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Cycle length while ttc
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hollyberry27 posted:
I'm just wondering about cycle length while ttc. I've never had a regular cycle, however it was always close, anywhere from 30-32 days on average. Since my husband and I have been ttc (this will be our 4th month) it has gotten longer and longer each month. My last cycle was 41 days! Why is this? Is this normal? I've never been on the pill and never missed a period. I'm using ovulation sticks to help pin point when I ovulate since I never know when it will happen. Will it be more difficult for us to conceive because of this?
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DUKE MEDICINE
David K Walmer, MD, PhD responded:
In the fertility world, we are better at therapy than diagnosis. When asking about cycle length, the question that you are probably wanting to know the answer to is, "Am I ovulating or am I releasing an egg that can be fertilized?" The only test that we have that actually answers that question is a pregnancy test. If the test is positive, then you released and egg that was fertilized. A disappointing answer, I know. For me as well. All of the other testing that we have looks at parameters that are necessary for ovulation but don't prove that the egg got out of the ovaries. Years ago, we tried to diagnose a condition called luteinized unruptured follicle syndrome, which means that the egg got trapped in the ovary. We made the assumption that if the follicle looked the same on ultrasound before and many hours after the LH surge (i.e. the signal to release the egg) that the egg must have been trapped in the ovary. However, many times we thought that the egg was trapped and the woman then got pregnant. Therefore, the ultrasound was not helpful in making the diagnosis. That said, we can identify issues that make it less likely that a woman will get pregnant and therefore increase the changes that she has a problem. With regard to cycle length, cycles shorter than 27 days and longer than 35 days are associated with pregnancy less often. The more that cycles vary in length from month to month, the more likely that they won't result in pregnancy also. There are many different types of problems that can cause problems with cycle length including problems with thyroid, prolactin, ovarian reserve, androgen/estrogen balance, etc. Many times these issues are fairly easy to correct with medical assistance. Some patients claim to achieve success with things like acupuncture but we don't understand how that might work. The younger you are the more leeway you have with regard to procrastination, i.e. a specialist will still be able to help you if you delay. The older you are the riskier it is to delay getting help. I hope that this helps. Good luck.


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