Dear An_250842, Yes you should definitely talk to your obstetrician and maybe even ask him/her for a referral to a maternal fetal medicine specialist for a consultation. You might even want to get a name and travel to talk with an expert that does research in preventing 2nd and 3rd trimester pregnancy losses. In the pursuit of parenthood, pregnancy losses are the hardest situations for both parents and their providers. Health care professionals don't always have answers but there are experts out there that are looking for those answers and they can share the latest knowledge and hopefully guide you to a better outcome. Just knowing that you are equipped with the latest knowledge and being watched by experts should at least give you the confidence that you are doing everything that you can for your child and each other. There are also grief counselors that specialize in helping couples cope with these issues. You don't have to struggle with this alone. I would love to know if you have success as your story is one that touches my heart. Best wishes. (email@example.com)View Thread
Dear An_250653, Understanding what is going on with a woman's reproductive cycle can be a lot like figuring out a puzzle. The first thing to do is to accept that you aren't going to get all of the answers all of the time. In fact, you might not have a clue what is going on some of the time. That is one of the beautiful things about women. Sometimes they are a mystery. The process of ovulation is an orchestrated dialogue between your ovaries and your brain. There are probably other members of the orchestra in there that we don't even know about yet. The only true proof of ovulation is a positive pregnancy test. The other pieces of the puzzle are things that we know are associated with normal ovulatory cycles. If I were you, I would keep a calendar and record days of bleeding, days of intercourse, cervical mucous changes, and the day the ovulation predictor kit turns positive. Don't start using the OPK until you can pretty accurately predict your next menstrual perioid. If you are having a normal ovulatory cycle, the OPK should turn positive 14 days before the next menstrual cycle begins. You want to start testing a couple of days before that. If your cycle is 34 days then the OPK should turn positive on cycle day 20. Your fertile period is 3-5 days leading up to the positive OPK. After that intercourse is recreation, not procreation, until the next month. If things don't seem right in any way, don't hesitate to take your data to your ob/gyn and sit down for a little preconception counseling. Try not to stress out too much. Remember in the long term the most important thing is relationships. Love your husband. Guide him in the process but don't forget that every day isn't about making a baby. After your kids are out of college, it will be back to just the two of you. This should be a time of fun and planning together. There are many paths to parenthood and sometimes that path requires a little help. I hope you don't need too much help. Good luck!View Thread
Dear brandi2022, Our goal is to figure out if your positive tests represent a real LH surge or not. Occasionally a woman will have a false positive test. Explanation: Women with ovulation problems sometimes have naturally high levels of LH in their blood stream that can result in a weak false positive OPK test. Those tests can alternatively be positive and negative. Alternatively, the test in the middle could have been a false negative test. There may have been something wrong with the one test that was negative. If you had a real LH surge then the hormone wouldn't really appear, disappear and reappear. We can figure this out by checking a serum progesterone one week after you had the surge and waiting to see when you get your next period. A real LH surge is followed by a rise in progesterone and the next period should appear about 14 days later if this is a normal LH surge. If the test was a false positive then your progesterone level will remain low. Here's hoping that it was the former and that your progesterone level is high but you miss your period because you are pregnant. Good luck!View Thread
Dear An_250343, I think that you are on the right track with the monitoring that you are currently doing. Normal ovulatory cycles are between 27-35 days most of the time. Situations that increase the suspicion of a problem with ovulation include short cycles, long cycles, cycles that are variable by more than /-1 day and short luteal phases. The luteal phase is the length of time from the positive OPK until the first day of your next menstrual period. Exceptions to these rules do occur. No one knows for sure when ovulation occurs but it is probably between 40- 45 hours after the LH surge. The LH surge appears first in the bloodstream and then later in the urine after the LH hormone is filtered through the kidney. One of the key principles for timing intercourse is to understand that the sperm can live for days In the female reproductive tract and eggs are probably receptive to sperm for only about 12 hours. Therefore the sperm need to be in the female reproductive tract waiting for eggs before or close to the time of ovulation. Throughout most of the menstrual cycle, sperm cannot get into the cervix and upper reproductive tract because of the very dense cervical mucus. As the estrogen rises before ovulation, the water content of the mucus increases. Somewhere 3-5 days before ovulation the mucus develops and egg white consistency, becomes very inelastic and for the first time sperm can gain access to the cervix its elaborate labyrinth of glands and the upper reproductive tract. When you have intercourse during your fertile window, your partner is filling the reservoir, i.e. cervix, which releases sperm into the upper reproductive tract continuously for days. Men should ejaculate, i.e. clean their pipes, once a few days before the fertile window and then You should have intercourse at least once during the fertile window. Fertility is highest when intercourse happens close to the time of the positive