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Fertility / Infertility (Expert Forum)
Why does my late ovulation make me have miscarriages?
Answered by
Elaine Brown, MD - Pregnancy, Gynecology
Elaine Brown, MD - BLOG
Billings - MT
Questions in the Fertility/Infertility forum are answered by doctors affiliated with USF Health. Topics covered include fertility or infertility issues, egg quality, fertility drugs and side effects, fertility tests, genetic testing, in-vitro fertilization (IVF), ovulation, relationship issues, risk factors, sperm count/quality, and surgery.
Why does my late ovulation make me have miscarriages?
by Jmo6877, Aug 16, 2009 03:46PM
I have gotten pregnant twice in this past year when I have ovulated very late. Days 30-35. The first pregnancy they called a blighted ovum and the second the fetus did not develop past 4 weeks. I had a d &c on the last miscarriage in May.
I went off birth control last year after being on it 10 years. I did not get my period for 3 months, but got pregnant on the first try right after my first period. However it was about 2 weeks after when I should have ovulated by the book. My periods have never gotten back to normal. I have not had a real period since my d & c this past May. My doctor induced a period with hormone pills and gave me 50mg Clomid to use on days 5-10. I have been tracking my ovulation since the Clomid with the clear blue easy fertility monitor, an over the counter ovulation testing kit, and tracking my temperature, etc. I am on day 21 and I still have not ovulated and have no signs/symptoms.
What is wrong with me? I thought the Clomid was supposed to make me ovulate. Clearly I can get pregnant, I just don't ovulate at the right times, and this results in my miscarriages. Is there anything else I can do to induce ovulation under the correct timing? Do I need progesterone, vitex or ovulex? Should I be going to an endocrinologist?
Please any information would be helpful.
Thank you.
I went off birth control last year after being on it 10 years. I did not get my period for 3 months, but got pregnant on the first try right after my first period. However it was about 2 weeks after when I should have ovulated by the book. My periods have never gotten back to normal. I have not had a real period since my d & c this past May. My doctor induced a period with hormone pills and gave me 50mg Clomid to use on days 5-10. I have been tracking my ovulation since the Clomid with the clear blue easy fertility monitor, an over the counter ovulation testing kit, and tracking my temperature, etc. I am on day 21 and I still have not ovulated and have no signs/symptoms.
What is wrong with me? I thought the Clomid was supposed to make me ovulate. Clearly I can get pregnant, I just don't ovulate at the right times, and this results in my miscarriages. Is there anything else I can do to induce ovulation under the correct timing? Do I need progesterone, vitex or ovulex? Should I be going to an endocrinologist?
Please any information would be helpful.
Thank you.
Doctor's Answer
by Elaine Brown, MD, Aug 22, 2009 11:45PM
, Aug 22, 2009 11:45PMTo: Jmo6877
Hi!
I'm sorry that you have lost two pregnancies! But you are looking at the situation correctly--you CAN get pregnant! Irregular ovulation does not cause miscarriages, but it can make it more difficult to get pregnant in the first place.
If you take Clomid on cycle day 3-7 your ovulation should occur on cycle day 14. If you are already at day 21, then the dose of Clomid that you took didn't work for you. It may be that you need a higher dose, or a different medication. I like Femara better, personally.
It may be that you should "start from scratch". If you were my patient, I would stop medications and do some hormone testing. In particular, I would check an FSH level on cycle day 3. (Your first cycle day is equal to the first day of your period.) I would also do an ultrasound to check for antral follicles. These tests are to check your ovarian reserve--or how many eggs you have left in your ovaries.
I would also check a TSH level, a prolactin level, and a progesterone level (day 21). I would ask you to use ovulation predictors through one natural cycle. If the evidence indicated that you weren't ovulating, I would recommend Femara plus or minus Metformin. If those medications didn't work within about 3 cycles, I would send you to a reproductive endocrinologist at that point. In your case, I would probably skip the HSG and semen analysis, as we know that he has sperm, and your tubes are open already since you conceived twice. If you did conceive again and miscarry again, I would start a workup for recurrent miscarriages.
I hope this helps!
Dr B
I'm sorry that you have lost two pregnancies! But you are looking at the situation correctly--you CAN get pregnant! Irregular ovulation does not cause miscarriages, but it can make it more difficult to get pregnant in the first place.
If you take Clomid on cycle day 3-7 your ovulation should occur on cycle day 14. If you are already at day 21, then the dose of Clomid that you took didn't work for you. It may be that you need a higher dose, or a different medication. I like Femara better, personally.
It may be that you should "start from scratch". If you were my patient, I would stop medications and do some hormone testing. In particular, I would check an FSH level on cycle day 3. (Your first cycle day is equal to the first day of your period.) I would also do an ultrasound to check for antral follicles. These tests are to check your ovarian reserve--or how many eggs you have left in your ovaries.
I would also check a TSH level, a prolactin level, and a progesterone level (day 21). I would ask you to use ovulation predictors through one natural cycle. If the evidence indicated that you weren't ovulating, I would recommend Femara plus or minus Metformin. If those medications didn't work within about 3 cycles, I would send you to a reproductive endocrinologist at that point. In your case, I would probably skip the HSG and semen analysis, as we know that he has sperm, and your tubes are open already since you conceived twice. If you did conceive again and miscarry again, I would start a workup for recurrent miscarriages.
I hope this helps!
Dr B
Member Comments (3)
by Didibonita, Aug 17, 2009 03:30PM
I am sorry to hear that but nfortunately Clomid does not work for every one. My Dr gave it to me in a attempted to get me to ovulate and it did not work. Sorry
by alwzmvn247, Aug 18, 2009 11:56AM
To: Jmo6877
Clomid makes your body produce more & larger follicles which produce "eggs" to stimulate ovulation is a different step most often using an HCG "trigger shot" with clomid. If your doctor is only using clomid and not ultrasounding/measuring follicles then triggering ovulation and they are aware that it's your ovulation timing you are concerned about then it's time to DEFINETLY see someone else. Most good doctors will give progesterone in some form to patients just in case while struggling with infertility. A reproductive endocrinologist is your best bet. Hope this helps!
