Hello, I'm Mrs Uma Gordon, Consultant Gynecologist and Specialist in Reproductive Medicine and Surgery. I'm also the Clinical Director of Bristol Fertility Clinic.
Many patients come to me with irregular periods. Irregular periods, so their periods may be happening every six weeks, once in two to three months, or sometimes complete absence of periods. What is necessary is an appropriate workup assessment to make a diagnosis.
The most common condition, though, that we deal with is polycystic ovarian syndrome but, again, you need to be satisfying certain criteria before that diagnosis is made and you're put on medications.
In terms of irregular cycles, the reason you're not conceiving is that your egg is not being released and that's called anovulation, you're not ovulating, or your cycles are very dysfunctional, they're not working as your menstrual cycle should. This is simply treated, it's very successfully treated, with medications. Previously, we used to use a medication called Clomid and you might have heard that, but now we use a more latest medication called Letrozole. It's much more effective and more successful as per studies. We use Letrozole for several months to see if conception can be achieved.
I have seen women going for IVF directly with anovulation and that shouldn't be the case. It's important that simpler treatments are used first and if they're not successful then we progress upwards. So, medical treatment is not effective, the next step could be ovulation induction with injections along with intrauterine insemination, sometimes known as IUI, and then we may go to IVF.
However, appropriate counselling is needed. The pros and cons should be discussed and you may decide that medical treatment has not worked. Based on your age, you may want to go straight for IVF but those are discussions that need to take place after you have understood the situation completely in relation to your own circumstances. But be aware that simpler medical treatments are usually effective with anovulation.
It could also be that you're not ovulating because a particular hormone called prolactin is raised. You may not be ovulating because your hormone levels are low.
So the diagnosis of your condition, of your specific situation, and then directing the appropriate treatment towards that, is important. Take care.
