New Normal After Stillbirth?

Question

My first child (a beautiful baby girl) was stillborn in February of this year (40 weeks gestation with no known cause). My husband and I are currently trying to conceive again. My periods returned four weeks after birth and I am now on my second cycle. I am using ovulation predictor kits and monitoring my cervical mucus and bbt. My cycles seem to have returned to normal length (27 days) but I am ovulating very late in the cycle (day 20 in the last cycle and I am currently on day 16 of this cycle with no sign of ovulation yet). I conceived our daughter after three months of trying and only started monitoring my fertility in the last of these cycles. The ovulation predictor kit I used then was positive on day 13 of my cycle with typical cycles lasting 27-29 days. I therefore appeared to have a normal luteal phase length before this pregnancy.
I was wondering if menstruation could have changed permanently following pregnancy/birth so that I now have a luteal phase defect (as this did not seem to be present before) or is the short luteal phase just a temporary problem while my cycles and hormones return to normal? If it is the latter, how long would you expect it to take to return to my previous luteal phase length? Also should I be looking to try to correct a luteal phase defect, possibly with B6 supplements?

Many thanks for your time and help on this matter – it really is greatly appreciated.

Regards
Paula 

Answer

Dear Paula,

It is possible you have a hormonal change due to stress, weight and insulin resistance, age or any number of problems. If your normal cycle pattern has not recovered within two or three months you need to deal with the new pattern. I would recommend a thorough hormonal workup especially of the luteal phase as is done by medical consultants trained at the Pope Paul VI Institute checking thoroughly on progesterone and estrogen levels. Fasting and two hour blood sugar and insulin levels are important in working up a luteal phase problem and also in trying to sort out why you lost your little girl. B vitamins are important in the luteal phase as are omega 3 fatty acids and stabilizing blood sugar.

Aggressive treatment of hypothyroidism is also important. You do not mention your age, but if you are 35 it is more likely you have undergone a permanent hormonal shift.

For your next pregnancy it would be important to have surveillance with periodic ultrasounds and non stress tests in the last two months of gestation. I am sorry for you loss and wish you the best in your attempts to conceive another child.

Mary L Davenport

Answered By:

Mary Davenport, MD, MS
Mary Davenport, MD, FACOG, an obstetrician/gynecologist from the Oakland Region of California, offers telehealth services over MyCatholicDoctor.com She graduated from Tufts University School of Medicine and completed her residency at UC San Diego. Dr. Davenport is a Fellow of the American College of Obstetrics and Gynecology, and serves on the Advisory Board of the California Association of Natural Family Planning.

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