QuestionHi, I am 41 years old in very good physical health. in 1999 i had an ectopic pregnancy that resulted in removal of my right fallopian tube. Immediately following the surgery, my periods changed from lasting 4 days to a cycle that began with a normal 4 day flow, but then I would have spotting (sometimes light, sometimes heavier, but always there) everyday until I ovulated. Then the bleeding would stop until the cycle ended. My periods were 28 days apart from start days. I had tubal reversal surgery 4 months ago in order to try and have a baby. My periods are now one day long, with a normal flow for that 24 hours and then it stops, with no additional spotting through out the month. They are still 28 days apart and I am ovulating 14-15 days after start of period. My question is, do the short periods mean anything that will affect my chances of conceiving? I appreciate all comments and questions. Tammy
AnswerHello Tammy from the U.S.,
The length of the period does not have any relationship to ovulation, but can be a sign that an inadequate endometrial lining is being formed. The way to check that is by doing an ultrasound in the luteal phase (after ovulation) to make sure the lining is at least 9 mms. If it is reaching the appropriate size, then the length of bleeding is of no consequence.
What is more important for you is your age. You have a decreased chance of natural pregnancy of about 1% per month, and it is getting worst with the passage of time. Tubal reversal was probably not an appropriate treatment for you because of this natural rate, and also because having had an ectopic pregnancy in the past, that is an indication of internal tubal damage in the past. Despite having open tubes you are at increased risk of an ectopic pregnancy should you achieve natural pregnancy, but more likely than not, your tubes probably will not function correctly. Not only are they now shorter than normal, but they probably have some level of scarring within that lead to the ectopic. My recommendation would be to proceed directly to IVF before you lose the opportunity to get pregnant using your own eggs (biological clock). That will give you the best chances of pregnancy and rates are as high as 50% per cycle in your age group. Because you have been pregnant before, your specific rate is probably a little higher.
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 follow me on Facebook at http://bit.ly/9Iw9oV
