Your irregular period could be the cause of delayed conception - Evewoman
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Your irregular period could be the cause of delayed conception

Dear Doctor,
I have a long menstrual cycle; I can go up to 3 months without a period. How then can I work out my fertile period as I am anxious about delays in getting pregnant?

 Most women have a regular menstrual cycle. This means they can predict fairly accurately when the next period is expected. Some will have irregular periods for various reasons. Still, regular periods could change into an irregular pattern, causing a bit of anxiety. Regular periods imply regular ovulation, and high chances of conception. Irregular periods, on the other hand, imply unpredictable ovulation patterns and often a delay in conception.

The average regular menstrual interval is 28 days. You can expect to ovulate around the mid-cycle, give or take a few days either way. Having sex around the ovulatory period, therefore, gives you a high chance of conception. But you don’t necessarily need to have sex timed around your mid-cycle.

Regular intercourse, about two to three times a week, will still catch you at the right time. Irregular and prolonged period intervals, however, mean ovulation is unpredictable, or it may not be happening at all. But still, a proportion of women with irregular periods will still conceive spontaneously. Again regular intercourse helps, with conception occurring as and when an egg gets released, even though somewhat unexpectedly.

Prolonged period intervals mandate gynaecological review to work out the cause. Majority of women will have a condition called polycystic ovarian syndrome (PCOS). The diagnosis will be confirmed following hormone tests and pelvic imaging. A minority may be diagnosed with rarer causes. A specific and definite diagnosis must be made prior to any recommendations on treatment options.

Once a diagnosis for irregular periods has been confirmed, fertility enhancing treatment can then be offered. Those with PCOS can be advised on lifestyle adjustments that may promote resumption of spontaneous ovulation. Treatment with ovulation tablets is often necessary.

It’s best not to self-medicate, as some basic monitoring is required to work out the optimal dose. Once you start ovulating, you can expect to conceive within three to six months. If a rarer diagnosis has been made, the most applicable and appropriate remedy will be recommended.

If you do not conceive shortly after the correction of ovulation, there may be additional fertility issues that may not be immediately apparent. A comprehensive additional fertility evaluation is warranted in these circumstances. And this must include testing of the male partner as well.

Some women with irregular periods and ovulation disorders will eventually require advanced fertility treatment to conceive.

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