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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11289
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I'm concerned that it's taking too long to to return after having

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I'm concerned that it's taking too long for fertility to to return after having my mirena removed as it's been 6 weeks and all the ovulation tests I've taken in this time are negative and I've had no menstruation. We're trying to conceive our first baby, I'm 30 and had the mirena for about a year and my periods stopped the day it was inserted. Prior to the mirena I had a copper coil for an around 18 months, this was swapped in favour of the mirena due to very heavy irregular menstruation with a flow time of around 10 days. Prior to the copper coil I had the implant for many years, again with absolutely no menstruation during that time.
My other worry is that I have psoriatic arthritis which was treated for at least 2 years with weekly methotrexate at a dose of 15mg. My last dose of methotrexate was over 12 months ago as I have more recently been using etanercept at a weekly dose of 50mg, my last injection was 9 weeks ago. My psoriasis is doing ok, but my joints are starting to object.

Your previous irregular periods and now no period in the past 6 weeks suggest that you probably don't ovulate regularly. Fortunately, this is the easiest fertility problem to help.

There are pills called Clomid that you can take each month to help you to ovulate.

I would recommend that you see your doctor for help to both confirm that you're not ovulating and for a prescription for pills to help you to do so.

Neither methotrexate nor etanercept affect fertility as far as we know. Methotrexate can cause birth defects if you got pregnant while taking it, but not afterwards.

Etanercept is a category B medication, meaning that it's safe during pregnancy as far as we know. Best wishes.

Customer: replied 2 years ago.

Is it possible that the copper coil was the cause of the irregular periods? Rather than not ovulating regularly? Is it at all possible that its just taking time to get a cycle and after removing the mirena?

The copper coil can cause periods to be heavy, but won't affect how regular the periods come. That's caused by your ovaries and whether or not you're ovulating.

Usually fertility returns soon after the mirena is removed. If you had regular periods before using the mirena, it might be worthwhile waiting longer to see if the regular periods resumed. In your case, I think you weren't ovulating much before, and you're still not ovulating much. The reason has nothing to do with the mirena. Often we don't know the reason. Some women don't ovulate regularly.

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Customer: replied 1 year ago.


I appreciate it has been a while but i'm still having issues, regularity hasn't happened yet. I've had hormone profile checked and that's normal, I've also had a TV scan that is normal. i'm really struggling to get an appointment with my GP do you know if it's possible for me to self refer to get clomid treatment privately? or what would my next step should be?

You don't really need a lot of hormonal tests or scans. You just need clomid. You need to see a doctor for it, public or private.