Posted by: keke | 2011-03-08



I''m a 30 yr old lady, i''ve been trying to conceive for over 2 years now. i went to a Gynae and i was diagnosed with PCOS and anovulation. My periods are very irregular. I was put on provera and clomid &  managed to conceive within the first month of treatment. But I lost the baby after few weeks &  then had a D &  C. My periods took almost 3 months to return. my last period began on the 27th of Jan till 02 feb. since then nothing. Is there anything that you can recommend that will help regulate my cycle and help with ovulation?

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Our expert says:
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Natural medicine can really offer a lot for fertility in particular Chinese medicine.

Women with hormonal irregularities may find it harder to conceive and when they do, they appear more likely to miscarry. A dominant feature of women with polycystic ovary syndrome (PCOS) is that they are likely to have multiple hormonal imbalances -- some are too high while others are too low.

Luteal phase defect. The luteal phase is the second half of your menstrual cycle, the time between ovulation and onset of the next menses. A luteal phase defect is essentially a failure of the uterine lining to be in the right phase of development at the right time, thus preventing implantation of the fertilized egg, or making the embryo's attachment to the uterus precarious.

A luteal phase defect may occur at several points during a menstrual cycle. It's thought that most luteal phase defects originate in the follicular phase of your cycle, before ovulation.

During the follicular phase, your body may not produce enough FSH (follicle stimulating hormone), or your ovaries have a weak response to FSH. The consequence is inadequate follicle development. After the follicle releases its egg, it converts itself into a different structure called the corpus luteum.

The corpus luteum produces the progesterone needed to thicken the lining of your uterus and stimulate development of additional blood vessels, which provide a place for your embryo to attach and to grow.

However, poor follicle formation will lead to a poor quality corpus luteum, and thus the corpus luteum is less likely to secrete the amount of progesterone required to ensure that the uterus can support the development of your embryo.

A luteal phase defect may also be caused by excessive levels of LH (luteinizing hormone) too early in the menstrual cycle, or an improperly timed LH surge.

LH (luteinizing hormone) hypersecretion. Some women with PCOS have elevated LH during the follicular phase (first half of the cycle), which prematurely sends a signal to the egg that it is about to be released from its follicle. The egg then prematurely disconnects from its supporting cumulus cells, which causes the egg to pause in its maturation process.

It is thought that this interruption in the normal maturation process may result in abnormal chromosomes in the egg, which would then substantially increase the probability of a miscarriage.

Other Hormones. Of course, other hormonal imbalances besides FSH and LH may be involved.

Women who miscarry appear to have higher levels of testosterone and DHEA than women with continuing pregnancies.

Women who miscarry may tend to have higher prolactin and androgen levels during the follicular phase of their menstrual cycle.

Insulin and insulin resistance. Some women with polycystic ovarian syndrome have insulin resistance, where an excessive amount of insulin is required to control blood sugar levels. High insulin levels stimulates further production of LH and testosterone. Excessive levels of insulin, LH and testosterone are associated with poorer egg quality, thus increasing the risk of miscarriage. Insulin resistance has been linked to recurrent pregnancy loss.

As you can begin to see, the risk of miscarriage may be increased by a complex, interacting web of hormones that are out of balance.

a full case history will help to recommend more specific meds to you. I suggest you consult a practitioner.

Kind regards
Dr Debbie

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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