I am so sorry for your losses. The prior responder is correct that recurrent pregnancy loss is usually evaluated after three losses if no delay to pregnancy and after two if also having delays to conception. That said, the fact that your losses were later in the first trimester (and in the case of the 13 week one, I presume after a heartbeat had been seen on ultrasound?), a visit to your doctor to carefully go over your personal and family history may be worthwhile. Some of the causes of recurrent miscarriages include: Genetics, blood clotting disorders, uterine cavity differences, hormones, or environmental. Genetics: While many pregnancies are lost because the embryo made a mistake in cell division (a spuratic event which does not increase risk for recurrence), some couples have differences in their chromosomes called translocations that can cause an increase in the chance of loss. Normal chromosomes on the second loss make this less likely, but not impossible (if the chromosomes were normal female, they may have cultured out maternal cells instead of the pregnancy cells) Clotting: Blood clotting disorders can increase the risk of loss. Losses later in the first trimester, or a family history of clotting can trigger testing. Uterine cavity: Fibroids, polyps, septums, scar tissue, uterine cavity differences can increase the chance for loss. An ultrasound with fluid inside the uterus can be used to evaluate the cavity. Hormones: Thyroid, prolactin and progesterone hormone differences and diabetes can all increase the chance for loss. Environment: Smoking, alcohol, and obesity can all increase the chance for loss. Since there are many possible causes, I recommended sitting down with your OB/Gyn to go over your personal and family history and discuss if any testing is prudent at this time. That said, the fact that you have a son and have less than three losses means that you have a good chance for pregnancy success next time. Good Luck!View Thread
Hello, When trying to conceive, we first recommend avoiding lubricants and trying to maximize your own natural lubrication through longer periods of arousal before intercourse. If that is not sufficient, PreSeed has been studied to have minimal effects on sperm motility. Mineral oil and Canola oils also have some support from research trials. You are correct to avoid the other lubricants. Good Luck!View Thread
Hello, It sounds like you are doing everything correctly, and have not yet met your pregnancy goal. Has your partner had a recent semen analysis? The miscarriages mean sperm was present, however do not necessarily mean that count is normal. While your tubal anastomosis has created a path for sperm to meet egg, there may be resultant scarring or changes in tubal function that are a source of delay. Pregnancy can be harder to achieve as we age, so we start to evaluate women 35 and older after 6 months instead of a year. Since you are 35 and it has been over 6 months of trying with at least one open tube, it is time to see a doctor about fertility. Good luck!View Thread
Hello, Menstrual cycle length can vary. Cycle length is determined by how long it takes the body to recruit an egg before ovulation and how long the cyst created by egg release makes progesterone after ovulation. Usually there are 14 days from ovulation until your period or a positive pregnancy test. So one possibility is that it is taking you longer to recruit an egg in the months that your cycles are longer. If the cycles are getting longer than 35 days, or you are no longer seeing positive OPK results, you may be not be ovulating robustly. Your OB/Gyn can help you determine if this is the case, by checing progesterone levels one week prior to your expected period or one week after a pos OPK. Good Luck!View Thread
Finding your fertile window using menstrual cycles can be confusing, especially if your period is slightly irregular. Women can bleed when their hormone levels change. In the month you missed a few pills, the hormones from the birth control dropped, you started to bleed and it took three weeks for things to stabilize. Breakthrough bleeding with missed pills is a a pretty common side effect.
Now that you have stopped the birth control pill, periods mostly reflect the hormone changes as the ovary picks and releases an egg, and the hormone production from the cyst of ovulation; women who are not ovulating can have irregular bleeding. Charting your cycle and using ovulation predictor kits can help you determine whether you are ovulating, releasing your egg, or not. I recommend charting for another month and then visiting with your OB/Gyn. He or she can check a progesterone level one week after you ovulate (one week after you see a surge on your ovulation predictor kit, or cycle day 21 or 22 if you did not see a surge). If you ovulated your body will be making progesterone. If you did not ovulate, your progesterone will be low, and your OB/Gyn will do some additional testing to evaluate.
Rest assured you have not "messed up your cycle." The hormones from the birth control are quickly gone (that is the reason we recommend back up birth control for missed pills). You are doing a great job of listening to your body. Your Ob/Gyn will help you determine exactly what your bleeding means and either reassure you that you are ovulating or help you to ovulate. Good Luck!View Thread
Charting your cycles and finding your fertile window can be confusing. The good news is that you are putting in the most important day, the day your period starts. A period start usually coincides with the time that our ovary hormones are at there lowest, when the cyst of ovulation from the last cycle has gone away and the body is just starting to pick our next cycle's egg. This is the most important date for your monitor. A period end date is much less helpful because length of cycle is affected by too many factors. I recommend continuing to do exactly what you are doing: enter the first day, best guess on the last day or just let it calculate the date. Good Luck!View Thread
Interpreting the menstrual cycle can be a challenge. If I am understanding correctly, you started your period on June 30 and another on July 27. Therefore, you have had a 28 day cycle (the first day of full flow is day one), which is within the normal range. If you have been trying for over a year, or if your other menstrual cycles are more irregular, a visit to your OB-Gyn will be helpful. In preparation for that visit, start marking your days of bleeding on a calendar. If you want to add more information, you can also try ovulation predictor kits to help you find your fertile window. Good Luck!View Thread
It is unlikely that psychological stress could cause a miscarriage. Stress and miscarriage is a difficult area to study. Most research looks at woman after they have already had a miscarriage; a prior miscarriage increases the likelihood that a couple will be under stress in future pregnancies. That said, decreasing stress can only be of benefit for health and wellness. Therefore, I encourage all of my patients who are trying to conceive or already pregnant to take care of their health, both physical and mental. Techniques that I recommend include: identifying stressors and finding ways to eliminate or minimize them, acupuncture, massage, yoga, writing in a journal, cognitive behavioral therapy under the care of a psychologist, participating in activities that are relaxing (music, dance, walking). Reaching out to friends and family or joining a local mind/body wellness group can also be helpful. Good luck!View Thread
I recommend discussing your plans for pregnancy with your OB-Gyn at your routine annual exam and pap smear. Your OB-Gyn will be able to discuss preconception counseling and identify risk factors for fertility. That said, if a woman is in her 20s, has regular predictable menstrual cycles, no history of prior pelvic infection or surgery, no family history of fertility problems or premature menopause, and her partner has no history of surgery, injury or infection to his reproductive tract, we would not embark upon fertility evaluation for one year. Ovulation predictor kits may help identify the fertile window to increase the chance of conception. If conception does not happen by one year, the information from the ovulation predictor kits may help in your discussion of ovulatory function with your fertility doctor.View Thread
Intrauterine insemination with frozen sperm can help many couples with travel concerns continue fertility treatment. While half the sperm does not survive the freeze and thaw, the sperm that does survive maintains good pregnancy rates. In studies of women under 35 using donor sperm due to lack of male partner or partner without sperm, the pregnancy rate was 18.5% per cycle (just slightly less that the 20-25% per cycle quoted as the normal rate of conception). The chance of pregnancy success declines with the age of the female partner (12% per cycle for women 35-40; 5% per cycle for women > 40). Frozen sperm can provide flexibility and good pregnancy rates for couples who travel. Good Luck!View Thread