my wife is 40 and her ovulation duration is irregular. Please give me advice on how to get pregnant.

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Hi doctor. I have been trying for a baby 7 months, but i cannot get. my wife is 40 and her ovulation duration is irregular, sometimes 20 days, 24 days, 26 days. Please give me advice on how to get pregnant. Do I have to take the pill? What kind of that pill could I take.

To answer your question, there are 2 issues here. The first issue concerns the irregular ovulation of your wife. This issue has consequently affected the conceiving.

Although contraceptive pills are widely used to prevent ovulation or indirectly control ovulation, this is not recommended because your wife’s periods are irregular and she already has problems with ovulation. To begin ovulating, the OB/GYN – infertility specialist can help you calculate your wife’s cycle and suggest how to bring back her normal cycle. The specialist may prescribe details as well as address other reproductive health issues which may be of concern.

You should go to visit the specialist with your wife since both of you plan to conceive. Generally, for women aged under 35, the specialist will suggest to follow some guidelines to prepare your health before conceiving. In case of women aged over 35, this requires a more active plan. The wife and husband need to have their health checked for infertility issues. It is not the same as an annual health check-up but they can test the quality of sperm, check the female genital tract for problems, etc. After that the specialist will give a personalized plan for couples.

We can share with you the general guidelines to prepare for conceiving. Most of them are lifestyles guidelines which require at least 3 months in advance.

Here is a check-list to run through for healthy preparation. This can be used for both partners. (husband and wife)

Pre-existing medical problems (hypertension, diabetes, epilepsy, thyroid disorder, cardiac problems and drug history)

  • Stabilize medical conditions and ensure that medical control is optimal
  • Check that drugs needed are safe for use in pregnancy and do not affect sperm function
  • Where appropriate, refer woman to an obstetric physician for advice on implications of an existing condition on pregnancy


  • Check BMI
  • Modify diet and do more exercise to lose weight. Women should aim for BMI < 30. Women with BMI < 20 should be advised to gain weight and reduce exercise if they are exercising excessively. Being considerably underweight is associated with an increased risk of miscarriage and intrauterine growth retardation. Proper diet and exercise are important for optimal reproductive function.

Smoking & caffeine intake

  • Advise both partners to stop smoking
  • Caffeine intake less than 2 cups of coffee daily

Recreational drugs

  • Advise both partners to stop using recreational drugs

Check-up the immune system of both partners

  • For the safety of the child: some diseases may be genetically transmitted to the child including anemia, thalassemia, and hemophilia. In some families, these diseases have been transmitted through several generations. A health check-up before pregnancy will help to identify the potential risks that may affect your unborn child. It will also help in planning your pregnancy and to ensure that your pregnancy is safe. Blood test will be done for ABO Group for Hematology, Rh Group, Complete blood count, Hemoglobin Typing, VDRL, Anti-HIV, HBs Ag, Anti-HBs, Rubella Igs (women only), etc. Please read details here.
  • If you don’t have particular antibodies in your system such as for Hepatitis B or Rubella, then you need a vaccine to boost your immune system at least 3 months before pregnancy.

Boonsaeng Wutthiphan M.D.
OB/GYN and Infertility Specialist
Samitivej Hospital

Expecting Expats is the online resource for parents in and around Thailand.

We provide lifestyle and medical content to our visitors, with new content posted daily. Our lifestyle contributors are themselves expat moms who share their experiences and lessons learned through blog articles. We also provide medical content from our partner doctors at Samitivej Hospital in Bangkok, Thailand. Articles of interest span from before pregnancy through the toddler years and cover medical, behavioral and cognitive issues.

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