Early Menstruation After Second IVF: Key Concerns and Insights - Obstetrics and Gynecology

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Second artificial insemination?


Doctor, I underwent laparoscopic surgery to remove an ovarian cyst last November.
My last menstrual period started on November 24, and this is my second attempt at artificial insemination.
I received an ovulation trigger shot on December 6, had the embryo transferred on December 7, and had intercourse with my husband on December 9.
I started taking the medications (small white pills four times a day, immunosuppressants twice a day, and progesterone once a day) on December 10.
My next expected period is December 22, but on December 18, I experienced some cramping in my lower abdomen and noticed a bit of blood when I went to the bathroom, which made me think my period was coming early.
However, since then, I have only had a small amount of brown discharge, and occasionally I feel some heaviness in my abdomen, but nothing more has come out.
So far, this is my situation.
I would like to ask:
1.
Can artificial insemination affect the timing of my menstrual cycle? (As my cycles have been consistently 28-29 days, and my first attempt at artificial insemination was also on time.)
2.
I have heard that an early period could be due to insufficient progesterone, but I have been consistently taking the small white pills; does that not help?
3.
Is there a possibility of the ovarian cyst recurring? However, I had a health check on November 14, and my CA-125 level was 33, which is within the normal range.
4.
Should I continue taking my medications?
Thank you.

SSS, 30~39 year old female. Ask Date: 2016/12/19

Dr. Cao Guotao reply Obstetrics and Gynecology


Hello, artificial insemination may not necessarily affect the timing of menstruation.
Generally, after undergoing artificial insemination, it is recommended to continue taking the prescribed medication.
If you have further questions, it is advisable to consult your original obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2016/12/19

More Info


Understanding early menstruation after an IVF cycle can be a complex issue, especially when considering the various factors that can influence menstrual cycles and overall reproductive health. Based on your situation, let’s address your concerns systematically.

1. Impact of IVF on Menstrual Cycle: It is not uncommon for women undergoing IVF to experience changes in their menstrual cycle. Hormonal treatments, such as those you are taking (e.g., medications for ovulation induction and luteal support), can affect the timing and characteristics of your menstrual cycle. The medications can sometimes lead to early bleeding or spotting, which may be mistaken for an early period. In your case, the early onset of what you believe to be menstruation could be attributed to the hormonal fluctuations caused by the IVF process.

2. Luteal Phase Deficiency: You mentioned the possibility of luteal phase deficiency, which is a condition where the luteal phase (the time between ovulation and the start of menstruation) is shorter than normal or insufficient to support a pregnancy. While you are taking medications to support the luteal phase, it is important to note that not all women respond the same way to these treatments. If you continue to experience early bleeding or spotting, it may be worthwhile to discuss this with your healthcare provider, as they may consider adjusting your medication or exploring further evaluation of your hormone levels.

3. Recurrence of Endometriosis: You expressed concern about the recurrence of endometriosis (referred to as "巧囊" or endometriomas). While it is possible for endometriosis to recur after surgical intervention, regular monitoring and follow-up with your healthcare provider can help manage this risk. Your CA-125 level of 33 is within the normal range, which is a positive sign, but it is essential to continue monitoring for any symptoms or changes.

4. Medication Management: Regarding your medications, it is crucial to follow your healthcare provider's recommendations. If you are experiencing unusual symptoms or bleeding, you should reach out to your provider to discuss whether you should continue your current regimen or make adjustments. They may want to evaluate your situation further, especially if the bleeding persists or worsens.

5. Next Steps: Given your symptoms of cramping and spotting, it would be advisable to keep a close watch on your menstrual cycle and any associated symptoms. If the bleeding continues or if you have significant discomfort, it is essential to contact your healthcare provider promptly. They may recommend an ultrasound or other diagnostic tests to assess your uterine lining and overall reproductive health.

In summary, early menstruation or spotting after IVF can be influenced by various factors, including hormonal treatments and potential luteal phase issues. It is essential to maintain open communication with your healthcare provider to address your concerns and adjust your treatment plan as necessary. Regular monitoring and proactive management can help optimize your chances of a successful pregnancy.

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