QuestionThank you for taking the time to read my question, I really appreciate it.
I am a 37 year old lady with a history of irregular periods. I started menstruating at 16, but my periods were very irregular. In my late teens my periods stopped altogether for approximately 2 years. I was seen by a gynecologist who diagnosed polycystic ovarian syndrome. I started menstruating again in my mid 20s and my periods were regular. Shortly afterwards I started taking the combined oral contraceptive pill, which I took for 10 months. When I stopped taking the pill it took 4 years before I started menstruating again. I saw a gynecologist during this time, who confirmed the diagnosis of PCOS and advised that I may need some help conceiving in future. My periods were regular in my early to mid 30s, with a 30 day cycle. Occasionally there would be up to 42 days between my periods.
When I was 36 my husband and I started to try for a baby. I conceived after 3 cycles and my daughter was born last year after an uneventful pregnancy (although she did aspirate meconium during delivery and spent several days on intensive care). I exclusively breast fed her until she was 6 months old, and my periods returned when she was 6 to 7 months old. They were again regular, with a 28 day cycle.
We decided to try and conceive a second child when my daughter was 11 months old. To our surprise I became pregnant during the first month of trying, however when I was 8 weeks pregnant I started spotting and a scan revealed an empty gestational sac, of about 7 weeks size. I had surgical management of the miscarriage. That was 2 weeks ago.
My questions are
1. How long should we wait before trying to conceive again?
2. I am still breast feeding my daughter regularly as she has had some problems being weaned onto solid food. Will this affect my chances of conceiving or carrying a pregnancy to term?
3. I am going to be 38 next month, and am conscious that time is not on my side. Should I be consulting a fertility expert at this stage, or trying to conceive naturally for a few months first? I am prepared for the likely possibility of more miscarriages.
Thank you for your time.
AnswerHello Louise from the U.K.,
A recent study showed that a woman's fertility is heightened within the first six months after a miscarriage. So the recommendation would be to start trying as soon as you can. Basically, since you don't know how to time your intercourse/ovulation until you have a period, you have to wait until you have a period. Once that happens, go for it.
Breastfeeding could delay the return of your cycles for 6 moths to one year.
The recommendation is if you are over 35 years old, you should try on your own for no more than 6 months. If unsuccessful at that time then you need to see a fertility specialist ASAP for a more aggressive treatment plan. Don't waste time with a general Ob/Gyn doctor. Go directly to the specialist.
Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
