Regular cycle but no LH surge?

[ap242]

I am 41 (almost 42) and trying to conceive. For three cycles now I have been using an ovulation predictor kit (generic drugstore): first two cycles, mornings only; this cycle, morning and evening. I had been starting the kit on day 9 or 10 but this cycle I started it on day 7. I have never registered an LH surge. I also haven't seen any fertile-quality cervical fluid in these cycles. My first two cycles were 28 and 29 days respectively; currently I'm day 15. Two other possibly relevant pieces of information: my mother completed menopause at age 45; and I underwent an IUI with Follistim & trigger earlier this year that resulted in 5-6 matured follicles and a chemical pregnancy, followed by cysts on both ovaries that resolved within a month. Is it possible that I am having anovulatory cycles of regular length? Or, what else might be at work here? Thank you.

[Dr. Wisot]

That's possible but it's also possible that you are just not picking up the surge.

If you use a generic kit, it may not be as reliable as one of the major brands such as ClearBlue, First Response or Ovu-Quick. It's best to test in the afternoon since most surges occur in the morning, and don't drink for about 4 hours before you test to make the urine more concentrated.

At this point you probably need an ultrasound around day 10-11 to see if you are developing a follicle and at age 41 I would be getting more aggressive than this.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California