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Delayed Period: Pregnancy or Other Causes? - Expert Advice


Question
Hi Brenda,

I am 34 years old and my menstrual cycle is fairly regular (ranging 27-31 days). I have been TTC for about 6 months and have been charting my ovulation using ovulation test strips and BBT testing. For the past few months my luteal phase has been 11-12 days.

During the last cycle, I ovulated on schedule around Day 19, so according to my previous luteal phase, I should've gotten AF around Day 30. Instead AF came on Day 38... that's 8 days late! I took 3 pregnancy tests and all were Negative (on Day 29, Day 33 and Day 35). The pregnancy test strips that I used were supposed to pretty sensitive and should've been able to detect HcG levels as low as 20 mlU. I didn't have the chance to do another home pregnancy test before the bleeding started on Day 38.

My BBT was also fairly elevated for about 13 days prior to AF.

Does it sound like I simply had a late period with an unusually longer luteal phase? Or is there a chance that I may have had a chemical pregnancy (very early miscarriage) even though the pregnancy tests were negative? If so, is there also a chance that I have Luteal Phase Defect (since my HcG levels were undetectable and thus very low during the testing days)?

Thanks!

Answer
Dear Lily,

In the first half of your menstrual cycle, lots of things are going on including various hormonal fluctuations to prepare the egg for ovulation and ultimately to actually cause ovulation itself. In the luteal phase, the major hormonal event is the rise of progesterone levels and the uterine lining's preparation to receive a fertilized egg (in the event that conception has occurred). Luteal phase defect means that a problem exists with the luteal phase, resulting in the uterine lining not being optimally prepared for implantation of a fertilized egg. Two common occurrences or symptoms which are seen with LPD are a short luteal phase (a woman getting her period 10 days after ovulating rather than 13 or 14 days afterward) and a low progesterone level. But many times LPD can contribute to early miscarriages because, as I said, that uterine lining is just not fully ready for implantation.

The fact that the hCG levels were no yet detectable may or may not be significant. As you surmised, because they likely never reached an amount over 20 mIU/ml, it can indicate that you simply had a longer cycle and never had a pregnancy OR that hCG which would have been produced/risen more rapidly after implantation never had a chance to occur because implantation never took place.

You can pose the scenario to your GYN or fertility doctor but unfortunately, unless your progesterone IS low, there is really nothing they can do as a "fix" for you at this point. It sounds like you are ovulating pretty regularly and truly, 6 months is an average amount of time to try to conceive a pregnancy. I know it is frustrating on your end, but it really isn't lengthy on average.

Keep trying and, most of all, RELAX! It is usually when couple relax that something happens. Just try having fun with it. I usually suggest having sex every other day from cycle days 10-21 - and if you had a 38 day cycle, I'd even extend that to CD 25. This allows for any variation in your ovulation day and also gives your partner's body a chance to build back up his sperm stores.

I hope this information has helped you and answered your questions. I wish you well.

Brenda