Question: I am 32 years old and have a nine month old baby girl. Since her birth I have had extremely irregular periods. Prior to getting pregnant they were like clockwork but now they’re not following anything remotely close to a schedule. Is that normal? I’m worried that this might be a sign that something’s wrong.
Answer: There are several possible reasons for irregular menstruation after giving birth. Toe begin with, breastfeeding may result in an irregular cycle, as high Prolactin level (lactation hormone hence the name) may interrupt the cycle. The same may happen when one starts a progestogen-only pill for contraception during breastfeeding or with postnatal lifestyle change – such as embarking on a diet following the birth of your baby. So assuming you are not (1) breastfeeding (2) on a pill or (3) on a weight loss diet, you should have a cervical smear test and then discuss other functional and organic causes with your GP such as hormonal bloods (thyroid function test, Prolactin, day two to three FSH with LH and Oestradial, day 21 Progesterone). The results of these tests and scan should reassure you or provide you with further information regarding the best course of treatment.
Question: I am 37 years of age and my partner (40) and I have been trying for two years to get pregnant. I had a miscarriage at around seven weeks last year. We are both healthy non-smokers and my GP wants to refer us on for fertility tests. Can you please explain the types of tests that we would require?
Answer: Unfortunately, you haven’t provided details of your menstrual pattern or regularity which are the signs and symptoms of ovulation. However, a basic assessment of a couple with your background and age profiles would require both you and your partner to undertake some tests. He should undergo a semen analysis test and I also suggest you get a blood test to look out for thyroid function, day 2-3 FSH/LH and Oestradial levels, day 21 progesterone. Even if your test results are fine it may be worth visiting a fertility specialist for further assessments such as sonography with tubal study or estimation of so-called ovarian reserve-just two of the most common variables. Current medical consensus recommends couples under 35 should seek medical help if they haven’t conceived within one year or trying or six months for those aged of 36.
Dr Bartlomej Kuczera is a Specialist Fertility Consultant at Beacon CARE Fertility in Dublin. Dr Kuczera has worked in Ireland for many years as a senior medical consultant in fertility treatment and is recognised as a leading authority in reproductive medicine in Ireland and Poland. Dr Kuczera’s experience includes working in reproductive medicine in Ireland for the past five years before which he worked in Poland in the area of gynaecology, obstetrics and reproductive medicine for 12 years 220.127.116.11/~beaconcare