QuestionHello,
I'm 28 years old and I've been trying to get pregnant for a year now, with no success. I've always had fewer periods than the average woman, from age 14 to 19 they were every 2nd month (jan, mar, may, etc). When I was 19 I started Depo-Provera and was on that for 9 months. Since then I don't get my period at all unless on a monthly birth control (pill or ring). I got pregnant in 2007, 6 weeks after quitting birth control. I've tried birth control again as a way to get my system to co-operate, but no luck. My doctor has tested for PCOS, and hormone levels. He found my thyroid was low, and prescribed synthroid. Since starting synthroid, I get mild menstrual-like cramps around the same time every month, but no period. I have rheumatoid arthritis and I am very overweight. Besides losing weight (which I'm trying to do) and without costly fertility treatments, what do you recommend?
Thank you,
Desiree, from Alberta Canada
AnswerHello Desiree from Canada,
At this point, it is clear that you have an ovulatory dysfunction. There is a reason for this, and this needs to be evaluated to find the specific reason. The most likely source is PCO, which is what I would assume. Irregular menstrual cycles and obesity are enough criteria to make the diagnosis of PCO. You don't have to have all the different abnormalities for the diagnosis.
Because you have an ovarian dysfunction, your hormones are out of sync and you are not ovulating on a regular basis. The correction for this is to use fertility treatment/drugs to make your ovaries work correctly. However, sometimes, reducing the weight closer to a normal BMI can be enough to get the ovaries to function correctly. It works is some PCO patients but not all. Because you have now been trying for over a year, you have earned the classification of being an infertility patient. That is the direction you need to go and get under the care of an infertility specialist. I thought that in Canada your health care was covered by the government?
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
