This is a fairly common problem, and it sounds like you are having a hard time determining your fertile window. You could still have an ovulation disorder even though your periods appear to be more regular now. I would recommend talking to a specialist from now. They can do some initial testing to determine whether you are in fact ovulating regularly.View Thread
I'm very sorry about your pregnancy losses. Early pregnancy losses with an empty sac can indicate an egg quality issue. After three pregnancy losses, I generally recommend that couples undergo an initial evaluation to rule-out an underlying genetic and hormonal disorder, a uterine abnormality, and a possible immune disorder. I would contact a specialist to discuss your next step.View Thread
PCOS, or polycystic ovarian syndrome, is the most common endocrine disorder that affects reproductive age women. Eight to 10% of reproductive age women have PCOS, and they generally present with irregular menses and/ or infertility because they don't ovulate regularly. Fifty percent of women with PCOS are obese, and it is thought that the high insulin production associated with obesity and subsequent insulin resistance (i.e. decreased ability of the body to take-up and utilize glucose) contributes to the underlying infertility associated with PCOS.
Fertility treatment for women with PCOS is typically a two-pronged approach:
1. Weight loss through changes in diet and exercise can increase insulin sensitivity in obese women with PCOS. Sometimes, losing 5-10% of one's body weight can help women with PCOS ovulate on their own because their insulin sensitivity improves.
2. When weight loss is not enough to induce ovulation in women with PCOS, hormonal stimulation is needed. The first line treatment here is Clomid. Clomid typically induces ovulation in 70-80% of women with PCOS, and there is a 15% chance that women who respond to Clomid will have a live birth.
If you have PCOS and you have been struggling to get pregnant, you should seek assistance from a fertility specialist to talk about ways to increase your chances of getting pregnant. Sometimes, simple measures such as weight loss are all that is needed to help you conceive.View Thread
Trying to conceive can be a long and difficult process. Having a trusted specialist who will be there with you from start to finish can make the process a little easier. Here are a few simple pointers for finding the right specialist for you:
1. Ask your friends, family, colleagues, and physicians if they know other couples who have struggled with infertility, but subsequently conceived with the help of a great specialist. In my opinion, this is often the best route to take when seeking a specialist because your family and friends won't steer you wrong. Chances are if someone you know had a great experience with their fertility specialist, you will, too.
2. Find out a clinic's live birth success rates. This is usually easy to obtain because most fertility clinics report their success rates annually. A clinic's live birth rate can give you an idea of how effective their treatment protocols are and whether their laboratory is any good. In the end, it's only natural to seek assistance from someone who can help you get pregnant!
3. Meet with a few specialists before deciding on "the one." Choosing the right fertility specialist for you can take time. For some, this realization may come sooner as it becomes obvious that not all fertility specialists offer the same fertility services or have the same bedside manner. Remember, from start to finish, you will probably spend more time with your specialist than your partner. So, you want to make sure that your specialist is going to be by your side for the long haul and is readily accessible.
Needless to say, trying to get pregnant can be stressful and emotionally taxing especially when prior attempts have failed. Finding the right fertility specialist for you can take time, but it should always be your first step when you need help starting a family.View Thread
When I talk about ways to enhance natural conception with my patients, I focus on two things: timing and implementing certain lifestyle changes. First, timing is everything when you are trying to conceive! Intercourse has to be timed to a woman's "fertile window" in order to get pregnant. This fertile window is usually three to six days prior to ovulation, but it can be difficult for some to predict. Some useful methods to predict one's fertile window is to chart intermenstrual intervals, do basal body temperature monitoring, note cervical mucus characteristics, and/or use ovulation predictor kits. A simpler option is just to have regular, timed intercourse starting on cycle day 10 if the female partner's menstrual cycle is regular.
When timing does not appear to be an issue, implementing certain lifestyle changes may help to enhance natural conception. Extremes of weight (i.e. too thin or too heavy) can negatively affect fertility. We need a certain amount of body fat to reproduce and anything above or below this threshold can affect fertility. Implementing a healthy diet and regular exercise, 30 minutes per day five times a week, can sometimes help couples achieve their goal of pregnancy.
In addition, couples who are trying to conceive should not smoke and should limit their caffeine and alcohol intake. Smoking can reduce one's chance of getting pregnant by 50%, and increased caffeine intake (more than 5 cups/day) has been linked to longer times for conception and increased miscarriage rates. The effect of alcohol on natural conception is less clear, but excess alcohol consumption during pregnancy is associated with fetal alcohol syndrome.
Sometimes, just by implementing these few things, couples are able to conceive on their own without any assistance.View Thread
There are no definitive studies that link stress to infertility, but when your body is faced with certain chronic stressors (i.e. chronic illness or the loss of a loved one) it does its best to conserve energy in order to allow us to carry out our daily functions. This "protective" mechanism can sometimes limit our ability to reproduce, and it can cause some women to ovulate later or not at all. Although the exact mechanisms by which stress can affect fertility are unknown, it is believed that the stress hormone, cortisol , may alter communication between the brain and the ovaries to release eggs.
A lot of what we know about the effects of stress on fertility comes from research on in vitro fertilization. Studies have shown that infertile women under a lot of stress have lower success rates during their in vitro fertilization cycles (i.e. lower egg yield and pregnancy rates) than women under less stress. Furthermore, when stress reduction methods are implemented in this population (i.e. acupuncture) pregnancy rates have been shown to be higher.
Trying to get pregnant can be nerve racking, especially if prior attempts have failed, and finding ways to relieve stress may be helpful. This is a great time to take up a new hobby, exercise, try yoga, read a good book, or just shop. Anything goes here, as long as it helps you not to obsess over your struggles with fertility. This may also be a good time to share your concerns and experiences with your partner, friends, or a trained professional, so that you do not feel as though you are going through this alone.View Thread
This is a fairly common issue and a delay in the onset of menses can occur after the use of Depo-Provera. It takes about 6-8 months to clear Depo-Provera from your system. You should be evaluated by your physician if you have not gotten a period by 9 months after the last Depo Provera injection.View Thread
Dear Missverjan, In order to conceive, you have to ovulate and ovulation can be difficult to predict when your cycles are irregular. If you do not ovulate regularly, your physician or a specialist can prescribe hormones that induce follicular growth and development and that help to release the egg. I recommend that you contact your physician to discuss your next step.View Thread
If you've been trying to conceive on your own and have been unsuccessful, you may be wondering if it's time to seek a specialist. But when is it time to make that call? Generally speaking, I recommend a consultation from an infertility specialist after a year of regular, unprotected intercourse with no pregnancy.
Earlier evaluation is warranted if the female partner has irregular menstrual cycles, a history of pelvic infections or endometriosis, suspected male infertility, or recurrent pregnancy loss. Furthermore, women over age 35 should see a specialist if they have been trying to conceive for more than 6 months or earlier if clinically indicated.
One's chance of having a child decreases with age and duration of the infertility. When in doubt, seek help from a fertility specialist. Some simple tests can be offered to help you determine if there is a reason as to why you have not gotten pregnant yet.View Thread
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