How to Get Pregnant with Irregular Periods

Home » fertilPEDIA » How to Get Pregnant with Irregular Periods

By



Attention: You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.

This content is WordProof timestamped

How to Get Pregnant with Irregular Periods

Main article: Irregular Periods Overview

Updated: 14-September-2024

How to Get Pregnant with Irregular Periods

Women with irregular periods can become pregnant naturally or with medical assistance. Only 1 in 3 women with irregular periods are diagnosed with infertility.1

For this reason, doctors usually recommend women try to conceive naturally for 6+ months if their cycles are sometimes regular or there is room for improvement (lifestyle modification).

However, if the couple are still unsuccessful after 6 to 12 months, the doctor will recommend medically assisted reproduction.

Natural Conception with Irregular Periods

Many women with irregular periods are able to get pregnant naturally however this does take longer than normal fertile couples

Regular menstrual cycles ensures good ovulation, sperm friendly cervical mucus and a receptive endometrium.

Even though women with irregular cycles can still get pregnant, especially if they’re tracking ovulation, this is not usually recommended on its own.

Instead, experts recommend women trying to get pregnant naturally with irregular periods consider:

  • Weight
  • Exercise or calorie intake
  • Diet
  • Stress and anxiety
  • Sleep
  • Drugs
  • Endocrine disrupting chemicals
  • Fertility awareness-based methods (FABM)
  • Supplements

Weight

Adjusting weight prior to treatment is recommended in women high (or low BMI) and amenorrhea, to minimize pregnancy related complications, and simultaneously increase the chances of pregnancy.2,3

Studies show that spontaneous ovulation resumes in obese women during a 6 month lifestyle and diet modification program leading to significantly higher number of ongoing pregnancies (and lower miscarriage rates).4,5,6

Meanwhile, women who are overweight but ovulating irregularly, may be able to reduce the time to pregnancy as weight decreases.7,8 A randomized control study showed that reducing food intake (minus 500 calories/day) and increasing physical activity (plus 2.5 hours/week), resulted in an average weight loss of 3.4% after 6 months, and almost tripled the spontaneous pregnancy rate (33% vs. 12%) after 18 months, similar to an earlier study.9,10

At the opposite end of the spectrum, women with low BMI and amenorrhea will begin to experience menstruation at approximately 17% total body fat, while regular cycles return at approximately 22% total body fat.11

