QuestionSince going of birth control pills, my premenstrual spotting has increased each cycle. I went to an ob/gyn who said that 7 days of premenstrual spotting was nothing to worry about. She felt around for possible polyps, but no ultrasound. She said if I wasn't pregnant in 6 more months, see a fertility specialist, which of course is not covered by my insurance. I am willing to pay cash, but am wondering if I should wait the six more months or go now. I am 34, trying to conceive for six cycles now. Thank you! I do have a 14 day luteal phase and my temps do stay elevated until the last day.
AnswerHello Carol from the U.S.,
I am not sure that I agree with your Gyn doc that 7 days of premenstrual spotting is normal. If the pelvic examination was normal, ie nor source of the bleeding can be seen in the vagina or cervix, then I would probably do an endometrial biopsy and maybe even a hysteroscopy. A hysteroscopy is one of the tests for infertility so if it is done in advance for abnormal bleeding, your insurance may cover it.
The general recommendation to see an infertility specialist is if you have not gotten pregnant within 12 months, unless your are over 35 years old. Then we cut it down to 6 months. However, that doesn't mean that if you want to go sooner that you can't. You certainly can.
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
