Fertility: Key Questions for Women Trying to Conceive

Want to conceive?

Hello, this year my average menstrual cycle is 31 days (last year it was as long as 40 days).
My last period started on April 6, and I had light bleeding from May 3 to May 10 (very little, brown in color).
After a doctor's diagnosis on May 10, I started taking medication to induce my period.
I ovulated on May 12 (as confirmed by an ultrasound on May 15).
I had intercourse on May 13, and my period started again on May 17 (heavy, red in color).
I currently have a 2 cm chocolate cyst and am planning to conceive.

A: 1.
I started taking myo-inositol and folic acid vitamins on April 2.
Will this affect my menstrual cycle? 2.
Can I continue taking myo-inositol and folic acid vitamins with the chocolate cyst? 3.
Was the bleeding from May 3 to May 10 ovulation bleeding? 4.
After having intercourse on May 13, is there still a chance of pregnancy? 5.
After my period ends on May 17, should I wait for ovulation to have intercourse again? Thank you.

Regina, 20~29 year old female. Ask Date: 2019/05/20

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The average menstrual cycle is 31 days (with the longest being 40 days last year).
Menstruation started on April 6, with light bleeding from May 3 to May 10 (very light, brown in color).
After a doctor's diagnosis on May 10, medication was prescribed to induce menstruation.
Ovulation occurred on May 12 (as confirmed by ultrasound on May 15 and June 2).
Intercourse took place on May 13, and menstruation began again on May 17 (heavy, red in color).
Currently, there is a 2 cm chocolate cyst, and there are plans to conceive.
A: 1.
With the longest cycle being 40 days, will starting inositol and folic acid vitamins affect the menstrual cycle?
Ans: No, it will not affect the menstrual cycle.

2.
Can I continue taking inositol and folic acid vitamins with the chocolate cyst?
Ans: Yes, you can continue.

3.
Was the bleeding from May 3 to May 10 ovulation bleeding?
Ans: Not necessarily.

4.
After having intercourse on May 13, is there still a possibility of pregnancy?
Ans: Yes, there is a possibility.

5.
After menstruation ends on May 17, should I wait for ovulation to have intercourse?
Ans: Yes.

Reply Date: 2019/05/20

More Info

Hello! Thank you for your questions regarding fertility and conception. It’s great that you are actively seeking information to better understand your reproductive health. Let’s address your concerns one by one.

1. Impact of Inositol and Folic Acid on Menstrual Cycle: Inositol and folic acid are often recommended for women trying to conceive. Inositol, particularly myo-inositol, has been shown to improve ovarian function and may help regulate menstrual cycles, especially in women with polycystic ovary syndrome (PCOS). Folic acid is crucial for fetal development and can help prevent neural tube defects. Generally, these supplements should not negatively impact your menstrual cycle; instead, they may help in regulating it. However, individual responses can vary, so it’s essential to monitor your cycle and consult with your healthcare provider if you notice significant changes.

2. Chocolates Cysts and Supplements: Chocolate cysts, or endometriomas, are a type of ovarian cyst associated with endometriosis. While they can affect fertility, continuing to take inositol and folic acid is generally considered safe. These supplements may even support overall reproductive health. However, it’s always best to discuss any supplements with your healthcare provider, especially in the context of existing conditions like chocolate cysts.

3. Understanding Spotting During the Cycle: The light bleeding you experienced from May 3 to May 10 could be due to several factors, including hormonal fluctuations, ovulation spotting, or breakthrough bleeding from hormonal medications. If this bleeding coincided with your ovulation period, it could indeed be ovulation spotting, which is relatively common. However, if you have concerns about the nature of this bleeding, it’s advisable to consult your doctor for a thorough evaluation.

4. Chances of Conception After Intercourse: Engaging in intercourse on May 13, which was close to your ovulation date, does provide a good opportunity for conception. Sperm can live in the female reproductive tract for up to five days, so if you ovulated shortly after, there is a possibility of becoming pregnant. If your menstrual cycle is regular, you may want to wait until your next expected period to take a pregnancy test.

5. Timing for Future Intercourse: After your period ends on May 17, you should indeed focus on timing intercourse around your ovulation period for the best chances of conception. Tracking your cycle can help you predict ovulation more accurately. Many women find using ovulation predictor kits helpful, as they can provide a clearer indication of when ovulation is likely to occur.

In summary, it’s essential to maintain open communication with your healthcare provider regarding your fertility journey, especially with the presence of chocolate cysts. Regular check-ups and monitoring can help you understand your reproductive health better. Additionally, maintaining a healthy lifestyle, managing stress, and ensuring proper nutrition can all contribute positively to your fertility. Best of luck on your journey to conception, and don’t hesitate to reach out to your healthcare provider with any further questions or concerns!

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