instantly.
We tried Merional injections on big doses for 4 months , Along with Clomid and also didn’t get pregnant - then we thought to give her a couple of months without hormones or medicines. This cycle, we went for an Ultra Sound check up and found a 4.4CM (or MM I don’t recall) Cyst at cycle day 13 and saw no follicles at all. Doctor said we should start Diane on Day 5 of her next period. And then try an IUI –
We also use the OvaCue machine (Oral and Vaginal) to check her cycles , the machine had a confirmed ovulation on CD 13 , OPKs are all negative and Pregnancy Tests are negative as well.
We were also told that we will need Clexane injections on daily bases due to the above two genetic mutations.
We were thinking of giving her Duphaston starting today (IN CASE – She is pregnant) .
So my question is:
1- Should I start duphaston? Or wait for a possible late ovulation?
2- Will this cyst effect ovulation? Or pregnancy possibility? Doctor said it was a Functional cyst.
3- Does Duphaston cause no ovulation?
4- Most importantly, I need a great advice on our case in particular based on all the above given information.
Thanks,
XXXXX
My wife is 38, and she had her first miscarriage at the age of 20 – then 2 other miscarriages and finally last year (After 5 years of the last miscarriage) we had an induced abortion at 14 weeks because the heart of the baby stopped beating. We were on Duphston (not to mention that we stopped Duphaston at 12 weeks as well).
We did all medical checkups which came back normal except for 2 genetic mutations which are:
Beta – Fibrinogen G455A Heterozygous mutant & MTHFR A1298C Heterozygous mutant.
She has hepatitis C caused by a tattoo she placed back in 2000, diagnosed after a full checkup in late of 2014.
We’ve been trying to conceive since February without luck – her last pregnancy didn’t take any effort! It was one shot that got her pregnant instantly.
We tried Merional injections on big doses for 4 months , Along with Clomid and also didn’t get pregnant - then we thought to give her a couple of months without hormones or medicines. This cycle, we went for an Ultra Sound check up and found a 4.4CM (or MM I don’t recall) Cyst at cycle day 13 and saw no follicles at all. Doctor said we should start Diane on Day 5 of her next period. And then try an IUI –
We also use the OvaCue machine (Oral and Vaginal) to check her cycles , the machine had a confirmed ovulation on CD 13 , OPKs are all negative and Pregnancy Tests are negative as well.
We were also told that we will need Clexane injections on daily bases due to the above two genetic mutations.
We were thinking of giving her Duphaston starting today (IN CASE – She is pregnant) .
So my question is:
1- Should I start duphaston? Or wait for a possible late ovulation?
2- Will this cyst effect ovulation? Or pregnancy possibility? Doctor said it was a Functional cyst.
3- Does Duphaston cause no ovulation?
4- Most importantly, I need a great advice on our case in particular based on all the above given information.
Thanks,
XXXXX
Brief Answer:
Right treatment is being followed
Detailed Answer:
Hello Sir, thanks for trusting health care magic.
I understand your anxiety and appreciate your efforts for making it happen in a best possible way.
Yes she should start duphaston now and take it twice a day for 14 days and after stopping that she will get periods properly in case she is not pregnant.
Duphaston can interfere with ovulation in case taken prior to the maturity of follicle but in her case there is no developing follicle and she has an ovarian cyst too so there are no chances of developing one either so late in her cycle.
Duphaston interferes with ovulation only if taken in a continuous fashion from day 5-25 which is given to regulate cycle in some women.
Her next step of management should be the use of oral contraceptive pills for 3 months at least to shrink the size of cyst and regulate the ovarian and endometrial health.
Then take ovulation induction drugs followed by in utero insemination.
I basically practice infertility so in case you have any questions in future you can contact me directly on http://bit.ly/drmanishajain
Right treatment is being followed
Detailed Answer:
Hello Sir, thanks for trusting health care magic.
I understand your anxiety and appreciate your efforts for making it happen in a best possible way.
Yes she should start duphaston now and take it twice a day for 14 days and after stopping that she will get periods properly in case she is not pregnant.
Duphaston can interfere with ovulation in case taken prior to the maturity of follicle but in her case there is no developing follicle and she has an ovarian cyst too so there are no chances of developing one either so late in her cycle.
Duphaston interferes with ovulation only if taken in a continuous fashion from day 5-25 which is given to regulate cycle in some women.
Her next step of management should be the use of oral contraceptive pills for 3 months at least to shrink the size of cyst and regulate the ovarian and endometrial health.
Then take ovulation induction drugs followed by in utero insemination.
I basically practice infertility so in case you have any questions in future you can contact me directly on http://bit.ly/drmanishajain
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor - but what about the genetic mutations mentioned above?
Plus, if she takes Duphaston now (we've been told she must take it for 10 days not 14) I will prolong her cycles because its regular and should be due on the 9th. What do you think?
Finally, we've been told that she should take diane for 20 days only - then IUI - you still recommend taking it for 3 months?
What about her age? is it too late to get a baby or two?
And finally, how does Hepatitis C affect all this?
Thanks
Plus, if she takes Duphaston now (we've been told she must take it for 10 days not 14) I will prolong her cycles because its regular and should be due on the 9th. What do you think?
Finally, we've been told that she should take diane for 20 days only - then IUI - you still recommend taking it for 3 months?
What about her age? is it too late to get a baby or two?
And finally, how does Hepatitis C affect all this?
Thanks
Brief Answer:
Should take Diane for 3 months
Detailed Answer:
Duphaston is usually given to support already existing pregnancy or induce withdrawl bleeding so can be given fro 10-14 days depending on the reason as in your case you were hopeful of pregnancy so should be taken for 14 days and then on finishing the course do a pregnancy test and in case negative then is stopped.
It will prolong your cycle only this time and your period will be late by few days but that is not a matter of concern as the effect is limited to this cycle only.
Taking Diane for 3 months will regulate all hormones and will resolve the cyst too so you can discuss that with your doctor.
But in case you guys are very anxious and dont want to wait for three months you can opt for IUI straight after one cycle of Diane but it has been documented to have lower implantation rates.
The mutations you have mentioned can be managed by intake of active form of folic acid so nothing much to worry as of now.
But as soon as she hets the IUI procedure done she will be put on clexane injections and steroids along with folic acid which will help in early implantation,
All the best.
Should take Diane for 3 months
Detailed Answer:
Duphaston is usually given to support already existing pregnancy or induce withdrawl bleeding so can be given fro 10-14 days depending on the reason as in your case you were hopeful of pregnancy so should be taken for 14 days and then on finishing the course do a pregnancy test and in case negative then is stopped.
It will prolong your cycle only this time and your period will be late by few days but that is not a matter of concern as the effect is limited to this cycle only.
Taking Diane for 3 months will regulate all hormones and will resolve the cyst too so you can discuss that with your doctor.
But in case you guys are very anxious and dont want to wait for three months you can opt for IUI straight after one cycle of Diane but it has been documented to have lower implantation rates.
The mutations you have mentioned can be managed by intake of active form of folic acid so nothing much to worry as of now.
But as soon as she hets the IUI procedure done she will be put on clexane injections and steroids along with folic acid which will help in early implantation,
All the best.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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