Patient :My wife has no dominant follicle on her 16th(10/17/2014) day of follicular study. this time she didn't get her periods her last LMP is 11/02/2014 according to it now she is 6W5D.we did an ultrasound on 12/16/2014 the result show she is 4W3D pregnant with 0.55mm gestational sac in regular yolk sac fetal pole not visible.
Women with polycystic ovaries, hyperprolactnemia and various other conditions have typically long cycles or irregular periods because of infrequent ovulation or anovulation. These women typically ovulate late in their cycles sometimes as late as the 21st or 22nd day of the cycle. In women with longer cycles the standard calculation of gestational age from last menstrual period does not apply. In such cases it is important to rely upon the gestational age calculated by ultrasonographic methods.
Another explanation for a gestational age (calculated on sonography) not matching the menstrual dates is a blighted ovum or a non viable pregnancy. In cases of a blighted ovum, the fetal pole is usually not formed as a result of an arrested development. In such cases it is advised to repeat a sonography in a week's time to note the growth in the fetus. In case of no growth or regression of indicators, the pregnancy is usually declared as a missed abortion and further treatment is then advised.
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