Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello XXXXXXX

Thanks for your query. I understand your concern and current situation.

1) I suggest you to repeat blood beta-hCG after 1 week in absence of period to rule out late conception though there is quite LOW chance.

2) Female body hormones are regulated by Hypothalamus- Pituitary- Ovarian Axis (HPO Axis) and it can be affected by mental stress, psychological factor, fertility medicine or external hormone, high prolactin level etc.

Women are fertile for about 24–48 hours around the time of ovulation and you have confirmed your ovulation or follicle rupture through Serial Follicular Study. However, high progesterone level is the reason of NOT getting period in spite of your ovulation.

Progesterone levels remain high unless the egg goes unfertilized, in which case the egg is re-absorbed and progesterone levels fall. In this event, progesterone levels continue to fall until day 28, when progesterone reaches its lowest level, menstruation occurs, and the cycle repeats. However, menstrual cycle varies from women to women from 21 days to 40 days due to disturbance of HPO axis.

3) In my point of view, it is MOST likely physiological phenomena. You should wait for upcoming cycle up to ONE week and repeat pregnancy test. Another thing, you can undergo Serum prolactin level and LH/ FSH test to determine underlying cause. Kindly, consult with your doctor following above tests.

Hope, it helps to understand clearly. Kindly, close the discussion if you don't have any other query.

Wish your good health and take care yourself.

Regards,
Dr Soumen

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

---

Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for follow up query. Followings are my comments:

1) Luteal Phase Defect or progesterone deficiency and High Progesterone level (mostly due to hCG injection) are to be ruled out in this context. It is related to the disturbance of Hypothalamus- Pituitary- Ovarian axis as a result of repeated stimulation in each cycle. It can lead to period disturbance certainly.

2) I suggest you to repeat pregnancy test first and undergo some tests like LH, FSH, Serum progesterone, Estradiol & pelvic ultrasound scan for current cycle. You can do those tests ANYTIME after pregnancy test.

3) Proper treatment depends on diagnosis of the case. Progesterone supplement or estrogen therapy (to combat high progesterone effect) may be required to induce period. Other supportive treatment may be given as per test reports.

4) HCG injection can be given for 4 to 6 cycles initially within therapeutic doses and it can be repeated according to next plan of treatment.

Repeated hCG injection stimulation for triggering oocyte release may lead to Ovarian Hyper-Stimulation Syndrome (in small percentage) and it should be cautioned as it is MOST dreaded complication.

5) You should know that around 10% causes of infertility remain UNEXPLAINED where all test reports are NORMAL including physical examination.

In that case, we suggest our couples to proceed ART (Assisted Reproductive Technology) following consultation with Infertility Specialist. It includes IVF (In Vitro Fertilization), GIFT, IUI etc.

Hope, I have answered your queries. Kindly, close the discussion.

Good luck and all the best.

Regards,
Dr Soumen

---

Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for additional query.

1) YES, you would take Progesterone pill as prescribed by your doctor to induce period in case of NEGATIVE blood test for beta-hCG.

Another thing, you can undergo above mentioned tests following pregnancy test to rule out underlying cause before taking 5 days medicine.

2) Late conception may be detected slight lately, even 1-2 weeks after missed period. Blood test for beta-hCG is more accurate test to rule out pregnancy at this stage. It will be more informative and worthwhile.

3) You would try for pregnancy naturally or with fertility treatment. Assisted Reproductive Technology (like IVF, IUI etc) is the LAST option for couple with Unexplained Infertility. You should consult with Infertility Specialist regarding this for proper management.

Wish your good health and good luck. Kindly, close the discussion.

Regards,
Dr Soumen

---