Missed Period After Fertility Injection: Am I Pregnant or Just Menstruating?

If your period is late and you received an injection to induce menstruation, but then you tested positive for pregnancy and experienced bleeding, it is important to consult a healthcare professional. The bleeding could be a sign of implantation bleeding, a miscarriage, or another issue related to early pregnancy. It is essential to seek medical advice to determine the cause of the bleeding and to assess your pregnancy status?

Hello doctor, I have been taking Clomiphene citrate to regulate my menstrual cycle due to polycystic ovary syndrome.
After my period on May 10, I decided to pause the medication for a while to let my body rest.
During this time, I did not have sexual intercourse with my husband until June 17, when my period did not arrive.
I went to the obstetrics and gynecology clinic for a check-up, where I had a urine test and an abdominal ultrasound, confirming that I was not pregnant.
The doctor then administered medication to induce my period.
However, by the morning of June 25, I still had no signs of menstruation, so I returned for a follow-up.
The doctor performed another urine test and found a faint second line, suggesting I might be pregnant, and advised me to wait five more days for a follow-up.
I am very certain that I did not have sexual intercourse with my husband in May or June.
It is possible that I had sexual intercourse in April, but I do not remember.
However, I had my periods on April 9 and May 10, which were both light, as usual.
Then, on June 25, I experienced abdominal bloating and light bleeding, which felt similar to my usual menstrual symptoms.
Does this indicate that I am not pregnant? Should I really wait another five days for a follow-up?

emily, 30~39 year old female. Ask Date: 2019/06/25

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Due to polycystic ovary syndrome, I have been taking Clomiphene to regulate my menstrual cycle.
However, after my period on May 10, I decided to pause the medication to let my body rest.
During this time, I did not have sexual intercourse with my husband.
On June 17, when my period did not arrive, I went to the obstetrics and gynecology department for a check-up, where I had a urine test and an abdominal ultrasound, confirming that I was not pregnant.
The doctor then administered medication to induce menstruation.
By the morning of June 25, with no signs of my period, I returned for a follow-up.
The doctor conducted another urine test, which showed a faint second line, suggesting I might be pregnant, and advised me to wait five more days before returning for confirmation.
However, I am very certain that I did not have sexual intercourse with my husband in May or June.
I cannot recall if I had intercourse in April, but I did have my period on April 9 and May 10, which was light as usual.
Then, on June 25, I experienced abdominal bloating and light bleeding, which felt similar to my usual menstrual symptoms.
Does this indicate that I am not pregnant? Should I really wait five more days before returning for a follow-up? Answer: It is likely that you are not pregnant.
You should wait five days to confirm with another pregnancy test.

Reply Date: 2019/06/25

More Info

Based on your situation, it appears that you are experiencing a complex interplay of hormonal changes and potential pregnancy signs after undergoing fertility treatments. Given your history of polycystic ovary syndrome (PCOS) and the recent fertility injection, it's understandable that you are feeling anxious and confused about your current state.

First, let's address the missed period and the faint positive pregnancy test. In cases of PCOS, irregular menstrual cycles are common, and sometimes ovulation can be unpredictable. Even if you believe you have not had sexual intercourse, it is still possible to conceive if there was any unprotected intercourse during your fertile window, which can sometimes be difficult to pinpoint. The faint line on the pregnancy test indicates that there may be some level of hCG (human chorionic gonadotropin) in your system, which is produced during pregnancy. However, it is also possible for certain medications or hormonal treatments to affect test results, leading to a false positive.

The bleeding you experienced on June 25 could be a sign of several things. It could be an early pregnancy loss, often referred to as a chemical pregnancy, where an embryo implants but does not develop further. Alternatively, it could simply be a breakthrough bleeding due to hormonal fluctuations, especially after receiving fertility injections. The abdominal bloating and discomfort you describe are also common symptoms associated with both early pregnancy and the onset of menstruation.

Given that you have already been advised to wait five days for further evaluation, it is crucial to follow your doctor's recommendations. During this waiting period, monitor your symptoms closely. If the bleeding becomes heavier or you experience severe pain, it would be advisable to seek immediate medical attention.
In the meantime, here are some important considerations:
1. Follow-Up Testing: When you return for your follow-up appointment, your doctor may recommend a blood test to measure your hCG levels. This can provide a clearer picture of whether you are pregnant and how the pregnancy is progressing. Blood tests are more sensitive than urine tests and can detect lower levels of hCG.

2. Understanding Your Cycle: Since you have a history of PCOS, it might be beneficial to keep a detailed record of your menstrual cycles, including any symptoms you experience. This information can help your healthcare provider make more informed decisions regarding your treatment and management.

3. Emotional Support: The uncertainty surrounding potential pregnancy can be emotionally taxing. Consider reaching out to support groups or counseling services that specialize in fertility issues. Sharing your experiences with others who understand can provide comfort and guidance.

4. Medication Awareness: If you are taking any medications, including those for PCOS or fertility treatments, be sure to discuss them with your healthcare provider. Some medications can influence menstrual cycles and pregnancy tests, and your doctor can help you understand any potential effects.

In conclusion, while the faint positive test and subsequent bleeding can be concerning, it is essential to give your body time to respond and to follow up with your healthcare provider for further evaluation. They will be able to provide the most accurate information based on your specific circumstances and help guide you through this process. Remember, you are not alone in this journey, and seeking support is a vital part of managing your health and emotional well-being.

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