References

  1. He Y, et al. (2020). Prevalence of oligomenorrhea among women of childbearing age in China: A large community-based study. https://journals.sagepub.com/doi/full/10.1177/1745506520928617 ↩︎
  2. Ovesen P, et al. (2011). Effect of prepregnancy maternal overweight and obesity on pregnancy outcome. https://journals.lww.com/greenjournal/abstract/2011/08000/effect_of_prepregnancy_maternal_overweight_and.15.aspx ↩︎
  3. Rich-Edwards J W, et al. (2002). Physical Activity, Body Mass Index, and Ovulatory Disorder Infertility. https://journals.lww.com/epidem/fulltext/2002/03000/physical_activity,_body_mass_index,_and_ovulatory.13.aspx ↩︎
  4. Van Oers A M, et al (2016). Effectiveness of lifestyle intervention in subgroups of obese infertile women: a subgroup analysis of a RCT. https://academic.oup.com/humrep/article/31/12/2704/2354543 ↩︎
  5. Clark A M, et al. (1998). Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. https://academic.oup.com/humrep/article/13/6/1502/815807 ↩︎
  6. Clark A M, et al. (1995). Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women. https://academic.oup.com/humrep/article-abstract/10/10/2705/725410 ↩︎
  7. Fang Y, et al. (2020). Pre-pregnancy body mass index and time to pregnancy among couples pregnant within a year: A China cohort study. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231751 ↩︎
  8. Gaskins A J, et al. (2015). Association of Fecundity With Changes in Adult Female Weight. https://journals.lww.com/greenjournal/abstract/2015/10000/association_of_fecundity_with_changes_in_adult.26.aspx ↩︎
  9. Belan M, et al. (2019). OR11-2 A Lifestyle Program Targeting Women with Obesity and Infertility Improves Their Fertility: A Randomized Controlled Trial. https://academic.oup.com/jes/article/3/Supplement_1/OR11-2/5482691 ↩︎
  10. Clark A M, et al. (unpublished). The Obesity-Fertility Protocol: a randomized controlled trial assessing clinical outcomes and costs of a transferable interdisciplinary lifestyle intervention, before and during pregnancy, in obese infertile women. https://bmcobes.biomedcentral.com/articles/10.1186/s40608-015-0077-x ↩︎
  11. Frisch R E, et al. (1987). Body fat, menarche, fitness and fertility. https://academic.oup.com/humrep/article-abstract/2/6/521/639220 ↩︎
  12. De Souza M J, et al. (2010). High prevalence of subtle and severe menstrual disturbances in exercising women: confirmation using daily hormone measures. https://academic.oup.com/humrep/article/25/2/491/674505 ↩︎
  13. Morris S N, et al. (2006). Effects of Lifetime Exercise on the Outcome of In Vitro Fertilization. https://journals.lww.com/greenjournal/abstract/2006/10000/effects_of_lifetime_exercise_on_the_outcome_of_in.18.aspx ↩︎
  14. De Souza M J, et al. (2021). Randomised controlled trial of the effects of increased energy intake on menstrual recovery in exercising women with menstrual disturbances: the ‘REFUEL’ study. https://academic.oup.com/humrep/article/36/8/2285/6308647 ↩︎
  15. Fujita Y, et al. (2022). Menstrual Status and Pregnancy in Former Elite Long-Distance Runners With Menstrual Disorders. https://journals.lww.com/cjsportsmed/abstract/2023/03000/menstrual_status_and_pregnancy_in_former_elite.12.aspx ↩︎
  16. Kim K, et al. (2021). Low Intake of Vegetable Protein is Associated With Altered Ovulatory Function Among Healthy Women of Reproductive Age. https://academic.oup.com/jcem/article/106/7/e2600/6178346 ↩︎
  17. Bethea C L, et al. (2008). Neurobiology of Stress-Induced Reproductive Dysfunction in Female Macaques. https://link.springer.com/article/10.1007/s12035-008-8042-z ↩︎
  18. Berga S L, et al. (2003). Recovery of ovarian activity in women with functional hypothalamic amenorrhea who were treated with cognitive behavior therapy. https://www.fertstert.org/article/S0015-0282(03)01124-5/fulltext ↩︎
  19. Friedler S, et al. (2011). The effect of medical clowning on pregnancy rates after in vitro fertilization and embryo transfer. https://www.fertstert.org/article/S0015-0282(10)02958-4/fulltext ↩︎
  20. Lynch C D, et al. (2014). Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study—the LIFE study. https://academic.oup.com/humrep/article/29/5/1067/2913997 ↩︎
  21. Massey A J, et al. (2016). Relationship between hair and salivary cortisol and pregnancy in women undergoing IVF. https://www.sciencedirect.com/science/article/pii/S0306453016306229 ↩︎
  22. Michels K A, et al. (2019). The influences of sleep duration, chronotype, and nightwork on the ovarian cycle. https://www.tandfonline.com/doi/full/10.1080/07420528.2019.1694938 ↩︎
  23. Fernandez R C, et al. (2020). Night Shift Among Women: Is It Associated With Difficulty Conceiving a First Birth? https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2020.595943/full ↩︎
  24. Lawson C C, et al. (2015). Work schedule and physically demanding work in relation to menstrual function: the Nurses’ Health Study 3. https://www.sjweh.fi/show_abstract.php?abstract_id=3482 ↩︎
  25. Stocker L J, et al. (2014). Influence of shift work on early reproductive outcomes: a systematic review and meta-analysis. https://journals.lww.com/greenjournal/abstract/2014/07000/influence_of_shift_work_on_early_reproductive.15.aspx ↩︎
