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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: 11288
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 have been trying to conceive few months now without

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Hi i have been trying to conceive for a few months now without success. for over a year every single month during my ovulation i have mid cycle spotting. i never took this seriously as i read that it is un harmful but now i am starting to think that there could be a problem especially because an ultra scan revealed 3 uterine fibroids but none of these were on the lining on the womb so the doctors seem to think there is no problem at all and we could just carry on trying to conceive as usual.
I need an expert to point me in the right direction because I very much would like to have my second child and i am just feeling very frustrated at the moment.
Doctors are saying it is normal to bleed mid cycle but i am talking red blood not pink blood every cycle 2 days apart.... then it stops and i have a normal period after 28 days.
I never was bleeding when i conceived my first child so i do not consider this bleeding as good sign of fertility as my GP claims.
What does 2 days apart mean? Do you bleed for 2 days, or bleed once, and again 2 days later?How large are the fibroids?How do you know when you ovulate?How old is your first child? Thank you.
Customer: replied 2 years ago.
Unfortunately i do not have the the doctors notes here but one was like 20mm, one apparently was truncated 20mm, one is subdural something like that .... and the other 22mm
Customer: replied 2 years ago.
I will ring my doctors office and find out now the exact sizes
Customer: replied 2 years ago.
Hi I do have very fertile cervical mucus for about 3-4 days and notice red blood when i wipe my self. I never need a pad but when i wipe i see red blood some times on day 2 of my fertile window and then one day when there is no blood and then 3 days later i will notice blood again....
Customer: replied 2 years ago.
my first child is 5 years old
Customer: replied 2 years ago.
I have never taken an contraceptive pills.
did a cervical smear test which came back normal
other infection test also came back normal
Assuming that your fibroids are only around 22mm and not located near the uterine lining, they are not likely to cause any problem in getting pregnant.I'm not sure about the spotting. Mid-cycle spotting that only lasts a day can be very normal, and is related to the estrogen drop that comes after ovulation. Usually that doesn't last more than 1 day. Fibroids located near the uterine lining can cause spotting and bleeding, but usually not fibroids located farther from the lining.Since it's only been a few months that you've been trying, I would give it more time. The average normal couple takes 4-5 months to get pregnant, and that means that many normal couples take longer than 5 months. Also, at 33 you're not as fertile as you were 6 years ago when you got pregnant.
If you get pregnant within the next 6 months, that would suggest that everything is fairly normal.Fibroids do have a tendency to enlarge during pregnancy, but since yours are starting small, that's unlikely to be a problem.
Customer: replied 2 years ago.
I have been trying for over a year i am afraid.. not a few months...
Customer: replied 2 years ago.
If i wasn't bleeding i wouldn't worry as much the fact that i am bleeding during my fertile window and not getting pregnant leads me to believe that there is a problem which you all could be missing.
Sorry. Your first sentence said a few months.Since it's been more than a year, I would recommend further evaluation by your doctor or a fertility specialist.Do you have the same partner now as last time?Has there been any possible tubal infection?
Customer: replied 2 years ago.
Yes it is the same partner
The bleeding should probably be investigated further, perhaps by a hysteroscopy (tube through the cervix to look inside the uterus).And normal ovulation should be confirmed, perhaps by a blood progesterone done around day 21.
As long as you're ovulating normally, that's still the most important thing.If a small fibroid were found near the lining, it could be removed through the cervix, but it's uncertain whether that would actually help you to get pregnant. But it would likely stop the mid cycle bleeding.
Your tubes could be checked by putting dye through the cervix and watching it on x-ray. But probably it would be best to figure out the mid cycle spotting first.
Your partner's sperm could be checked. Perhaps he has borderline sperm, which might explain why it's taking longer for you to get pregnant (combined with your age).
Customer: replied 2 years ago.
so could i be ovulating normally with the fibroids etc. what can i do naturally to help me be more fertile
i eat very green food and lots of fruit every day and take folic acid and blood tablets is there anything i could do ?
I suspect that even with the bleeding, you'll likely get pregnant sooner or later, but some investigation is warranted now, since it's been more than a year.As long as you're healthy and eating healthy foods and don't smoke, the main thing you can do is to be sure you have sex close before ovulation time every month.
Customer: replied 2 years ago.
is there any vitamin or medicine to boost fertility ?
As long as you're ovulating normally, the sperm are normal, your tubes are normal, then you should get pregnant.The fibroids are probably incidental and not keeping you from getting pregnant, even if there is a small fibroid close to the lining that may be causing the spotting.
There is no medicine or vitamin to boost fertility (despite what you may read), as long as you are basically normal.
Customer: replied 2 years ago.
really so how can i then be sure i ovulate ? Polycystic Ovary Syndrome could this be the problem ?
Your doctor can help to be sure you ovulate, mostly by the progesterone test on day 21.Women with polycystic ovary syndrome don't ovulate much.
Urine ovulation testing can also be helpful.
Customer: replied 2 years ago.
so you cant recommend any vitamins
Any multivitamin with folic acid is as good as anything.Lack of vitamins rarely prevents pregnancy, and extra vitamins don't help the normal healthy woman.
Customer: replied 2 years ago.
emmh not sure but i may just have to book an appointment again to see my Gp WHO doesn't sound very helpful most of the time
I would try to get referred to a fertility specialist.Please click the rating button. Thank you and good luck!
Dr. Norm S. and other OB GYN Specialists are ready to help you
Customer: replied 2 years ago.
Hi Dr. Norm,
I took your advice and did a progesterone test on day 21 of my cycle and it showed up as 31nmol/L.
Would that be considered normal or confirm ovulation ?Also I managed to get my scan test results off my Doctor it reads :uterus bulky in size measuring 13.4 x 6.1 x 7.6 and has a heterogenous echotextures and has multiple heterogeneous lesions within suggestive of fibriods. there are three intramural fibriods 13mm intramural fibroid in the posterior myometrium along with two calcified intramural fibroids within the posterior myometrium and anterior myometrium measuring 13 and 10 mm respectively. there is also a 38mm pedunculated fibroid arising from the right fundal wall this contains internal calcification. the endometrium measures 9mm in thickness and appears regular in contour. homogenous in echotexture withn no focal endometrial lesions seen. Both ovaries appar norma with no focal lesions or cysts within.I am not sure if you can still assist me but please let me know if this results need further action and what you recommend I do.Thanks,
The progesterone level shows normal ovulation, which is good.The ultrasound shows the fibroids, which you knew about.Since you've been trying for over a year, I would still recommend seeing a fertility specialist if possible.I would also recommend ovulation testing each month, both to be sure that you're ovulating every month, plus to be sure you have intercourse before ovulation each month.Thank you for your payment and rating.
Customer: replied 2 years ago.
I was told 31 is borderline is that true ? and also the position of the fibroids .. Are they dangerous in preventing implantation and pregnancy?
31 is normal.The fibroids as seen on ultrasound would not be a problem for implantation and pregnancy.