Delayed Ovulation After D&C: What Could Be Happening?

Question
Hi.  I am writing from Pittsburgh, PA. I had a miscarriage in late August 2010 (at 10 weeks gestation).  I have only had two periods since my D&C, both cycles lasting approximately 60 days.  I also use a fertility monitor daily to track my cycles. The monitor did not detect ovulation in either of those cycles.  Prior to this last pregnancy, my cycles lasted 34 days with ovulation around day 20.  I have a 3 and 1/2 year old daughter which we conceived naturally.  Is this normal after a D & C and how much longer should I wait before I consult a specialist?  THANKS!!!!

Answer
Hello Terri from the U.S.,

It sounds like you have some sort of Ovarian dysfunction going on.  I cannot tell you exactly what the cause is without doing an evaluation.  This should include blood tests (hormone panel consisting of FSH, LH, TSH, Prolactin, Estradiol), an ultrasound and diagnostic hysteroscopy.  The blood tests need to be done on cycle day #2 or 3 of the menses, so you will need to take Provera (or another progesterone), to start a period instead of waiting for the natural one to start.

This is not normal after a D&C and as I stated, needs an evaluation.  For that reason, I would go to see a specialist to get the evaluation done.  You can either see a reproductive endocrinologist (infertility sub-specialist) or a gynecologist that is well versed in infertility (not just one that says they do infertility but one that knows what they are doing).

Good Luck,

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