Infertility/Fertility/LH levels post D and S


Hi Dr. Ramirez,

Thank you very much for your time, I greatly appreciate it. My question is this: I am 30 with 1 child, my husband is 43. I unfortunately had a missed abortion discovered at about 8 weeks and had a d and s 4 weeks ago. The bleeding from the procedure has  tapered with just occasional light spotting and I am now having negative HPTs. My husband and I are anxious to try again soon and today I got a positive result on an OPK. Does this likely mean I am ovulating again or will my LH levels remain high for a period of time because of the miscarriage? Thank you again for your time. I am writing from Connecticut.

Hello Anna from the U.S. (Connecticut),

Once the bHCG hormone is cleared from your system, the ovaries will reset and proceed with an ovulatory cycle.  The positive OPK is probably a sign that ovulation is about to occur.  There is not residual LH surge from the previous pregnancy.  LH should be gone from your system.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  I now provide personalized fee for service consultations/advice/direction via email and payable via Pay Pal.  If interested, contact me via my email at  This service will allow you to have your own personal on-demand infertility expert


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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