Increasing cycle lengths & trouble getting pregnant

[Red19512]

My husband and I are currently trying to conceive. I've been off the pill since about August last year and we've been actively trying since February this year. When I first came off the pill my cycles were every 28 days give or take a day or so but they have been increasing in length 40, 57, 79. I'm on day 41 at the moment.

I've been to the doctors and they sent me for a blood test for PCOS which came back normal. I had hoped that my cycle would go back to normal after the getting the results (weight off my mind and all that) but this doesn't seem to have been the case.

I started my periods when I was quite young (10) so I'm worried that this may have some bearing on me not getting pregnant and my cycles being so mental. The doctor didn't seem too worried about it all but I can't shift it off my mind.

[AttilaTheMeerkat]

What hormone levels were tested and on what cycle day?. If the test was done on the wrong day the test result is meaningless.

Usually with PCOS the blood tests done are specific; a day 2 test measures LH and FSH levels against each other. As your periods are so irregular they should be looking properly to see if PCOS or problems with your thyroid gland are the root cause. You need a diagnosis first and foremost.

I do not think that starting your periods at 10 has any real bearing at all on what is happening now.

I would return to the GP and insist that you are now referred to a gynae at a subfertility unit. Both of you as well should be tested further.

[Red19512]

I had the test done on day 2 of my cycle and I've had tests for thyroid before as my mum has an under active thyroid but they came back normal too.

[AttilaTheMeerkat]

These tests need to be redone or at the very least looked at again.

With regards to the day 2 test did they compare LH against FSH?.

Do not just accept “normal”. You should always ask for the actual figures of your test results – your level as well as the ranges. Be aware that different areas in the country use different test ranges so one TSH test range might be 0.5 – 5.0 but in another area the TSH range might be 0.4 - 4.0. You could be “borderline” (near the bottom or top of the range) or have “subclinical hypothyroidism” (high TSH and normal FT4) or “subclinical hyperthyroidism” (low TSH and normal FT4) and not be aware of this because you have not been given the ranges of the tests. Subclinical thyroid disease is not usually treated although treatment may be useful.

[FET14]

I had similar cycle / infertility issues as you when I came off the Pill to TTC too. After over a year TTC properly with no success and my cycles being weird and erratic (having never having been like that prior to going on the Pill) my GP referred me for a day 21 progesterone test to check that I was ovulating and the result was 'normal'. They then sent me for an internal ultrasound which found that both ovaries were (still are!) very polycystic and also found a couple of small polyps. Further blood tests (day 2 etc) showed hormones were all normal but I was then referred to the sub-fertility clinic where the specialist ordered a lap and dye (to check tubes) and a hysteroscopy (to remove polyps and take a look inside womb to check no endo etc.) under general anaesthetic. He wouldn't prescribe Clomid until knowing tubes were fine. After the op, and while waiting for a referral to the Assisted Conception clinic to come through, I was prescribed Clomid - a low dose for 4 months, to 'boost' ovulation, even though I was ovulating naturally. It made no difference for me. In the end, we had successful IVF treatment and now have one child - our happy ending!

You can have polycystic ovaries AND 'normal' blood results and therefore not have full blown PCOS. You can have PCOS without having the usual PCOS issues of being overweight or having unwanted hair etc. You can have regular-ish periods yet not ovulate and you can have no periods and ovulate - both are unusual circumstances but can happen. It's useful to remind doctors of this in case you're an unusual case, so that they investigate properly.

Attila is totally right about the timing of the tests being critical. Some GPs can be massively ignorant / dismissive of infertility issues to push for a referral to a specialist if you feel you're getting nowhere.

So while my ovaries were / still are polycystic, our infertility was 'unexplained' as I was ovulating naturally at least on most cycles, if not all, and there were no other issues identified with me or DH.