How to Get Pregnant + Infertility

Can you get pregnant with irregular periods? Yes, but it may be more difficult for you than someone with regular cycles. According to one study, women whose menstrual cycles varied by less than two days were twice as likely to become pregnant within a given time period than women whose cycles varied by more than six days.

Another study found that women with regular cycles were four times more likely to become pregnant than women whose cycles varied by more than 10 days. Some women with irregular periods will need fertility treatments. Sometimes, lifestyle changes can correct previously irregular periods and help you conceive.

Are your periods really irregular?

Irregular menstruation is defined as a menstrual cycle that is shorter than 21 days or longer than 36 days. Your cycle can also be considered irregular if it varies significantly between months. For example, if one month your cycle is 23 days and another is 35, your cycle will be considered irregular.

Research has found that changes in cycle length are more strongly associated with infertility than just having regular shorter or longer cycles. In other words, if your cycles tend to be a little longer than the normal limit, but they’re all about that length, you may have fewer fertility problems than people with variable cycles. significant, but the length is within the normal range.

If your cycle is off by a day or two from month to month, you don’t need to worry. That’s when the variations are longer—five days or more—that you may experience fertility difficulties.

An irregular cycle is also normal. Stress or illness can slow down ovulation or menstruation, making your cycle longer, and sometimes shorter, than usual. If you only have one or two of these “off” periods per year, you don’t need to worry. However, if your periods are often irregular — or you go a long way between periods — you should see your doctor for an evaluation.

Detect ovulation when the cycle is irregular

If you are ovulating but irregularly, you will need to make a special effort to determine your most fertile time. There are many ways to predict ovulation. You may need to use a variety to help find the best time to have sex.

Ovulation prediction tests work like a pregnancy test, in that you pee on a test strip to determine when you are most fertile. However, in some women, the tests give repeated “false positives”. This is especially common in women with PCOS.

Another error that can occur when using these tests when your periods are irregular is that you will need to use more than the average number of test strips. You don’t use the tests during your entire cycle, but only around the time you can expect to ovulate. When your cycle is irregular, ovulation may last longer than for other women.

Of course, the most accurate way to detect ovulation, or the absence of ovulation, is through a transvaginal ultrasound and/or through a blood test done in your doctor’s office. Talk to your doctor about these options to determine if they’re right for you.

A better method of conceiving with irregular cycles

You may also decide to give up trying to detect ovulation and just have sex regularly throughout your cycle. Some couples feel stressed about when to have sex during pregnancy. This avoids that stress. You will not attempt sex when you receive a positive ovulation test result. You will only have sex often, lasting a whole month (ideally every other day).

With this method, you don’t have to worry about missing ovulation. If you have sex three to four times a week, you are likely to have sex on your fertile day.

Causes of irregular periods

Irregular periods can indicate a hormonal imbalance. You may still ovulate every month, but your ovulation date may change. If you are ovulating, you can get pregnant without the help of fertility drugs. Here are some possible causes of irregular periods that are also risk factors for infertility.

Anovulation

However, sometimes irregular periods are a sign of ovulation. Ovulation cycle is a menstrual cycle in which ovulation does not take place. If you don’t ovulate, you can’t get pregnant without the help of fertility treatments.

Polycystic ovary syndrome (PCOS)

Irregular periods can be a sign of polycystic ovary syndrome (PCOS). PCOS is a common endocrine disorder affecting 1 in 8 women. Not everyone with PCOS will be infertile, but many will take longer to get pregnant. Women with PCOS also have a higher risk of early miscarriage.

Thyroid imbalance

An underactive or overactive thyroid gland can cause irregular periods, as well as infertility. Other possible symptoms of a thyroid imbalance include weight changes, trouble sleeping or feeling tired all the time, unexplained anxiety or depression, or problems with constipation or diarrhea .

Increased blood prolactin

Prolactin is a hormone primarily responsible for stimulating breast milk production. Hyperprolactinemia is when the hormone is elevated even when a woman is not pregnant or breastfeeding. (Hyperprolactinemia can also occur in men.)

Abnormally high levels of prolactin can cause irregular periods or even stop your periods altogether. Other possible symptoms may include breast swelling or tenderness, leakage of breast milk from the nipple, or painful sex (due to vaginal dryness).

