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What Do Delayed Period And Negative Pregnancy Result Suggest?

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Posted on Wed, 22 Apr 2015
Question: Hello! My name is XXXX, I'm 32, 129#, 20.8 BMI. My husband and I are TTC. I stopped taking the pill (Jolessa-84 pack) in January of this year after consistently being on the pill for about 7.5 years. In 2007, I was off the pill for about 7 months during which time I recall having regular cycles, once they returned, which took a little more than a month. Prior to that, I had been on the pill for about 4 years starting in 2003. The first day of my last cycle, which was a "pill period" while taking the placebos, was 1/27/15 and it lasted through 2/3/15. I haven't had any spotting or blood flow of any kind since then. I experienced what felt like PMS cramps and fatigue on 2/25, but I was back to feeling normal the following day, but I am still experiencing occasional, dull, lower abdominal pains. Although my husband and I were using another form of contraceptive through 3/6/15 (we had the MMR vaccine on 2/6/15), I took a HPT on 2/28/15, just to make sure (because there was just one time when the condom slipped off inside), and it was negative. The first time we had unprotected sex was 3/10/15 and I noticed I had a little bit of EWCM on my panties on 3/13/15. I haven't been doing any BBT charting, but I'm checking my CM daily (although I'm not consistently charting it). I haven't had any "dry" days, but I've had a couple when it was a little sticky and grainy (after the day I noticed EWCM), and ever since then, it's been fairly wet, clear, and slippery. Considering I noticed EWCM on 3/13, I thought I might be able to expect my cycle to start sometime between 3/27-3/30, if I wasn't pregnant. So, I took another pregnancy test on 3/27/15 and it was also negative. I haven't had any "pregnancy symptoms" really. I did have some waves of nausea on the evening of 3/26 - which was another reason I decided to take a HPT on 3/27, but no other symptoms, so I thought perhaps it was just indigestion since we had eaten dinner shortly before. Now that my husband and I are TTC and having unprotected sex on a regular basis (2-4 x/wk), I'm wondering how often I should take a HPT without knowing when my cycle is? Also, if they keep coming up negative, when should I see a doctor about my cycle not returning? At this point, I don't even know for sure that I'm ovulating and I've read some things about POV and PCOS that have me concerned. I'm 32 and we plan to have more than one child, so I just don't want to wait too long to find out if my system is working the way it should. Thank you for your time!
doctor
Answered by Dr. Mahesh Koregol (1 hour later)
Brief Answer:
Details required

Detailed Answer:
Hi

I need few more details before answering your query.

1. Please attach your husband's semen analysis report with this.

2. Have you got any tubal patency test done like HSG ?

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mahesh Koregol (46 minutes later)
Hello Dr. Koregol,

Thank you for your reply. My husband hasn't had a semen analysis done and I haven't had a tubal patency test done... We just started TTC in March of this year (earlier this month), but I've been off the pill since January. We haven't seen a fertility specialist yet. My regular gynecologist (she doesn't practice obstetrics) recommended we try for at least a year before seeking fertility consultations, but that was when I saw her in February prior to realizing my cycle wasn't returning when expected. I'd prefer not to wait for a year, especially not knowing whether or not I'm ovulating...
doctor
Answered by Dr. Mahesh Koregol (2 hours later)
Brief Answer:
Follicular growth scan required

Detailed Answer:
Hi XXXXXXX

Following is my detailed reply:

1. EWCM and mucous thickness are not reliable tests.

2. There are no specific signs or symptoms of pregnancy that occur early which confirms pregnancy.

3. Since you are already 32, I don't want you to waste anymore time.

4. Ask your doctor to give you progesterone tablets to induce periods.

5. After periods get transvaginal ultrasound scan done to know number of antral follicles. This will confirm if you have PCO.

6. Get HSG (Hysterosalpingogram) for yourself and semen analysis for your husband after your periods.

7. Undergo regular follicular growth scan to check growth of follicle and thereby ovulation occurrence so that you have sexual intercourse on the day of ovulation.

I hope your doubts are clarified.

Regards
Dr. Mahesh Koregol.
IVF and Infertility Specialist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mahesh Koregol (40 hours later)
Hi Dr. Koregol,

Thank you for your reply and advice. I contacted my gynecologist and she is prescribing 10-12 days of progesterone tablets (Provera) for me to start taking on Sunday 4/5, providing the pregnancy test she requested I take Sunday is again negative. She said the progesterone will hopefully trigger a withdrawal bleed, but if it doesn't, I need to come in and see her. However, I see your further instructions regarding ultrasound, HSG and follicular growth scans, so I'll follow up on that as well - whether or not the progesterone induces periods - Hopefully it works! I previously scheduled a "pre-conception" appointment with an Ob/Gyn specialist for 4/22 (my current gynecologist doesn't practice obstetrics). Would you recommend I keep that appointment and follow up with him on the other items, or is it something my current Gyn can do?

Thank you again!

XXXX
doctor
Answered by Dr. Mahesh Koregol (5 hours later)
Brief Answer:
Keep the appointment

Detailed Answer:
Hi,

It is good to know you had good start. Follow your gynecologist's advice.

You can keep the earlier appointment you had booked for 22 April and go ahead as 2 opinions are better than one.

Keep me updated about progress so that I can help you at each step.

If you wish to ask me questions next time, you can contact me directly by pasting following link in your browser :

http://bit.ly/askdrmaheshkoregol
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3830 Questions

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What Do Delayed Period And Negative Pregnancy Result Suggest?

Brief Answer: Details required Detailed Answer: Hi I need few more details before answering your query. 1. Please attach your husband's semen analysis report with this. 2. Have you got any tubal patency test done like HSG ? Regards