Pregnancy Chances After Miscarriage and Irregular Cycles

What is the likelihood of getting pregnant?

Hello, doctor...
In January and March of this year, I experienced prolonged menstrual periods lasting about ten days, which led me to visit a gynecologist.
After a pregnancy test, I found out I was pregnant, but the pregnancy discovered in January ended in miscarriage, which was incomplete.
In March, I discovered I was pregnant again, but due to unhealthy fetal genetics, I took medication to terminate the pregnancy on March 30.
My menstrual period started on May 1 and ended on May 6.
However, during this time, I had intercourse with ejaculation on May 7, 10, 14, and 17.
Pregnancy tests on May 18 and May 24 both showed negative results, and my menstrual period started on May 24, accompanied by brown discharge.
I occasionally experience pain in my lower abdomen and left side.

I have a few questions:
1.
Why did I have my menstrual period but still become pregnant?
2.
Why, despite having unprotected intercourse during the fertile window, did I not become pregnant?
3.
Is the pain in my lower abdomen and left side due to irregular menstruation or is there another issue?
I have read various articles suggesting that brown discharge could indicate an infection or remnants from early pregnancy.
Some say that bleeding can occur before implantation, but it shouldn't be as heavy as a menstrual period.
Another theory is that menstruation can still occur before the body has a chance to suppress it after implantation.
However, I took a pregnancy test today, May 27, and it still showed negative.
I really want to become pregnant; could you please help me with these questions? Thank you.

Ms. Chen, 30~39 year old female. Ask Date: 2017/05/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In January and March of this year, I experienced prolonged menstrual periods lasting around ten days, which led me to visit a gynecologist.
After a pregnancy test, I discovered I was pregnant; however, the pregnancy found in January ended in a miscarriage, which was incomplete.
In March, I found out I was pregnant again, but due to unhealthy fetal genetics, I took medication to terminate the pregnancy on March 30.
My menstruation started on May 1 and ended on May 6.
During this period, I had sexual intercourse with ejaculation on May 7, 10, 14, and 17.
Pregnancy tests on May 18 and May 24 both showed negative results, and my menstruation started on May 24, accompanied by brown discharge.
I occasionally experience pain in my lower abdomen and left side.

1.
Why did I have my menstrual period but still get pregnant?
Answer: There are instances of ovulation occurring outside the typical menstrual cycle.
2.
Why did I not get pregnant despite having unprotected intercourse during the fertile window?
Answer: Ejaculating during the fertile window does not guarantee pregnancy.
3.
Is the pain in my lower abdomen and left side due to irregular menstruation or another issue?
Answer: An ultrasound, pelvic examination, and blood tests are necessary for further evaluation.

Reply Date: 2017/05/27

More Info

Understanding your chances of pregnancy after experiencing miscarriages and dealing with irregular menstrual cycles can be quite complex and emotionally taxing. Let's break down your questions and concerns systematically.

1. Why did I get my period but still become pregnant?
It is possible to experience a menstrual-like bleeding even when you are pregnant, particularly in the early stages. This is often referred to as "implantation bleeding," which can occur when a fertilized egg attaches to the lining of the uterus. This bleeding can sometimes be mistaken for a light period. Additionally, irregular cycles can make it difficult to predict ovulation accurately. If you have irregular cycles, it may be that you ovulated later than expected, leading to a situation where you could conceive even if you had bleeding that seemed like a period.

2. Why did I not get pregnant despite having unprotected intercourse during my fertile window?
Several factors can influence fertility, even during what is considered the "fertile window." Sperm can live inside the female reproductive tract for up to five days, but if ovulation does not occur within that timeframe, conception will not happen. Additionally, factors such as hormonal imbalances, the health of the sperm, the quality of the egg, and the overall health of the reproductive system can all play significant roles in fertility. Given that you have experienced miscarriages, it may be worth investigating further with a healthcare provider to assess any underlying issues that might be affecting your ability to conceive.

3. What could the pain in my lower abdomen indicate?
Pain in the lower abdomen can be caused by a variety of factors. It could be related to ovulation, menstrual cramps, or even conditions such as ovarian cysts or endometriosis. Since you mentioned that you have had irregular cycles and have experienced miscarriages, it is advisable to consult with a healthcare professional to rule out any potential complications or underlying conditions. The presence of brown discharge could also indicate leftover blood from a previous cycle or a sign of hormonal fluctuations, but it is essential to get a professional opinion to ensure there are no infections or other issues.

Given your history of miscarriages and irregular cycles, it is crucial to maintain open communication with your healthcare provider. They can offer personalized advice and may recommend further testing, such as hormone level assessments or imaging studies, to better understand your reproductive health.
Additionally, if you are actively trying to conceive, tracking your ovulation through methods such as basal body temperature charting or ovulation predictor kits can help you identify your most fertile days more accurately.
Lastly, emotional support is equally important during this time. Consider seeking counseling or joining a support group for individuals who have experienced similar challenges. This can provide you with a safe space to express your feelings and gain insights from others who understand what you are going through.

In conclusion, while the journey to conception can be fraught with challenges, understanding your body and seeking appropriate medical guidance can significantly enhance your chances of achieving a healthy pregnancy.

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