<s>[INST] I have been trying for my second baby for almost 20 months , had a miscarrage (blighted ovum) in April 2013, followed by surgical removal, after which my periods have never returned. Scans and blood tests all normal.slight bleed this month for a matter of hours. Have now been prescribed norethisterone to takedown for 7 days from what I believe will be day 21 of my cycle. Should I be using other contraception. Worried that I am taking ovulation tests at the same time and have just picked up an lh surge? [/INST] Hi,History of total absence of menstruation followed by surgical (mostly Dilatation and Evacuation and Curettage) termination of blighted ovum pregnancy is suggestive of adhesions formation in the uterine cavity due to trauma to the uterine lining and the musculature. This entity is known as Aschermann Syndrome. This could be the cause of failure of conception. Hysterosalpingography / Hysteroscopy can diagnose this condition. If Aschermann syndrome is present, the adhesions can be severed delicately during hysteroscopy. Putting some intrauterine device and continuous high Oestrogen treatment may help regeneration of the uterine lining (endometrium). Norethisterone will not help the regeneration of endometrium; it will just be an attempt to have withdrawal bleeding. You need not go for ovulation tests at this stage. Please get the cause for loss of menses diagnosed and treated. Once you start menstruating regularly and normally, you may consider the ovulation monitoring. I hope this gives you preliminary guidelines. Let me know if I can assist you further. Regards,Dr. Nishikant Shrotri </s>