Does Menstrual Irregularity Affect Fertility in Women?

Does the menstrual cycle affect conception?

Hello, Doctor: I am currently 37 years old and my husband is 44.
We started trying to conceive without contraception in February of this year.
We had a premarital health check two years ago, and everything was normal! My husband has a 15-year-old child from his previous marriage, so his fertility should not be an issue, right? As for me, my menstrual cycle is somewhat irregular, but I do not experience menstrual pain or any other problems when my period comes.
Since we have been trying for over two months without contraception, I am concerned about the possibility of early menopause due to my age.
My last one or two cycles have shortened from the usual 4-5 days to 3 days, and this month my period was delayed by 7 days.
However, for the past two days, I noticed dark brown or light red spotting on the toilet paper.
Today, my period started, but the bleeding was heavier in the afternoon and then returned to light spotting afterward.
Although my menstrual cycle is irregular, this situation is new to me! Previously, my cycles were just delayed, but the flow was always normal.
I would like to ask for your advice, thank you.
(I am currently not in Taiwan, so if I need to undergo detailed examinations, could you please tell me the names of the tests in English? Thank you.)

Sylvia, 30~39 year old female. Ask Date: 2017/04/16

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the general definition of infertility is the inability to conceive after one year of regular sexual intercourse.
If infertility is suspected, it is advisable to visit a gynecologist for evaluations, which may include semen analysis, hysterosalpingography, ovulation testing, and hormone blood tests, among others.
Currently, you may not be experiencing infertility and can simply observe the situation.
If you still have concerns, you may consult your regular gynecologist.
Wishing you good health.

Reply Date: 2017/04/16

More Info

Menstrual irregularity can indeed affect fertility in women, and your concerns are valid, especially considering your age and the changes you've noticed in your menstrual cycle. At 37 years old, you are approaching the age where fertility can begin to decline, and irregular cycles can be indicative of underlying hormonal imbalances or other reproductive health issues.

Firstly, it's important to understand that a regular menstrual cycle is often a sign of normal ovulation. Irregular cycles can suggest that ovulation is not occurring consistently, which can make it more challenging to conceive. In your case, the changes you've described—such as a reduction in the length of your period and the occurrence of spotting—could be related to hormonal fluctuations that may affect ovulation.

The fact that your husband has a child from a previous relationship suggests that his fertility is likely intact, but fertility is a shared responsibility, and female factors can play a significant role. Given that you have been trying to conceive for over two months without success, it may be beneficial to monitor your ovulation. You can do this through various methods, such as tracking basal body temperature, using ovulation predictor kits, or monitoring changes in cervical mucus.

Regarding your concern about early menopause, it's important to note that while irregular periods can be a sign of perimenopause (the transitional phase before menopause), they can also be caused by other factors such as stress, weight changes, or medical conditions like polycystic ovary syndrome (PCOS) or thyroid disorders. The spotting you mentioned could also be a sign of hormonal fluctuations, which are not uncommon in women approaching their late 30s.

If you are considering further evaluation, you might want to discuss the following tests with your healthcare provider:
1. Hormonal Panel: This can include tests for estrogen, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and thyroid hormones. These tests can help determine if your hormonal levels are within a normal range and if ovulation is occurring.

2. Transvaginal Ultrasound: This imaging test can help assess the health of your ovaries and uterus, checking for conditions like ovarian cysts or fibroids that could affect your menstrual cycle and fertility.

3. Hysterosalpingography (HSG): This is an X-ray procedure that examines the inside of the uterus and fallopian tubes. It can help identify any blockages that could prevent conception.

4. Luteal Phase Defect Testing: If you have irregular cycles, your doctor may want to assess whether your luteal phase (the time between ovulation and the start of your period) is long enough to support a potential pregnancy.

5. Genetic Testing: If there are concerns about early menopause or other genetic factors, this may be worth discussing.

In terms of your menstrual irregularity, it is crucial to consult with a healthcare provider who can provide personalized advice and treatment options based on your specific situation. They may recommend lifestyle changes, medications, or other interventions to help regulate your cycle and improve your chances of conception.

In summary, while menstrual irregularity can affect fertility, it is not the sole determinant. A thorough evaluation by a healthcare professional can help identify any underlying issues and guide you on the best path forward in your journey to conceive.

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