  26. Smith M R and Eastman C I, (2012). Shift work: health, performance and safety problems, traditional countermeasures, and innovative management strategies to reduce circadian misalignment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630978/ ↩︎
  27. Monastra G, et al. (2018). Vitamin D: a steroid hormone with progesterone-like activity. https://www.europeanreview.org/article/14845 ↩︎
  28. Jukic A M et al. (2015). Lower plasma 25-hydroxyvitamin D is associated with irregular menstrual cycles in a cross-sectional study. https://rbej.biomedcentral.com/articles/10.1186/s12958-015-0012-5 ↩︎
  29. Mello N K, et al. (1997). The Effects of Chronic Cocaine Self-Administration on the Menstrual Cycle in Rhesus Monkeys. https://jpet.aspetjournals.org/content/281/1/70.long ↩︎
  30. Lin M, et al. (2021). Bisphenol A promotes autophagy in ovarian granulosa cells by inducing AMPK/mTOR/ULK1 signalling pathway. https://www.sciencedirect.com/science/article/pii/S0160412020322534 ↩︎
  31. Gibbons T, et al. (2023). Timed intercourse for couples trying to conceive. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011345.pub3/full ↩︎
  32. Su H W, et al. (2017). Detection of ovulation, a review of currently available methods. https://aiche.onlinelibrary.wiley.com/doi/10.1002/btm2.10058 ↩︎
  33. Jukic A M et al. (2015). Lower plasma 25-hydroxyvitamin D is associated with irregular menstrual cycles in a cross-sectional study. https://rbej.biomedcentral.com/articles/10.1186/s12958-015-0012-5 ↩︎
  34. Irani M and Merhi Z, (2014). Role of vitamin D in ovarian physiology and its implication in reproduction: a systematic review. https://pubmed.ncbi.nlm.nih.gov/24933120/ ↩︎
  35. Monastra G, et al. (2018). Vitamin D: a steroid hormone with progesterone-like activity. https://www.europeanreview.org/article/14845 ↩︎
  36. Singh V, et al. (2021). Association between serum 25-hydroxy vitamin D level and menstrual cycle length and regularity: A cross-sectional observational study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717082/ ↩︎
  37. Mumford S L, et al. (2016). Serum Antioxidants Are Associated with Serum Reproductive Hormones and Ovulation among Healthy Women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700980/ ↩︎
  38. Luck M R, et al. (1995). Ascorbic acid and fertility. https://academic.oup.com/biolreprod/article/52/2/262/2761466 ↩︎
  39. Loh H S and Wilson C W, (1971). RELATIONSHIP OF HUMAN ASCORBIC-ACID METABOLISM TO OVULATION. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(71)90843-9/fulltext ↩︎
  40. Henmi H, et al. (2003). Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect. https://www.fertstert.org/article/S0015-0282(03)00657-5/fulltext ↩︎
  41. Coker S J, et al. (2023). Effects of Low Vitamin C Intake on Fertility Parameters and Pregnancy Outcomes in Guinea Pigs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10574174/ ↩︎
  42. Genazzani, A D, et al. (2011). Acetyl-L-carnitine (ALC) administration positively affects reproductive axis in hypogonadotropic women with functional hypothalamic amenorrhea. https://link.springer.com/article/10.1007/BF03347087 ↩︎
  43. Genazzani A D, et al. (1991). Acetyl-1-carnitine as possible drug in the treatment of hypothalamic amenorrhea. https://obgyn.onlinelibrary.wiley.com/doi/10.3109/00016349109007165 ↩︎
  44. Gysler M, et al. (1982). A decade’s experience with an individualized clomiphene treatment regimen including its effect on the postcoital test. https://www.sciencedirect.com/science/article/pii/S0015028216460334 ↩︎
  45. Imani B, et al. (2002). A nomogram to predict the probability of live birth after clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility. https://www.fertstert.org/article/S0015-0282(01)02929-6/fulltext ↩︎
  46. Eijkemans M, et al. (2003). High singleton live birth rate following classical ovulation induction in normogonadotrophic anovulatory infertility (WHO 2). https://academic.oup.com/humrep/article/18/11/2357/644824 ↩︎
  47. Franik S, et al. (2022). Aromatase inhibitors (letrozole) for ovulation induction in infertile women with polycystic ovary syndrome. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010287.pub4/full ↩︎
  48. Angel M, et al. (2014). A randomized trial comparing the ovulation induction efficacy of clomiphene citrate and letrozole. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121933/ ↩︎
  49. Mitwally M F and Casper R F, (2001). Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. https://www.fertstert.org/article/S0015-0282(00)01705-2/fulltext ↩︎
  50. van Santbrink E J and Fauser B C, (1997). Urinary follicle-stimulating hormone for normogonadotropic clomiphene-resistant anovulatory infertility: prospective, randomized comparison between low dose step-up and step-down dose regimens. https://academic.oup.com/jcem/article/82/11/3597/2865946 ↩︎
  51. Sasaki L, et al. (2021). Successful pregnancy after ovulation induction with human chorionic gonadotropin in a woman with selective luteinising hormone deficiency. https://academic.oup.com/humrep/article/36/11/2916/6372200 ↩︎
