The first thing that comes to mind when a woman tells me that she's missed her period is that she must be pregnant. But, besides the obvious, missed periods can sometimes signify a more serious problem that can affect long-term health (i.e. development of osteoporosis) or one's chance of getting pregnant. A missed period usually indicates a problem at the level of the brain, ovaries, or uterus, and it can be due to a hormonal dysfunction at any level in the reproductive system, an acquired disease, or a congenital abnormality. The list of potential causes for a missed period is long, but some common reasons include: stress, extremes of weight, eating disorders, chronic illness, and excessive exercise.
In order to establish the cause for missed periods, a thorough history and physical examination should be performed with additional testing that addresses each level of the reproductive axis (i.e. brain, ovaries, uterus). The evaluation may reveal that more than one system is involved here. I generally recommend that women be evaluated if they have had complete cessation of menses for 3 months or irregular periods for fewer than 9 cycles per year. When in doubt, always contact your physician.View Thread
I do tend hear a lot in my practice about different methods to enhance fertility. Some work very well, while others just have you wondering. My top three conception myths are:
1. Can I get pregnant with the pull-out method or the initial ejaculate? Oh, yes, you can. Even if a man pulls out before ejaculation, a small amount of semen can still be expelled into the vagina during intercourse. This is because the initial ejaculate contains the most sperm. If you are not trying to get pregnant, I would not rely on the "pull-out" method to prevent conception.
2. Do men who wear tight underwear have a hard time conceiving? Unfortunately, the answer isn't clear here. There is no conclusive evidence that wearing tight underwear makes it harder to conceive. However, normal sperm production requires a cool environment. If in doubt, switch to boxers.
3. Does lifting my legs up after intercourse increase my chances of getting pregnant? No. Lifting your legs in the air after intercourse will not increase your chances of getting pregnant. Once sperm is deposited into the vagina, they find their way to the egg fairly quickly. However, I do recommend that women lay on their backs for 10-15 minutes after intercourse to make sure that the majority of the semen stays in the vaginal vault.
When in doubt, always ask your physician to help you with ways to enhance your fertility. View Thread
"Try, try, and try again," is my motto when I talk with women who have had an early pregnancy loss. Miscarriages, early on in pregnancy, are very common. About 12-15% of clinical pregnancies (i.e. documented by ultrasound or a tissue diagnosis) will spontaneously abort, and most losses occur before 8 weeks of pregnancy. The most common reason for an early loss is a genetic abnormality of the egg, sperm, or embryo and this is often a spontaneous event that should not recur. Usually after an early loss, most women are able to conceive on their own without any difficulty or intervention.
However, when a couple has experienced two or more failed pregnancies, I generally recommend that they undergo an evaluation to see whether they have any predisposing factors for recurrent miscarriages. Certain genetic and hormonal disorders, uterine abnormalities, and immune disorders have been linked to recurrent pregnancy loss. Most of the time, the evaluation does not reveal anything and these couples end up doing just fine with emotional support and reassurance.
In the end, it is important to remember that most couples who have experienced a loss are likely to achieve a successful pregnancy. I always find that support from one's family, friends, and physicians can be very comforting and helpful during this difficult time.View Thread
It sounds like you're really having a hard time trying to conceive. First, I hope your husband is doing better. There may be an issue with your fallopian tubes or uterus. I would recommend talking to a specialist to find out whether there are any additional tests that you should do before doing another donor insemination cycle.View Thread
I know that it can be frustrating at times when you're trying to conceive. I would try on your own for another 3 months if you're ovulating. However, you should seek assistance if there are any concerns about tubal patency or male infertility.View Thread
Male infertility plays a role in for 45% of all infertility problems, and in 20-40% of infertility cases the problem is primarily associated with male partner. Most male infertility is caused by a problem with sperm not being produced or not exiting the body properly. Symptoms of infertility may include difficulty with ejaculation or maintaining an erection, decreased libido, decreased facial or body hair growth, and lethargy.
Both partners should be evaluated at the same time. The easiest and simplest way to determine whether male infertility problems exist is to do a semen analysis. This test will let your doctor know whether your partner is producing sperm, and whether the sperm are misshaped or slow-moving. Fortunately, most causes of male infertility are treatable, and this allows most infertile men a chance to start a family. Treatment for male infertility varies, and can range from artificial inseminations for mild forms of male factor infertility to in vitro fertilization for more severe cases.View Thread
I am often asked if egg freezing is a viable option to help women preserve their fertility, and who would benefit the most from it. Egg freezing can only be offered to women who are doing in vitro fertilization, because it involves stimulating the ovary, harvesting unfertilized, mature eggs, and freezing them for later use. It is viewed by some as a way to preserve fertility and to stop a woman's biological clock, since it is easier for a woman to conceive using her "younger" eggs years later.
In the past, egg freezing was considered experimental because pregnancy rates using thawed eggs were lower than those using fresh embryos. This difference was due to increased damage to the egg during the freeze and thaw process. However, pregnancy rates are similar to those achieved with fresh eggs during in vitro fertilization in low risk groups.
I generally recommend that egg freezing be offered to women who have a medical reason to postpone pregnancy (such as women undergoing cancer treatment) and for those who are at increased risk for premature ovarian failure, since they have few options to help preserve their fertility. It can also be offered as a last resort to couples who have insufficient sperm at the time of their egg retrievals, and to couples who have do not want to consider freezing embryos.
Many clinics are now also offering elective egg freezing as an option to preserve fertility in women who want their biological children but want to delay childbearing. Despite improvements in pregnancy rates with egg freezing using newer processes, patients should still be advised about the limitations of elective egg freezing since its safety and effectiveness has only been studied in select groups.View Thread
Many women ask if having an orgasm will increase their chances of conception. The thinking is that since an orgasm helps to increase uterine contractions, this wave-like motion could potentially help to "suck up" sperm into the uterine cavity. Unfortunately, though, this theory doesn't carry any weight — studies have not shown higher pregnancy rates in women who are able achieve orgasms during intercourse. However, even though orgasms do not directly increase the likelihood of conception, they may make a woman want to have more intercourse, and this can definitely help when you're trying to conceive.
Have you heard anything about orgasm affecting fertility? Are there any other myths that you have questions about?View Thread
Many women question what effect, if any, their prior use of contraceptives might have on their efforts to conceive.
Contraceptives like birth control pills won't affect your ability to conceive (unless you're still taking them, of course!), but it could have a slight effect on timing, depending on which contraceptive you were taking. If you've been using the birth control pill or the ring, their effects disappear almost immediately. It's estimated that 50% of fertile women trying to conceive will get pregnant by 3 months after stopping the pill and having sex regularly. Users of mechanical methods (i.e., intrauterine devices or IUDs) also should have no delay in conception. If you use an injectable form of contraception, on the other hand, it can take longer to get back to a normal menstrual cycle and ovulation — in some women, up to 9 months after the last injection. I usually suggest that women who want to conceive immediately after discontinuing their contraceptive use other kinds besides depo-medroxyprogesterone acetate (Depo-Provera, an injectable contraceptive).
Besides the potential delay in timing with the injectable forms of contraception, there is no increased risk of infertility from the use of hormonal forms of contraception.View Thread
It sounds like you're really having a hard time conceiving. It may be time to initiate an infertility work-up if one has not been done already before doing anymore treatment cycles. You should contact your doctor or a RE to discuss your next steps.View Thread