Delayed Menstruation After Ovulation Induction Treatment

Menstruation did not occur after taking menstrual induction medication?

Hello Doctor, I have polycystic ovary syndrome and I want to conceive, so I have been taking ovulation medication for regulation.
After taking the ovulation medication, my cycle was 31 days; then I took the ovulation medication a second time, but my period did not come.
I visited a gynecologist, and my expected period was supposed to start on August 20.
The doctor performed an ultrasound and confirmed that ovulation had occurred, but the pregnancy test was negative.
I was prescribed 7 days of progesterone (which is used to support pregnancy) and was informed that my period should come within a week after finishing the medication, expected between August 30 and September 5.
As of now, my period has not arrived, but I am experiencing breast tenderness and abdominal bloating.
I would like to ask the doctor, what could be the reasons for the delayed period after taking the progesterone? I am traveling abroad next week and would prefer not to be on my period during my trip.
Should I wait for my period to come naturally, or should I ask the doctor for medication to induce my period?

A-Liang, 30~39 year old female. Ask Date: 2017/09/08

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Due to polycystic ovary syndrome (PCOS) and the desire to conceive, I have been taking ovulation medication for regulation.
After taking the ovulation medication, my cycle was 31 days; however, after taking the second round of ovulation medication, my period did not arrive.
I visited a gynecologist, and my expected period was on August 20.
The doctor performed an ultrasound and confirmed that ovulation had occurred.
A pregnancy test was negative, and I was prescribed 7 days of progesterone (which is used to support pregnancy) and informed that my period should arrive within a week after finishing the medication, expected between August 30 and September 5.
As of now, my period has still not arrived, but I am experiencing breast tenderness and abdominal bloating.

1.
What causes a delay in menstruation when taking progesterone?
Answer: Taking progesterone can cause a delay in menstruation.
2.
I am traveling abroad next week and would prefer not to have my period during the trip.
Should I wait for my period to come naturally, or should I ask my doctor for medication to delay it?
Answer: An ultrasound is necessary.

Reply Date: 2017/09/08

More Info

Delayed menstruation after ovulation induction treatment can be a complex issue, particularly for individuals with polycystic ovary syndrome (PCOS) who are trying to conceive. In your case, it seems that you have undergone ovulation induction with medication, which can sometimes lead to irregularities in your menstrual cycle.

When you take ovulation-inducing medications, they work by stimulating the ovaries to produce eggs. This process can sometimes disrupt the normal hormonal balance in your body, leading to changes in your menstrual cycle. In your situation, you experienced a regular cycle of 31 days after the first round of medication, but after the second round, your period did not arrive as expected.

The ultrasound confirming ovulation indicates that your body did respond to the medication, which is a positive sign. However, the absence of menstruation could be attributed to several factors:
1. Hormonal Imbalance: The medications used for ovulation induction can affect your hormone levels, particularly progesterone. If your body does not produce enough progesterone after ovulation, it may not trigger the shedding of the uterine lining, leading to a delayed period.

2. Pregnancy: Although you mentioned that a pregnancy test was negative, it is important to note that sometimes tests can yield false negatives, especially if taken too early. The symptoms you are experiencing, such as breast tenderness and abdominal bloating, could be indicative of early pregnancy or hormonal changes.

3. Effects of Medications: The progesterone you were prescribed (the yellow body hormone) is typically used to support the uterine lining and can also be used to induce a period. If your body is still adjusting to the hormonal changes from the ovulation induction treatment, it may take some time for your cycle to normalize.

4. PCOS: Since you have PCOS, your menstrual cycles may already be irregular, and the introduction of medication can further complicate this. PCOS is known for causing hormonal imbalances that can lead to delayed or missed periods.

Regarding your upcoming travel plans, it is understandable that you would prefer to avoid menstruation during your trip. If you are considering taking medication to induce your period, it is crucial to consult with your healthcare provider. They can provide guidance on whether it is appropriate to take such medication in your specific situation, especially considering your recent treatment and current symptoms.

In summary, the delay in your menstruation could be due to hormonal imbalances from the ovulation induction treatment, the effects of the progesterone, or other factors related to PCOS. It is essential to monitor your symptoms and consult with your healthcare provider for personalized advice. If you choose to wait for your period to arrive naturally, be aware that it may take some time, but if you prefer to take medication to induce your period, your doctor can help you make that decision based on your health status and travel plans.

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