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Menstrual cycle length can vary. Cycle length is determined by how long it takes the body to recruit an egg before ovulation and how long the cyst created by egg release makes progesterone after ovulation. Usually there are 14 days from ovulation until your period or a positive pregnancy test. So one possibility is that it is taking you longer to recruit an egg in the months that your cycles are longer. If the cycles are getting longer than 35 days, or you are no longer seeing positive OPK results, you may be not be ovulating robustly. Your OB/Gyn can help you determine if this is the case, by checing progesterone levels one week prior to your expected period or one week after a pos OPK. Good Luck!View Thread

Now that you have stopped the birth control pill, periods mostly reflect the hormone changes as the ovary picks and releases an egg, and the hormone production from the cyst of ovulation; women who are not ovulating can have irregular bleeding. Charting your cycle and using ovulation predictor kits can help you determine whether you are ovulating, releasing your egg, or not. I recommend charting for another month and then visiting with your OB/Gyn. He or she can check a progesterone level one week after you ovulate (one week after you see a surge on your ovulation predictor kit, or cycle day 21 or 22 if you did not see a surge). If you ovulated your body will be making progesterone. If you did not ovulate, your progesterone will be low, and your OB/Gyn will do some additional testing to evaluate.
Rest assured you have not "messed up your cycle." The hormones from the birth control are quickly gone (that is the reason we recommend back up birth control for missed pills). You are doing a great job of listening to your body. Your Ob/Gyn will help you determine exactly what your bleeding means and either reassure you that you are ovulating or help you to ovulate. Good Luck!View Thread








The beginnings of a fertility evaluation focus on eggs, tubes, and sperm. With regards to eggs, your doctor will want to confirm that you are releasing your egg and determine how many eggs remain. Signs that you are releasing an egg are regular, predictable menstrual cycles, positive ovulation predictor kits, shifts in basal body temperature, and/or a high progesterone level approximately one week before your period. Ovarian reserve, the number of eggs remaining in the ovary, can be evaluated with blood tests (FSH, AMH) and ultrasound for antral follicle count. Fallopian tubes can be evaluated by a hysterosalpingogram, an xray test where xray dye is injected into the cervix. The xray shows the cavity of the uterus and whether the tubes are open. Sperm are evaluated with a semen analysis to look for sperm number and motion. If a semen analysis is not normal, it will be repeated to rule out normal fluctuations. If it is normal either the first or second time, no further evaluation is needed. If it is abnormal twice, you will be referred to urology for further evaluation. The next steps in fertility evaluation and treatment will be based on results to the above tests. While these tests can identify some fertility factors, mother nature is more complex. Occasionally all the tests will be normal, despite a continued delay to pregnancy. Therefore, your doctor will discuss fertility treatment in the context of the evaluation you have completed.View Thread
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