Brief Answer:
Very likely you are ovulating due to the estradiol levels, previous pregnancy and monthly periods- please see the detailed answer

Detailed Answer:

Hello,

I carefully read your question and understand your concern.

Because you have conceived previously and because you have your periods every month (even though there is a small variation in the length) very likely you are able to ovulate and conceive again.

To have an understanding of ovarian reserve (how well your ovaries are functioning and if they will go on to ovulate) it is needed to have in day 2-4 of the menstrual periods both FSH and estradion. FSH at that time should be less than 20 ui/l and estradiol over 220 pmol/l- if these are the values at day 2-4 of the menstruation than very likely your ovarian reserve is good and there is nothing to worry.

On the other hand there are other factors to consider related to conception and pregnancy. The male partner needs to have the sperm examination to make sure it is normal and also sometimes Hysterosalpingography is also done on the female partner (you in this case) to make sure that the tubes are functioning well.

Sometimes even if all these conditions meet (ovulation happens, the tubes are functioning well, the man's sperm examination is normal) a woman might take long to get pregnant so it is best to relax and just make sure you have regular intercourse. Being stressed related to the matter might delay the process of conceiving.

So to conclude i would say:
- please make sure you have a FSH and estradiol done in day 2-4 of your menstruation
- if these are in good values (mentioned above) than your partner needs to have a semen analysis (examination of the sperm)
- if this is normal also than you will need to have a hysterosalpingogram to make sure the uterine tubes are well
- if all are normal than just relax, try to live healthy and access medical support and advise regularly.

I hope this is helpful and answers to your question but please feel free to reply in case more clarification is needed on this.

Kind regards,

Antoneta Zotaj, MD

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Brief Answer:
Very likely you do not have higher risk for miscarriage than a woman that never had a miscarriage before- please see below for more details

Detailed Answer:

Hello,

I understand your concern with the risk on miscarriage after the experience you have had. Generally we do not do any testing if it is only one miscarriage so at the moment there is no need to worry for another miscarriage. This means that one miscarriage can happen without a specific reason. If a woman gets 3 miscarriages we start to investigate for possible causes. Age over 35-40 might be a risk factor for miscarriage but does not necessarily mean you are high risk for miscarriage.

To increase the chance of a healthy pregnancy please make sure you get good advise and follow up with a doctor on the pregnancy. This will make sure you get the right tests during the pregnancy and timely treatments and interventions when needed.

So to conclude i would say:
- you do not need to worry at the moment for another miscarriage, the odds for you for another miscarriage are similar to a woman that did not have a previous miscarriage. Only repeat miscarriage are concerning.
- make sure you get good regular medical care and follow medical advise when pregnant.
- make sure you live healthy meaning no smoke, no alcohol use, keep active, etc.
- the tests that i have mentioned above related to ovarian reserve (function) is FSH and estradiol in day 2-4 of the menstrual cycle.

I hope this is helpful and answers to your question but please feel free to reply in case more clarification is needed on this.

Kind regards,

Antoneta Zotaj, MD

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