A 31- year old woman has been trying to conceive for nearly 3 years without success. Her last period started 7 months ago and she has been having periods sporadically for about 5 years. She bleeds for 2-7 days and the periods occur with an interval of 2-9 months. There is no dysmenorrhea but occasionally the bleeding is heavy. She was pregnant once before at the age of 19 years and had a termination of pregnancy.
She had a laparoscopy several years ago for pelvic pain, which showed a normal pelvis. Cervical smears have always been normal and there is no history of sexually transmitted infection. The woman was diagnosed with irritable bowel syndrome when she was 25, after a thorough investigation for other bowel conditions. She currently uses metoclopramide to increase gut motility, and antispasmodics. Her partner is fit and well, and has two children from a previous relationship.…
