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Does irregular period indicate problems with fertility?

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5 fertility expert(s) answered this question

Answer from: Valentina Denisova, MD PhD Obstetrician Gynaecologist

Gynaecologist, Fertility Specialist
Next Generation Clinic
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Many patients worry about this question, especially young patients, does regular periods show any fertility problem. Once somebody didn’t try to conceive, they cannot say that irregular periods will lead to infertility but we realize that sometimes irregular periods being a consequence of gynecological problems can lead to infertility. If patients tell us about irregular periods we try to know the reason for this condition: we ask patients about the cycle from the beginning and when it has become irregular and probably about some comorbidities which can lead to these irregular periods. Then we clarify possible reasons. We can try to treat them and those we will promote pregnancy.
How can you get pregnant with irregular periods?
First, it can happen itself: if your ovaries work well in spite of irregular periods, you can have ovulation so you can conceive by yourself but if you have no ovulation you will need some help to get pregnant.
Regarding your ovaries condition, fallopian tubes condition and partner sperms, we can carry out both ovarian stimulation or assisted reproductive technologies.

Answer from: Wael Saab, MRCOG, Bsc

Gynaecologist, Deputy Clinical Director at CRGH, Associate Professor at UCL
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Answer from: Stephen Davies, BSc MBBS DCH DRCOG

Gynaecologist, IVF specialist & retired NHS GP
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If a lady has irregular cycles, if she’s having three or four periods in a year — it’s extremely unlikely that she’s going to necessarily ovulate and even if she does ovulate, you’ve got very little chance of necessarily being able to predict when the ovulation occurs and therefore to time your intercourse appropriately. So, ladies with erratic cycles need looking at sooner and start working them up sooner.

Answer from: Madhavi Gudipati, MBBS MD MRCOG

Gynaecologist, Obstetrician, Consultant OB-GYN, HFEA 'Person Responsible' at Sunderland Fertility Centre
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Irregular periods can suggest irregular or infrequent ovulation so, if it is just a few days on this side that said, it’s not a problem – up to a week is not a problem. Generally, you start thinking that if they are spacing out more than six weeks apart then, yes, they have reduced chances of ovulation and particularly, women who feel they have only a period every two to three months or few periods a year, certainly suggests that they have reduced ovulation and therefore reduced chances of conceiving.

Answer from: Radwan Faraj, MD

Gynaecologist, Gynaecology and Reproductive Medicine
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Regular periods are quite reassuring for us as gynecologists and specialists in fertility. In general, regular periods very likely will indicate ovulation is happening. However, there are so many causes for irregular periods. You need to know; irregular means either longer cycles, which will be more than 35-day cycles because then the normal cycle length is actually ranging from 25 to 35-day cycles. So, if you have more than 35-day cycles or really actually shorter periods if you have period maybe every two weeks. This is clearly an irregular cycle and I will be surprised if ovulation is happening regularly in these cases.

So for irregular cycles, the most common cause is polycystic ovarian syndrome, which is a condition causing hormonal imbalance and may have abnormalities and male hormone androgen level or testosterone, and can have the shape of the ovaries on ultrasound look polycystic or slightly bigger in volume.

Other causes of irregular periods again are weight gain; women who are on the extreme weight. Not just overweight women but also underweight women. Women who have eating disorders may miss periods for a long time and these women likely will not ovulate. Women on certain drugs; contraception obviously will clearly suppress ovulation but there are other drugs that may also suppress ovulation and they may contribute to irregular periods. Psychological factors will contribute to irregular periods. Stress, part of the same central effect on the hypothalamus which is a gland in the brain – interfere with the pituitary gland and then that will interfere with the ovarian hormones. All these will suppress period and suppress ovulation.

A condition we call prolactin level also; the milk hormone. There are so many drugs that can contribute to that and will lead to irregular ovulation and irregular periods. So there are so many causes that will lead to irregular periods that need to be investigated with your doctor, do some hormones, maximize your weight and following that you may need to have an ultrasound scan, a blood test to establish if there is any reason for that, and in most cases, the treatment is rewarding and will lead to a good outcome.

About this question:

How can I get pregnant if my periods are irregular?

Being proactive is beneficial on many levels, also in such essential aspects of our life like our fertility. Although we are not able to know for sure that we may expect difficulties in conception, there are several signs that women should be aware and recognise them as a sign of potential challenges.

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