Planning to start a family

[Tigger0902]

Hi all
My husband and I got married last year and want to start a family in the next couple of years. I’m in no hurry and accept that it’ll happen when it’s meant to happen.
I was on the contraceptive pill for some time due to irregular periods and chronic period pain, so my first step was to come off the pill. Doctors said it can take up to 6 months to flush the pill out of my system. It’s been 6 months and I’ve had 2 periods…one was 3 months after I came off the pill and the second was 40 days later. I’ve had blood tests and they came back as normal but I’m now confused as to when my cycle is and therefore when we’d need to try and conceive.
Can anyone give any advice or tips on who to speak to/ what to do please?
Thanks!

Comment 1 (what should I ask nhs for)

When you say blood tests and normal... what blood tests and when?

It's likely you have an underlying cause of cycle disruption like PCOS or similar. How long were your cycles before? The pill is given to regulate but it isn't at all a treatment, just hides the symptoms and side effects. The cycle the pill creates is artificial.

Ideally ask your GP to do:

1. Hormone profile bloods on cycle day 3 and 21 (measuring LH, FSH, progesterone). These should show that you are not ovulating on normal time scale (which will be the case - it is not possible to have big long cycles and ovulate at normal timescales).
2. an androgen profile with bloods to check nothing wrong with androgens impacting on cycles
3. refer you to generic gynaecology for a scan for ?PCOS
4. at a year ttc, ask them to refer to assisted conception

Also if you are overweight, they may ask you to lose weight. A 5%+ reduction in body weight has been shown to improve cycles.

Comment 2 (what do I need to know and do):

Sorry if any of this you already know.

In a woman's cycle the time between period starting and ovulation is what varies, the time between ovulating and period starting is fixed (usually 9-16 days long). For people with a 28 day cycle (ha! I wish), CD 1 is period, CD14 is approx ovulation, CD28 is last day (so a 14 day gap from ovulation to cycle end). For people with long cycles either 1) ovulation is delayed or 2) they aren't ovulating. This can be cycle by cycle (I usually don't ovulate but do sometimes).

Many women who have long cycles still ovulate esp if they are only longish (like 35-40 days, mine are commonly 72+!) BUT ovulation certainly cannot be as early as CD14. So if your cycle is 40 days approx, ovulation is likely to be around CD 24-30.

Now, issue if cycle length changes is... when is that window? For that reason us irregular cycle girls need to be having a lottt more sex that normies to conceive. People on a 28 day cycle max out their chances having sex a few times in the CD10-17 week. We need to have sex regularly over a wider window, depending on your cycle lengths and how much they vary.

In terms of tests and temping - OPKs are useless for irregular cycles so don't bother. Temping can help you work out if you are ovulating but doesn't help w actual conception as you will only find out you ovulated AFTER it happened.

Hope all this helps @Tigger0902

So if your cycles settle at 40 days, expected ovulation is between CD 24 and 31, so you'd be wanting to have sex every 2nd day from CD 20- 30 or so

It took me over a year to get my period back.

@TheDaydreamBelievers

Comment 1 (what should I ask nhs for)

When you say blood tests and normal... what blood tests and when?

It's likely you have an underlying cause of cycle disruption like PCOS or similar. How long were your cycles before? The pill is given to regulate but it isn't at all a treatment, just hides the symptoms and side effects. The cycle the pill creates is artificial.

Ideally ask your GP to do:

1. Hormone profile bloods on cycle day 3 and 21 (measuring LH, FSH, progesterone). These should show that you are not ovulating on normal time scale (which will be the case - it is not possible to have big long cycles and ovulate at normal timescales).
2. an androgen profile with bloods to check nothing wrong with androgens impacting on cycles
3. refer you to generic gynaecology for a scan for ?PCOS
4. at a year ttc, ask them to refer to assisted conception

Also if you are overweight, they may ask you to lose weight. A 5%+ reduction in body weight has been shown to improve cycles.

Also point 4 here is only when you have been having regular unprotected sex for over a year with no conception.

Thank you so much. Whilst we’re not actively trying to conceive just yet, I don’t want to be trying to then be told I should have done this or that and then wait longer for results.
I’m not sure what they were checking for with my previous blood tests but will definitely enquire around the points raised above.
Pre-pill I had no regularity at all…I’d go anywhere between 6 weeks to 3 months and I’m worried this will be the case now which makes knowing when I could be ovulating so difficult to ‘work out’.
I’ve also previously had scans to check if I have PCOS which didn’t suggest that I did but my chronic pains would suggest otherwise. Is there anything I can push for to have this looked at further? Or is there anything I can take supplement wise?

Some people benefit from taking inositol/myo inositol/dchiro inositol but unfortunely they didn't help me.

I feel your pain as my cycles are 55-141 days (!) and it's been a bit of a battle to be honest

Women with PCOS don't always have cysts on their ovaries so the scan might not have shown anything. I don't have any cysts but was diagnosed with PCOS because of my irregular cycles and my blood results.

Yeah what @Salamander91 said! Look up Rotterdam criteria for PCOS. Be mindful though that unless you are Ttc the treatment they typically offer is the pill...