What effect does irregular periods have on ovulation?
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Hello Doctor, I am 33 years and often had irregular cycles. My last cycle was on 25 Sep. and i had no periods. i had ultrasound but everything was normal. i was asked to take Modus on 11 dec to have my periods and i eventually got them on 27th Dec. Then from D2 i had clomid 50 mg for 5 days. Now on D 10 i had multiple follicles approx 8-9mm and today on D 12 i have One Dominant Follicle in Only one ovary thats 1.03X1.1 cm. How many chances are of when my ovulation will happen? do i have to take meds to ovulate? I wanna conceive asap.
Posted Fri, 14 Feb 2014 in Menstruation and Miscarriage
Answered by Dr. Aarti Abraham 24 minutes later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hello Thanks for writing to us with your health concern. Firstly, you should get evaluated for the cause of irregular cycles. Suspecting from your clinical history, I think you might have PCOS - polycystic ovarian syndrome. Please get a baseline pelvic ultrasound scan. ALso, hormonal tests like - FSH, LH, TSH, Prolactin, OGTT, DHEAS, free testosterone, lipid profile, fasting serum insulin. Then go for one cycle of plain follicular monitoring without any induction - this will reveal if you are ovulating or not. Women with irregular cycles often do NOT ovulate regularly. Normally in a 28 day cycle, ovulation occurs around day 14. By day 14, the follicle should be atleast 18 - 20 mm in size. In your case, you have taken Clomid ( clomiphene citrate ) this month. In response to Clomid, more than 50 % of women ovulate in the first attempt. Considering day 12, the size of the follicle is still not adequate. However, as you have irregular cycles, it is possible that ovulation might be delayed. Continue the follicular monitoring for one week more, that will reveal if the dominant follicle is growing. If the follicle size is optimum, then you might need to take HCG injection to trigger ovulation. Continue remaining sexually active, as erratic ovulation might occur anytime. Take regular folic acid tablets, and maintain ideal BMI. Avoid stress and negative thinking If you fail to concieve after 3 - 6 cycles of Clomiphene therapy, please go for laparoscopy to check if your fallopian tubes are open. If they are blocked / stimulation fails, then consider IVF - In Vitro fertilization. Also, get your partner's semen analysis done. All the best. Please feel free to discuss further.
Follow-up: What effect does irregular periods have on ovulation? 18 days later
Hello & thanks doctor, I am not sure if i have PCOS but i got my blood test done. It showed all levels normal & a high T4. My Endo says it was due to the medications i was taking. I got my periods on 25.01.2014 after 29 days, which i think is because of meds. My question is 1: i took Fertomid on D2(today) as told by my doctor and instead of dinner by mistake i took it after breakfast,,So when should i take the next one? After Dinner or breakfast. 2: should i still go in for ovulation study as last time from D10-18 on alternate day none of my multiple follicles matured. Its painful process, what do u suggest? 3: should i take follic acid tablets as i am already overweight and will be taking duphaston 10 mg from D11 as well. I am eager for a child but i want a healthy one, so i can wait till my system is ready to create & hold onto the baby.
Answered by Dr. Aarti Abraham 24 minutes later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hello Yes, you do not need to take any medication for the high T4. For your answers - 1. You can continue taking them daily after breakfast, the timing should be constant. 2. Yes, there is no option but to go for follicular monitoring and ovulation study, other than that your chances of natural conception are very low due to irregular cycles. As you did not ovulate in the previous cycle, if the same phenomenon occurs this time, you might need higher doses of Clomiphene or injections added to clomiphene. If 3 - 6 cycles of ovulation induction fail, please go for laparoscopy ( if you do not conceive inspite of ovulation ) or IVF ( if no response to ordinary stimulation is observed ). 3. Yes, please continue folic acid tablets. They will not affect your weight. Take care. Do not delay conception for long, with age, the problems will only increase, not decrease.
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