  52. Zhang C M, et al. (2022). The Reproductive Outcome of Women with Hypogonadotropic Hypogonadism in IVF. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.850126/full ↩︎
  53. Marca A L and Longo M, (2022). Extended LH administration as a strategy to increase the pool of recruitable antral follicles in hypothalamic amenorrhea: evidence from a case series. https://academic.oup.com/humrep/article/37/11/2655/6700806 ↩︎
  54. Hager M, et al. (2022). Basal and dynamic relationships between serum anti-Müllerian hormone and gonadotropins in patients with functional hypothalamic amenorrhea, with or without polycystic ovarian morphology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9251918/ ↩︎
  55. Bergh T, et al. (1985). Pulsatile GnRH therapy – an alternative successful therapy for induction of ovulation in infertile normo- and hyperprolactinaemic amenorrhoeic women with pituitary tumours. https://academic.oup.com/ejendo/article-abstract/110/4/440/6802076 ↩︎
  56. Quaas P, et al. (2022). Use of pulsatile gonadotropin-releasing hormone (GnRH) in patients with functional hypothalamic amenorrhea (FHA) results in monofollicular ovulation and high cumulative live birth rates: a 25-year cohort. https://link.springer.com/article/10.1007/s10815-022-02656-0 ↩︎
  57. Chou S H, et al. (2011). Leptin is an effective treatment for hypothalamic amenorrhea. https://www.pnas.org/doi/full/10.1073/pnas.1015674108 ↩︎
  58. Plessow F, et al. (2018). Estrogen administration improves the trajectory of eating disorder pathology in oligo-amenorrheic athletes: A randomized controlled trial. https://www.sciencedirect.com/science/article/pii/S0306453018308102 ↩︎
  59. Baskaran C, et al. (2017). Estrogen Replacement Improves Verbal Memory and Executive Control in Oligomenorrheic/Amenorrheic Athletes in a Randomized Controlled Trial. https://www.psychiatrist.com/jcp/cognition-in-amenorrheic-athletes-receiving-estrogen/ ↩︎
  60. Van Kasteren and Schoemaker, (1999). Premature ovarian failure: a systematic review on therapeutic interventions to restore ovarian function and achieve pregnancy. https://academic.oup.com/humupd/article/5/5/483/620368 ↩︎
  61. Goldman R H, et al. (2019). The combined impact of maternal age and body mass index on cumulative live birth following in vitro fertilization. https://www.ajog.org/article/S0002-9378(19)30745-8/fulltext ↩︎
  62. Roeca C, et al. (2020). Birth outcomes are superior after transfer of fresh versus frozen embryos for donor oocyte recipients. https://academic.oup.com/humrep/article/35/12/2850/5982008 ↩︎
  63. Turan V, et al. (2020). Ongoing pregnancy and healthy live births following very short ovarian stimulation of incidentally observed big antral follicles in oligoamenorrheic patients with extremely decreased ovarian reserve. https://pubmed.ncbi.nlm.nih.gov/33507715/ ↩︎
  64. Rikken J F W, et al. (2021). Septum resection versus expectant management in women with a septate uterus: an international multicentre open-label randomized controlled trial. https://academic.oup.com/humrep/article/36/5/1260/6208126 ↩︎
  65. Rikken J F W, et al. (2020). Corrigendum. Septum resection in women with a septate uterus: a cohort study. https://academic.oup.com/humrep/article/35/7/1722/5848718 ↩︎
  66. Tonguc E A, et al. (2011). Hysteroscopic metroplasty in patients with a uterine septum and otherwise unexplained infertility. https://obgyn.onlinelibrary.wiley.com/doi/10.1016/j.ijgo.2010.11.023 ↩︎
  67. Tomaževič T, et al. (2010). Septate, subseptate and arcuate uterus decrease pregnancy and live birth rates in IVF/ICSI. https://www.rbmojournal.com/article/S1472-6483(10)00437-2/fulltext ↩︎
  68. Mollo A, et al. (2009). Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility: a prospective controlled trial. https://www.fertstert.org/article/S0015-0282(08)00796-6/fulltext ↩︎
  69. Ban-Frangez H, et al. (2008). The outcome of singleton pregnancies after IVF/ICSI in women before and after hysteroscopic resection of a uterine septum compared to normal controls. https://www.ejog.org/article/S0301-2115(08)00155-3/abstract ↩︎
  70. Sevindik B, et al. (2023). Differences in the anatomical structure of the uterus between fertile and infertile individuals. https://onlinelibrary.wiley.com/doi/10.1002/ca.24045 ↩︎
  71. Practice Committee of the American Society for Reproductive Medicine, (2024). Evidence-based diagnosis and treatment for uterine septum: a guideline. https://www.sciencedirect.com/science/article/abs/pii/S0015028224001213 ↩︎
  72. Piriyev E & Römer T, (2020). Coincidence of uterine malformations and endometriosis: a clinically relevant problem? https://link.springer.com/article/10.1007/s00404-020-05750-9 ↩︎
  73. LaMonica R, et al. (2016). Incidence of Septate Uterus in Reproductive-Aged Women With and Without Endometriosis. https://www.sciencedirect.com/science/article/abs/pii/S1553465016001138 ↩︎

Share this post

Share on LinkedIn Share on Pinterest

fertilPEDIA

Treatment of Irregular Periods

Treatment of Irregular Periods

Treatment of irregular periods varies according to which WHO Group you fall into and the exact cause. Fortunately, almost all cases of irregular periods…. Read more

Questions or comments?