Fertility concerns 2nd opinion

Hi,

I"m 34 years old and trying to conceive for 3 months. I have irregular cycles - varying between 30-40 days. And I don't have PCOS neither other major problems.
In 2007 I had a miscarriage with 6 weeks. And  the only test I did was the hormonal tests which came up OK.
I realized that I'm not  ovulating every month using the ovulation sticks.

My last 5 months periods:

December  12  2008
January     11  2009
February    12  2009
March        17  2009
April          15  2009  

How can I calculate when I am ovulating with these historic periods?
Should I worry with some fertility problems I may have?
What are your advices in my case? Tests? Treatments? What should I do?

Many Thanks

[Elaine Brown, MD]

Hi!
It sounds to me like you are ovulating intermittently.  For example,the Feb--March cycle is too long--you probably didn't ovulate.  But the March--April is pretty good.

The way to calculate when you ovulated is to subtract 14 days from the first day of the menstrual period--So April 1 for example.

Using something like Metformin plus Femara, or just Femara alone, can regulate your cycles and speed up the process.  

If you were my patient, I would check a prolactin level, a TSH and a progesterone level all on day 21 of your cycle. I would also check an FSH on cycle day 3 to evaluate your "ovarian reserve" which is the number of follicles remaining in the ovaries.  Its that "age" thing.

Hope this is helpful!
Dr B