What causes late periods despite negative pregnancy test?

Question

Hi doctor,

I am 23 years old. My BMI rate is 29 and I am trying to conceive for the past one and a half years. I have irregular periods and my doctor prescribed me Duphaston tablets for getting periods last year. Should I take this medicine again? It has been 90 days since my last period. I tested for pregnancy it was negative. My query is, what should I do for getting my periods or getting hormone balance? These days I cannot go to my doctor due to lockdown. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

You may be suffering from PCOD (polycystic ovary disease). If you want to conceive then the entire approach to treatment changes because we then focus on making you ovulate. Let me know your LMP (last menstrual period) and health history and also, any investigations done previously. I understand things are difficult with COVID but you can get the treatment at home only. Do not worry.

Answer 2

Hello,

Welcome back to icliniq.com.

First of all, continue Eltroxin 25 mcg. Start Folic acid supplements 5 mg once a day. You have to take Deviry (Medroxyprogesterone acetate)10 mg twice a day for five days and then you will get your periods. On day 2 of periods take Letrozole 2.5 mg once daily for seven days. This is usually followed by a serial ultrasound to see the development of the egg. However, you may skip that in view of COVID-19. On day 12 to day 16, you must have intercourse. This is the time when ovulation is likely. Since we won't be doing ultrasound we are taking a window period of five days when we expect ovulation. In the meantime continue Folic acid and Eltroxin. Next month if you do not get periods go for a pregnancy test.

For example, if you start tomorrow morning with Deviry then expect your periods around 8th. So on 10th June start Letrozole 2.5 until 17th June. 18 to 22 June is intercourse time. If you do not get periods by 8th July then go for a pregnancy test.

Answer 3

Hello,

Welcome back to icliniq.com.

I have seen the reports (attachment removed to protect patient identity).

The beta HCG (human chorionic gonadotropin) is negative. Semen analysis is good. The follicular study shows the same problem which I suspected. You are not ovulating. Your eggs are sort of getting wasted before release. So Letrozole is a good drug.

Just one suggestion, infertility treatment takes a lot of time and patience from both doctor and the patient. Do not panic. You are very young and have a lot of time in hand so be positive.