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Understanding Fertility After a D&C: A Patient's Experience


Question
I e-mailed you awhile ago and you were very helpful.  I have a few new questions about getting pregnant after my D&C.

I had the D&C back on Jan. 27.  Following the D&C, my cycles have been very unusual.  

I will give you a brief schedule to see if you can detect any patterns.

1/27- D&C  (bled light for 1 week)

2/4- bleeding became heavier and was very heavy by 2/6 when I had my follow-up (the doctor thought it seemed like a regular period)

2/14- saliva test showed ovulation

2/22-23- faint positive pregnancy tests (light brown discharge)

2/24- neg. pregnancy test and full period again

3/6-7- positive ovulation tests with Home Predictor Kit

3/9- slight brown discharge

3/17- brown bleeding (not spotting or discharge)which turned into a normal period over the next few days and continues to hang on lightly even today on 3/24

I began charting my basal temperature this cycle for more data, but as I look back over the notes on my calendar that I've kept since the D&C, it looks as though I ovulate and then I get my period too soon.  I have read about a Luteal Phase Defect and wonder if this may have caused my miscarriage before.  Before I got pregnant, I went off the pill and also had pretty short cycles (20-21 days) although I'm not sure when I ovulated during those cycles.  

If I have a Luteal Phase Defect, could I have gotten pregnant before and had it lead to a miscarriage or could this be a new problem?  I made an appointment with a fertility doctor but I cannot get in until May 19.  I started taking B6 supplements because I read that that can increase the luteal phase.  I also purchased Natural Progesterone cream but have not used it yet.  I was wondering if this is safe to use and how and when should I apply it?  I also started my husband taking zinc.  Is there anything else I can do?  I am anxious to get pregnant again but afraid that the same thing could happen again if I do.

Any information you could provide would be great.  

Answer
YOu only had two cycles since the D&C. We do not know exactly when the first period started because you were still bleeding from the D&C, but it appears as if the cycle was 19 days. The next cycle was 22 days in length. A cycle is considered normal if it is 21-35 days in length. YOu may or may not have a luteal phase defect and it cant hurt to take some progesterone supplementation. It is better to take progesterone suppositories rather tnan natural progesterone cream. I would prefer if you went over the entire issue with the reproductive endocrinologist and work out a plan of action when you have your appointment in May.