QuestionHi Doctor. I wrote to you about 2 months ago, about ttc after an early miscarriage. I already have 2 children (ages 4 and 3), concieved both my first month off of birth control. I was on loestrin birth control for 2 years which I stopped taking this past Dec 2009, got pregnant again and miscarried in February 2010 - approx 8 weeks.
Since then I have had 5 menstural cycles (from 25-29 days long) - and started trying again after the 1st cycle.My periods are extrmemly light, 1-2 days of moderate bleeding, then 2-3 days of spotting. The bleeding can also stop for maybe 12-24 hrs, then restart. My periods were never like this before loestrin or the miscarriage.At my insitance, my obgyn checked my hormone levels last month, I do not know the exact amounts. Progesterone was normal/indicative of ovulation; TSH was normal; FSH was 5 but my estrogen levels were on the lower end of normal and they want me to repeat the test on day 3 of my next cycle.
Would this lower estrogen level explain my lighter periods and possibly prevent conception? I am actively trying, but my obgyn wants to wait until Sept/Oct before she does any bigger tests, telling me to relax for the summer and stop trying. She said I am not premenaposal and that most doctors wouldn't even reapeat the lower estrogen level tests. What do you think, I really would like to conceive soon. Is it possible that I am like a weak ovulator? Is there anything I can do to build my estrogen levels back up? I jusy turned 31 and just can't seem to conceive again. Do I need clomid?
Thanks for your time and response.
AnswerHello Jackie from the U.S.,
Your blood tests are within normal limits. A cycle day #3 FSH or estradiol will show these two hormones at their lowest levels in the cycle. That is why we do the test on that day. If you want to see what your estrogen level is before ovulation, then it should be tested around the time of ovulation. Also, and ultrasound can be done around CD#14 to see how thick your endometrial lining is. If it is at least 9 mms, then it is sufficient for implantation. I don't think that either of these is the problem, and I don't think that you need Clomid at this time.
If you have been trying for pregnancy for less than one year, then it is too soon to declare that you have a fertility problem. By definition, infertility is diagnosed after one year of trying. 85% of patients less than 35 years old will take 8-12 months to achieve pregnancy. You have to give yourself that chance. I don't want to belittle your worries, but you may be worrying prematurely.
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
