What causes delayed periods and how to regularize them?

Hello doctor,

We are trying to conceive for almost five years now. Last year we tried IVF's first attempt but it was not successful. This month my period is delayed by 12 to 14 days today. The last period was 38 days ago, and the average cycle days are of 26 days. The period lasts for three to four days. I was expecting my period to be around 10 to 12 days ago but it got delayed. I did perform a UPT test 10 days ago and it was negative. Then eight days ago again I perform the UPT test, and there was a faint pink line. I did the beta hCG test seven days ago and it was negative. I have a couple of questions, which are bothering me. If possible try to answer the question, that would be really helpful for me. The beta hCG test is negative, yet a couple of times I got the faint pink line on the pregnancy kit strip. Why is this happening? It is leading to confusion for me. I contacted the gynecologist doctor here, she advised me to take Duphaston for five days and then stop it. This I am taking right now for a period to come. I was having doubt in my mind. There was very much doubt as yesterday morning again there was a faint pink line on the UPT strip. Today due to confusion, I also performed the ultrasound test of the abdomen and the uterus, which I am attaching it. Can you please clear my doubt as to why my period has been delayed? Can you give me a couple of reasons for this? There is doubt in my family's mind that it could be possible due to failed implantation or very early pregnancy termination. But I do not think this way after seeing the USG report, however, I am no doctor to confirm that. I also did my AMH test this month and that was 0.78, last year the AMH was 1.51. Could the sudden decrease in AMH be the reason for the delayed period? I am having this confusion because my period is never delayed. Also, there is one more thing, I am having a cough and was also suffering from a fever for the last week. All the possible reports have been attached. Can you please guide me regarding this I am really confused. Doctor has advised me to take Duphaston for five days and stop it and then the period will come naturally. I guess this is the right way. I am taking this medicine as prescribed.

Hello doctor,

Thanks for the quick reply. I will be attaching the reports again. However the beta hCG is 0.10, CBC report is normal with ESR is 60. AMH is 0.78. The USG report of the uterus is as follows-

Uterus- It is normal in shape, size (8.8 x 5.8 x 4.4 cm), and echo pattern. No focal myometrial lesion is seen.

Endometrial echo is in the midline. The double layer of endometrial echo measures 1.3 cm. The endometrial cavity is empty.

The cervix is normal.

Adnexa: No adnexal SOL is noted.

The right ovary is normal in shape, size, and echo pattern.

The left ovary is normal in shape, size, and echo pattern.

We have got your early reply and thanks for clearing the doubt. However do reply with the report which I am sending again, so the doubts can be further clarified to us. There is another simple query. As I told you I am having a cough and that is a dry cough. I have experienced that sometimes when I am coughing, there is little water discharge through the vagina. And I am sure it is through the vagina, not a urine discharge.

Hello doctor,

We are following up on your queries. I hope you can find our previous messages of ours in this thread. Here is the timeline for your reference.

1. We contacted you two months ago with our blood test reports and ultrasound reports. As you know my period was delayed and we did perform the beta hCG and that was negative. Ultrasound also was a good report.

2. I stopped my five-day course of Duphaston as prescribed by the doctor.

3. Then again just to be sure I again performed the UPT kit test and that was negative. I know this was not necessary, it was illogical. But still, you can understand that sometimes there are many unnecessary doubts in the mind.

4. I felt my period is about to come. There was little spotting. But that's about it. Only a little spotting was observed on that day.

5. Then after that my period came. The flow was low, but the color was brownish-red. By the evening, there was cramping and heavy cramping. I took Meftal spas in the evening and went to see the doctor physically. She gave me Aceclo spas as a SOS but I did not take it.

7. Yesterday, the flow become heavy and the color turns into reddish and a little bit brownish, the same as I observe in my regular periods.

8. Today also the flow is heavy, there are still cramps but the cramps are not that much now.

9. Three to four times since yesterday I have observed a little clotting along with the period. Not observed regularly but only three to four times since yesterday.

10. Whenever there is flow, means I can feel something shedding (as I know the uterine wall sheds) but I think I can feel that and in the lower abdomen area, I guess whenever there is shedding I can sense something crawling(not sure if it is the right term to use) or just sensation. I have never felt this way in earlier periods,

I have doubts regarding only these as to why there is so much problem going on. Why the flow has increased since yesterday? Is there any chance that I may have implantation that did not carry forward? Or is this only my apprehension? Is it due to hormonal imbalance or any other possible reasons? Also please let me know the Meftal Spas is a safe medicine. Can I take it in my periods? It won't disturb or interfere with anything else. Please guide me regarding my doubts. Thanks.