I am trying to conceive after stopping my birth control injections. Please guide me.

Question

Hello doctor,

I came off the Depo birth control injection about seven months ago. I have been trying to conceive, but nothing yet. I have prolonged periods, some lasting 38 days. For the past few months I have been using ovulation tests, but I never get a positive result. I have an application on my phone where I key in the date of my period each month, and it tells me my most fertile days. I take ovulation tests every day, even more than once a day sometimes, and still nothing. I am so confused. At the moment, I am on a 22-day cycle. I have been having a terrible breast pain, for the past week, which I never had previously. I feel totally sick and tired. I am experiencing mood swings as well. I am totally confused. I do not have any medical conditions except for fibromyalgia.

Answer 1

Hello,

Welcome to icliniq.com.

How are you doing?

The Depo-Provera (medroxyprogesterone) is supposed to disappear from the body within four months, but for some women, it takes longer. As per your history, the hormone balance is not yet achieved. In every cycle, only if the hormone balance is normal, the ovulation occurs. It is like a jigsaw puzzle where all the pieces have to sit at the right place to get the solution.

Now, the only way to get the hormonal rail back on track is to provide the same hormones which have got suppressed.

From the first day of the next period, I suggest you take the combined oral birth control pills. Take it for 21 days. Then, no pills to be taken for seven days. Start taking the next packet from the eighth day. Do no wait for your periods. You will have your menses in between. Have this for three cycles. That is, three weeks of pills, one week of no pills, and from the eighth day, start the next packet. Repeat this for a total of three cycles or packets. When you are done with this course, your hormones will be normalized, and ovulation will get regularized.

Even after trying this, if ovulation is not established, you will need to be administered the same hormones as injections, under the guidance of a doctor. But do no worry, you will do fine.

Do get your thyroid profile and serum prolactin done, on an empty stomach, to rule out other possible causes.

Hope I have been of help to you. Do write back. All the best.

For more information consult an infertility specialist online.