OPK. the reason for the first ejaculation that I mentioned above is to move the old sperm out of the way and the unhealthy sperm to the front of the next ejaculation. If men have not ejaculate for approximately 2 weeks, there may be no living sperm in the ejaculate. For example, if a woman has a 28 day cycle with a positive OPK on day 14 then her fertile window begins somewhere around cycle day 9-11 and ends shortly after cycle day 14. Men should ejaculate once within a few days of cycle day 11 and then you should have intercourse at least once in the11-14 day window, preferably closer to cycle day 14. It may be helpful to keep a calendar of your dates of bleeding, intercourse, cervical mucous changes and OPK. This can help you and your healthcare provider determine if you are timing things correctly. It is normal for it to take 4 months or so to get a positive pregnancy test. If you are close to 35 years old or older it is not unreasonable to seek help if you're not pregnant within six months. It is also very reasonable to seek counseling for preconception planning anyway and especially if you are suspicious that there may even be a subtle ovulation disorder. Good luck!View Thread
Mrs. Gonzalez, It is never wrong to see your primary care provider for preconception counseling. Interestingly, pregnancy is one of the riskiest and most rewarding things that women do in their lives and planning for pregnancy is wise. There are a number of screening tests that can help you ward off or anticipate potential problems in pregnancy. It would not be a bad idea to document that you are immune to German measles (Rubella) & chickenpox (Varicella). Also knowing your blood type and having an antibody screen can help your doctor manage your pregnancy. Many autosomal recessive genetic disorders can be predicted and eliminated through screening that is becoming less expensive every day. Also, identifying health problems before you become pregnant is also important. Once you become pregnant your doctor has two patients. Your healthcare provider can also help you assess your fertility potential and make decisions about when it makes sense to offer testing and assistance. If nothing else, sometimes just the psychological benefit of talking with your healthcare provider can make the journey easier. Good luck!View Thread
There are a number of ovulation predictor kits that work nicely, including the one that you are referring to. Your first goal will be to establish a regular predictable bleeding pattern most likely with an interval between 27 & 35 days. Once you have done this, you should expect the ovulation predictor kit to turn positive 14 days before day one of your next menstrual cycle. Your fertile window should be 3-5 days leading up to the positive ovulation predictor kit. Ideally your partner should ejaculate once within 5-7 days before the fertile window and then have intercourse at least once during the window. Pregnancy rates are higher when you time intercourse closer to the time of the positive ovulation predictor kit. Good luck!View Thread
The birth control pills probably don't really have anything to do with the slow return of your cycles. They are out of your system pretty quickly after you stop taking them. Studies have shown that approximately the same percentage of women have menstrual cycle abnormalities going on and coming off of the pill but they aren't necessarily the same women. The slow return of your cycle may be a new hormonal problem that needs an evaluation or just jump starting. You can either be patient for a month or two more to see if it will start on its own or go in to get checked out. There are a number of possible issues from the common (androgen/estrogen imbalance) to the rare (ovarian failure) with a host of other possibilities including thyroid dysfunction. It may be worth making an appointment with your gynecologist to help get your cycles back on track...
I wouldn't beat yourself up over the choice to stay on birth control pills. If anything, birth control pills may be fertility preserving because the decrease in menstrual flow each month probably lowers the chances that you will develop endometriosis.
This is an interesting question. Probably the only true evidence of ovulation, i.e. the egg got out of the ovary,is a positive pregnancy test. Most of the time we are looking for evidence of things that are necessary for ovulation to occur. Regular predictable menstrual cycles suggest ovulation. Better evidence is the presence of an LH surge ( OPK) and the production of a corpus luteum. Evidence of the corpus luteum is a rise in progesterone after the LH surge. Progesterone can be measured in the bloodstream or it can be seen in directly by observing a biphasic basal body temperature. The length of the menstrual flow probably has little to do with whether or not ovulation occurred. it may be helpful for you to keep a calendar of menstrual bleeding, intercourse, cervical mucous changes & OPK testing. This can help you look for evidence of ovulation and proper timing of intercourse around your fertile window. Good luck!View Thread
It can be a challenge to figure out what is going on after you take depoprovera. DepoP can clear from some women's bodies in the normal 3 month window and hang around for a long time in others. Progesterone-only therapy like DepoP or Norplant are associated with breakthrough bleeding much more often than hormonal contraceptives that contain estrogen, like birth control pills. The estrogen tends to stabilize the uterine lining. What your doctor does for you will depend on your goals (not bleeding, trying to get pregnant, etc.).View Thread
Women with irregular cycles get pregnant less often than women with regular cycles but it is always a good idea to check a pregnancy test if there is any question. If you are not pregnant, it may be very worthwhile for you to see a gynecologist for an evaluation. Ovulation problems are common. As much as 5-10% of women have a problem with ovulation those problems can have adverse effects on your general health as well as your fertility. View Thread