Primary ovarian failure (POI)

Also known as premature ovarian failure (POF), primary ovarian failure can cause irregular periods or even complete absence of periods. Low estrogen levels sometimes occur along with POI/POF and this can lead to symptoms such as vaginal dryness, pain during sex, hot flashes or night sweats, trouble sleeping, or depression or unexplained anxiety.

Fat

Obesity is the most common preventable cause of menstrual irregularities and reduced fertility. Obesity can cause irregular periods as well as difficulty conceiving. Sometimes, weight problems are caused by an underlying and undiagnosed hormonal imbalance. For example, both PCOS and hypothyroidism can cause sudden weight gain and difficulty losing weight.

If you’re struggling with your weight, sudden weight gain despite not making significant lifestyle changes, or having trouble losing weight, talk to your doctor. If your weight problem is caused by a hormonal imbalance, your doctor can treat the problem — and that can help you lose weight.

Underweight

Just as being overweight can cause irregular periods, being significantly underweight can also lead to irregular periods and fertility problems. Eating disorders are also a risk factor for infertility and amenorrhea.

Excessive exercise and extreme dieting are also potential causes of irregular periods. Female athletes are more likely to be infertile for this reason.

Pills to help you conceive

If in fact you are not ovulating, you may need fertility drugs to help promote ovulation. Even if you’re ovulating, if ovulation is irregular or occurs very late in your cycle, fertility treatments can help.

Clomid is the most commonly prescribed medication to treat ovulatory dysfunction, and it has a good success rate. Another possible option is the drug letrozole. This cancer drug is used off-label to trigger ovulation. Research suggests it may be more effective than Clomid in women with PCOS.

While not an aid in fertility, another drug your doctor may suggest trying is the diabetes drug metformin. Metformin may help women with insulin resistance and PCOS ovulate on their own. If these drugs don’t work, your doctor may suggest switching to injectable fertility drugs (gonadotropins), IUI, or IVF treatment.

If your irregular periods are caused by primary ovarian failure, your fertility treatment options may be limited. In many cases with POI, IVF with an egg donor is needed to conceive. However, this is not always the case. Talk to your doctor about your options.

If the cause of your irregular periods is a thyroid imbalance or hyperprolactinemia, treating these problems can regulate your periods and return your fertility to normal. This is why a doctor’s evaluation is essential.

Lifestyle changes and supplements to regulate ovulation

Fertility drugs are not your only option. You can make lifestyle changes, depending on what’s causing your irregular periods.

If you’re overweight, losing a little weight may be enough to kickstart ovulation and help you conceive. Research has shown that obese women who lose as little as 10% of their body weight can ovulate on their own.

However, keep in mind that some weight problems are caused by an underlying hormonal imbalance. Don’t assume your obesity is just a matter of eating right. See your doctor, and afterward Make a weight loss plan.

If extreme dieting is the problem, changing your diet to a more balanced plan, and even gaining weight if you’re underweight, can help regulate your cycle. If your problem is over-exercising, cutting back can correct your cycle. If you are an athlete, talk to your doctor about your options. You may need to take a break from sports to restart your cycle.

You might consider trying fertility supplements (only after consulting your doctor). Two fertility supplements that can help correct irregular cycles are myo-inositoland the berry of the virgin tree (vitex agnus-castus).Whether these supplements can be really effective in regulating menstruation and improving fertility has not been determined.

When to talk to your doctor about irregular periods

If you have irregular periods, the best thing to do is to see a gynecologist. Even if you’re not trying to get pregnant, you should get tested.

Usually, the advice is to try to get pregnant for a year (or six months if you’re 35 or older), and then, if you don’t conceive, see your doctor. This does not apply if there are signs of malfunction. Irregular periods are a risk factor for infertility.

Your doctor can run some simple blood tests to see if you’re ovulating. If your blood shows you’re ovulating and you’re not over 35, you can keep trying to get pregnant on your own for a while longer.

A word from Verywell

Ovulation problems are a common cause of female infertility, with a high success rate of treatment. There’s no shame in needing some help. Don’t be afraid to look for it.