Patient's question:
Doctor, hello: I have had one induced abortion and one medication-induced abortion in the past. I personally feel that my menstrual flow has decreased compared to before. Starting in March, I prepared to have a baby, but after such a long time, I still haven't conceived. Is this related to the reduced menstrual flow? In July, I had an ultrasound and a hydrotubation at the hospital, and the doctor said everything was normal. Additionally, over the past two months, I have been measuring my basal body temperature. Generally, around the middle of the cycle, my temperature gradually increases from 36.5°C to about 37°C, rising by about 0.1°C each day, and then slowly decreases. Is this normal? Does this indicate that I am ovulating?Doctor's answer:
Hello, secondary infertility is mostly related to tubal and pelvic factors. It is recommended to undergo a digital dynamic hysterosalpingography with iodized oil at three to seven days after menstruation to assess the basic conditions of both fallopian tubes and the pelvic cavity. Hydrotubation cannot clearly determine whether the fallopian tubes are blocked, the location and severity of blockages, or the presence of hydrosalpinx.Additionally, if menstrual flow decreases after an induced abortion, it is important to consider whether there are endocrine factors or uterine cavity factors involved. It is recommended to conduct an electrochemical endocrine test between days 2-5 of the menstrual cycle to evaluate hormone levels and ovarian function. A hysteroscopy should be performed three to seven days after menstruation to identify whether conditions such as uterine adhesions are causing the reduced menstrual flow.
Body temperature is influenced by many factors, making it an inaccurate method for determining ovulation. It is advisable to start vaginal ultrasound monitoring from day 10 of the menstrual cycle to check for ovulation. It is best to clarify the cause of infertility before initiating targeted treatment.