ovulation after weaning

[jdm1013]

Hi Dr. Roseff!
I stopped pumping/breastfeeding my 7 month old baby 6.5 weeks ago (no night feedings since 3 months, and I had slowly weaned him over a one month period). My husband and I would like to start trying for baby #2. I still have not had my period. I know I have not ovulated because I have been using opks and temping.

My history:
I am 31 years old. I had to use injectibles to get pregnant with my son. My only known fertility problem was a lack of ovulation for unknown reasons. I had previously been on bcp for 7 years and started the fertility meds after I'd been off bcp for 6 months and still hadn't had a period. I tried 2 cycles of clomid (50 mg and 100 mg) and did not ovulate. My fertility workup showed that my hormone levels all looked ok (no pcos) and my AFC was great. I started follistim with hcg trigger and was pregnant via timed intercourse within a few cycles.

My questions are:

1. How long is normal to go without a period after weaning?

2. I really hoped that having a baby would somehow kick-start my system back into regularity and that I wouldn't have to use fertility meds again. Does this seem unlikely?

3. How long should I wait before going down the whole fertility med route again? I don't want to jump the gun when I might ovulate regularly on my own, but I also don't want to waste another 6 months waiting only to find out I still haven't ovulated.

4. If I didn't ovulate on clomid last time, does it seem unlikely to work this time?

5. My opks have had a semi-dark line the past 4 or so days, esp early in the morning. They aren't positive, but they are more than the shadow they were a few weeks ago. My temps are still all over the chart. What does this mean? Are my hormones just all out of whack?

6. Are there any herbal medicines or acupuncture that you recommend?

Thanks for your time!

[Scott Roseff MD]

Hi,

To answer your questions:

1. How long is normal to go without a period after weaning?
==> It varies. Most women menstruate within 6 weeks of totally weaning.

2. I really hoped that having a baby would somehow kick-start my system back into regularity and that I wouldn't have to use fertility meds again. Does this seem unlikely?
==> Sometimes it does, this, most times it doesn't.

3. How long should I wait before going down the whole fertility med route again? I don't want to jump the gun when I might ovulate regularly on my own, but I also don't want to waste another 6 months waiting only to find out I still haven't ovulated.
==> The answer to this question is complex and depends on many factors I don't know about you. As a broad generalization, if you don't menstruate within 6-8 weeks of weaning (and it's not due to pregnancy), you should see your RE for diagnosis and treatment.

4. If I didn't ovulate on clomid last time, does it seem unlikely to work this time?
==> Yes, though not definitely.

5. My opks have had a semi-dark line the past 4 or so days, esp early in the morning. They aren't positive, but they are more than the shadow they were a few weeks ago. My temps are still all over the chart. What does this mean? Are my hormones just all out of whack?
==> Yes, it sounds like your hormones are out of balance.

6. Are there any herbal medicines or acupuncture that you recommend?
==> Absolutely! You should see a qualified acupuncturist (preferably one who is board certified in fertility acupuncture). He/she can best guide you in this realm (We work closely with a PHENOMENAL one here in South Florida)....

Hope this helps,
Dr. Roseff - Director