Hi,

Thanks for writing to us.

If you have had no other problems like polyps, fibroids or cysts in the ovary and your tubes have been shown to be patent, then the most likely cause for your bleeding at present is a threatened or inevitable abortion if you have conceived; it may be a delayed period if you failed to conceive in this cycle.

Progesterone medications that are given when to boost the fertility status when ovulation induction is being done can sometimes cause such heavy bleeding. There is endometrial hyperplasia when a cycle is delayed and heavy bleeding occurs in such a case.

If you had regular cycles previously, this delay in the cycle as you were shown to have ovulated three weeks ago, goes in favor of conception. You should see your consultant at once, get an evaluation and a sonogram along with a serum beta-hCG titre to confirm/exclude pregnancy.

If it is an inevitable abortion you may have to get an evacuation done. If it turns out to be a threatened abortion, you would need absolute bed rest, avoiding all activity that can strain you and avoid sexual intercourse. You may need progesterone supplementation after checking the status of pregnancy.

Hope I have answered your query. Please feel free to contact if you need further clarifications. I will be happy to help.

regards,
Shanti.V.

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Hi,

Thanks for writing back.

If you are on ovulation induction it is possible to get hyper-stimulation of the ovaries and release many ova simultaneously. Otherwise, usually only one ovum is released at a time from only one ovary in a cycle. The other possibility why you had many follicles is polycystic ovaries, a state of hormonal imbalance featured by simultaneous development of several follicles but none of them is mature enough to ovulate and fertilize. Cyst formation may occur. Infertility is an associated feature as are prolonged irregular menstrual cycles as ovulation is absent or irregular.

Presently, I would ask you to see your specialist immediately to exclude/confirm pregnancy and deal with the cause of the heavy bleeding. That done, we should concentrate on what is to be done next. If you are diagnosed to be pregnant, you will be dealt with accordingly. If not, you may have hormonal supplements to control your bleeding after other causes are excluded.

I think you should get a complete hormonal evaluation, including FSH/LH, Prolactin, thyroid profile, serum DHEAS levels, glucose tolerance test and ovarian reserve. A tubal patency test is also needed. Obesity is another associated feature and measures should be taken to maintain a normal body weight as this alone has been shown to improve fertility status. Assessment of male factor also is needed. These are the standard set of investigations done when anyone wants to conceive.

Hope I have clarified your doubt. Please get back f you have any more queries. I will be ready to help.

regards,
Shanti.V.

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Hi,

Thanks for writing again.

In the natural mode of conception, one cannot predict a twin pregnancy. It is a chance happening and often runs in families. During artificial reproduction, multiple pregnancy is possible when ovulation is induced and multiple ova are released at the same time. With IVF, multiple embryo transfer is done and twinning as well as multiple pregnancy is a possibility. You may discuss this further with your doctor about the possibility in your case.

Hope I have answered all your questions. You can contact me whenever you need me. I will be ready to help.

Wish you good health.

regards,
Shanti.V.

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Hi,

Thanks for writing again.

You may contact me for any OBGYN related disease or discomfort. I will be available to help you.

Wish you good health.

regards,
Shanti.V.

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