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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for difficulty in conceiving despite going through infertility treatment

Answered by
Dr.
Dr. Soumya

OBGYN

Practicing since :2010

Answered : 2977 Questions

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Posted on Mon, 19 Sep 2016 in Women's Health
Question: I am taking treatment for conceiving.
1st month of treatment i had tablet siphene and tried naturally but it did not work out
2nd month i was asked to take letrozole tablet.
This time I believed strongly that i will conceive as we were in good contact and everythign went fine, my period got delayed but all of sudden
on 37th day I got my periods. I was really shocked.
this month I also had follicular study done, and I ovuluted on 16th day...but den i readlly donot know wy it got delayed
till my 37th day..during this month after my ovulution I also has susten 200 mg tablet.

i did pregnancy test on 33rd day as wel as on 37th day, but result was negative.

Lat month even htough I could not conceive but i got my periods on 30th day.

Before that for last 6 months I had ovrall tablet, which i believed would regularise my periods as i had PCOD in past.

Also to let you know, i am taking neuro tablets like KEPPRA ,OLEPTOL
Following is my concern:-

1) as i got my period on 37th day, does it mean that my periods are irregular and do i need to take action on that first?
If that is reason, but my ovulution happened properly on 16th day nOt too late also.
2) Or this delay mean that there was a close chance for me to conceive but got missed, so may be next month
I can continue wiht my treatment for conceiving WITH HIGHER DOSAGE OF LETROZOLE or some other tablet like I am doing now
3) Also after crossing 30th day, i could observe some changes like body pain, specially leg and some changes that gave me a feeling
that i am pregnant.what can be the reason behind that?does it mean that i was about to conceive but got missed?
also to let you know, after my 30th day i travelled arn 15 km in 2 wheeler everyday, cpuld this have affected?
4) or this close chance could be missed out due to my neuro tablets?
doctor
Answered by Dr. Soumya 49 minutes later
Brief Answer:
Further evaluation Required

Detailed Answer:
Hi,

I understand your concerns about infertility.

Following is my reply :

1) Since you had irregular cycles the delay of 37 days is also because of irregular cycles.

2) Irregular periods could be due to PCOS, overweight issues. This cannot be cured by contraceptive pills.

3) Riding 2 wheeler or neuro tablets have nothing to do with this delay.

4) You were not pregnant. This was just delayed periods.

5) Please get further evaluation like semen analysis for your husband and HSG ( hysterosalpingogram) for yourself to assess the patency of fallopian tubes.

Let me know if you need anymore help.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Soumya 22 hours later
Hello, Thank you for your response.

Still I have some concerns. Lat month I had folicular study done and on 16th day was ovulution. But still I go tmy periods on 37th day.

1)If my ovulution happened on 18th or 19th day I can still understand that.
But after having it on 16th day, how come it extended till 37th ? That means my first half was regular and second half of cycly was irregular? Can you please explain more on that.

2) can this delay be due to letrozole tablet?

3) on my 34th day itself i had cramps and not able to sit down on floor with my legs folded, this situation went on increasing day by day and suddenly got my periods on 37th

4) To solve this issue, if its due to irregularity, what medicine I shohuld take, or treatment I sould undergo next month.

Also, my husbands semen analysis, my HSG all has been done, no issues with all these. I am trying since last 4 years, all possible tests I have done, to be XXXXXXX I am tired of doing these tests.

Plaese help me , Thank you
Also last month I got my periods on 30th day itself.

doctor
Answered by Dr. Soumya 4 hours later
Brief Answer:
IUI is next step

Detailed Answer:
Hi,

Periods happen after withdrawal of progesterone hormones in body. In ovulation induction cycle there is more amount of progesterone in the body which slowly reduces and hence delayed periods.

In natural cycle second of cycle ( luteal phase) is not delayed.

Irregular cycles cannot be completely cured.

Since you have tried for 4 years already, you seem to be suffering from unexplained infertility. I suggest you go ahead with IUI ( intrauterine insemination) procedure.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Soumya 12 hours later
Hi,

1)I had susten 200 mg table from my ovulution date till I got my periods , so can this affect my cycle, as I believe susten contains progesteron.
Also this month eveyday night I was having Glycomet tablet 500 mg during the entire cycle.
Can these 2 tablets influence my cycle and would have been reason behind delay?

2) I have already conceived 2 times.
But 1st time when I conceived, I was forced to go with voluntary abortion in my 5th month as baby was infected with RUbella infection
and 2nd time I had missed abortion

Both the times I conceived only with tablets and tried naturally .
So I believe that should be possible now also without IUI.

If I decide to go with medicine, can you please let me know medicine that will help me in conceiving.

Thanks.
doctor
Answered by Dr. Soumya 4 hours later
Brief Answer:
Better to do IUI

Detailed Answer:
Hi,

Thanks for additional information.

1) Susten is progesterone and is likely to delay periods. Hence your delayed cycle was due to progesterone.

2) Pregnancy chances reduce with age. Though you had conceived previously, you are unable to conceive for last 3 years which means that you should get treated with next step instead of waiting as you will lose out on age.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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