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Infertility/Fertility/Perimenopause vs pregnancy


I am a 45 year old woman from Canada who has a regular 28 day cycle. (Approximately 8-9 months ago I did have a 21 day cycle).  My husband and I had intercourse on day 20 of this cycle and I am now 5 days late.  I did do a regular urine test yesterday and it was negative.  Is it possible that I am pregnant with just not enough hormone in my system yet or more likely that I am going through perimenopause?  (I we conceived our 1 child when I was 39 on day 10 of my cycle.  After her delivery by emergency c-section even with breast feeding I began my menstruation at 6 weeks post delivery, one 2 weeks after that and then every 28 days since, with the one exception mentioned above).

Hello Adrienne from Canada,

I cannot say exactly why your period is late.  Some testing would need to be done, and of course, one of those should be a blood pregnancy test.  Anything is possible, although a very low statistical chance.

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.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at if you are interested in continuous access to me.  


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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, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

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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