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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Rheumatoid Arthritis, ANA +ve, On Medication. Trying To Conceive. PCOS, Long Periods. Ovulating Time? Pregnancy Chances?

Am a Rheumatoid arthritis with ANA +ve, on medication and on remission now.Two years back I was conceived but sadly ended in stillbirth 21 weeks. Now TTC again, , 3 natural cycles no success, period length 25 to 35 days. Undergoing natural cycle follicular imaging. Today Cd 16 - right overies have 12 mm follicle and ET 5.2., bilateral PCO seen. When will I ovulate, are there chances of getting pregnant this cycle. Not on fertility medications this cycle.
Mon, 25 Feb 2013
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OBGYN 's  Response
Hello
Thank you for your query.
On cycle day 16, the follicle size is not good enough.
Even if we consider the longest length of your cycle, that is 35 days, then we can wait till a further 4 - 5 more days to see if the follicle reaches a mature size of 20 mm atleast.
If you do not ovulate, you would need fertility medications from your next cycle.
Also, you need to have your PCOD under control, with weight reduction, lifestyle modification and Metformin to be added if your doctor agrees.
Your tubal patency should be checked, as well as semen analysis of your husband.
Your autoimmune disease is an obvious factor, but other reasons for stillbirth should be evaluated, such as Rh incompatibility, diabetes, hypertension, thalassemia, cord problems , chromosomal disorders etc.
Take care
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Rheumatoid Arthritis, ANA +ve, On Medication. Trying To Conceive. PCOS, Long Periods. Ovulating Time? Pregnancy Chances?

Hello Thank you for your query. On cycle day 16, the follicle size is not good enough. Even if we consider the longest length of your cycle, that is 35 days, then we can wait till a further 4 - 5 more days to see if the follicle reaches a mature size of 20 mm atleast. If you do not ovulate, you would need fertility medications from your next cycle. Also, you need to have your PCOD under control, with weight reduction, lifestyle modification and Metformin to be added if your doctor agrees. Your tubal patency should be checked, as well as semen analysis of your husband. Your autoimmune disease is an obvious factor, but other reasons for stillbirth should be evaluated, such as Rh incompatibility, diabetes, hypertension, thalassemia, cord problems , chromosomal disorders etc. Take care