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. 2023 Nov 15;59(11):2008. doi: 10.3390/medicina59112008

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© 2023 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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(A) Reproduction of Figure 4 [1] showing early return of fertility postpartum (mucus/bleeding colours—green: dry; yellow: non-lubricative sticky mucus; blue: lubricative, clear, stretchy mucus; red: bleeding/menstruation; TE: total urinary estrogens; end of full breastfeeding with introduction of solids indicated by arrow at 5.0 months, and complete weaning indicated by arrow at 5.7 months). (B) The first cycle postpartum with Mira, showing high estrogen in the fertile window leading up to a high LH surge and a weak progesterone response with a short (6-day) luteal phase. Cycle 2 (C) shows an appropriate estrogen rise in the fertile window, an LH surge, and a 6-day luteal phase. Cycle 3 (D) shows an improved follicular estrogen rise, a normal LH surge, and a higher PDG response with an 11-day luteal phase (i.e., gradual return to normal fertility). The longer luteal phase in the third cycle suggests improved chances of fertility.