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Depo-Provera injection - your questions answered

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Has the Depo-Provera injection damaged my menstrual cycle?
Q: I was on the Depo injection for three and a half years. My last injection was a year ago and my periods only just came back to normal after eight months. However, it has now been 31 days and my period is still not here. I have done a home pregnancy test, which was negative. I was wondering whether the Depo is still coming out of my system. What could be the reason for this sudden no-show?
zippy89

A: Research suggests that women trying to conceive after stopping the Depo-Provera injection take at least four months longer to become pregnant compared with women stopping other methods of contraception. In some cases, fertility may take up to a year or longer to return - as you have now been off the injection for around a year and your periods have returned, there may be another reason for your irregular cycle, such as hormone imbalances (eg polycystic ovary syndrome). If you have not already seen your doctor it is a good idea to do so and to have initial hormone tests done, assuming you are trying to conceive. It can also help to use an ovulation predictor kit. Sticks can end up being expensive, but there is an interesting test (Calista), that lets you check saliva under a small microscope, which can be used over and over and which might work out cheaper.

Why can't I conceive?
Q: I had my last Depo-Provera injection 18 months ago and have not used any form of contraception since because I'm trying for a baby. My first child was conceived after one month, so I am very confused as to why I have not fallen pregnant yet. I was not on Depo before I had my daughter, just a normal birth control pill.

We have been referred to a fertility clinic for some tests, but is there anything I can do in the meantime to help? And how can I tell if I am ovulating without using ovulation predictor kits, which my doctor told me only detect the luteinising hormone surge prior to ovulation and does not necessarily mean you will ovulate?
annajwales

A: The luteinising hormone surge usually kick starts ovulation, and kits (or Calista saliva testing in which you examine saliva under a pocket microscope) are the best way to predict your fertile time. You might want to consult a herbalist, as Agnus castus is successful in increasing fertility where difficulty in conceiving is linked with low progesterone levels during the second (luteal) phase of the menstrual cycle (from ovulation to the onset of menstruation). In one study of 45 women with this form of infertility, seven became pregnant during the three-month trial and 25 women had their low progesterone levels restored to normal. Treatment should be stopped as soon as pregnancy is suspected, however. It is also helpful for irregular periods - tending to shorten a long cycle and lengthen a short one.



 
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