Pregnancy: Trying to Conceive: Worries

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Trying to Conceive: Worries Big and Small

WebMD Live Events Transcript

Does it seem like everyone but you got pregnant on the first try? Is something wrong, or will it just take time? We discussed what to worry about and what's no big deal with Amos Grunebaum, MD, medical director of the WebMD Fertility Center, on June 7, 2004.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MEMBER QUESTION:
For how long do sperms retain their fertilizing capability once deposited in women's tract? Is this different from their lifespan?

DR. AMOS:
Sperms usually die within minutes in the vagina. And most sperms die within one to two days inside the cervix and uterus. But a few sperms can survive for up to five days inside the uterus.

MEMBER QUESTION:
I am TTC since January 2004. I recently got pregnant but miscarried right away. I was wondering if it might be because my menses is usually two to three days of moderate bleeding? My cycles are regular, 29-30 days, and I ovulate regularly.

DR. AMOS:
Your cycles have little to do with a miscarriage. Most miscarriages are due to chromosome anomalies, and these have nothing to do with the cycle length.

MEMBER QUESTION:
I don't seem to ovulate until day 20-21 of my cycle and my period comes one week later. I am doing OPKs and charting BBT. I read that 11-17 days should elapse between when I ovulate and the first day of my period. This is a reason for infertility, correct?

DR. AMOS:
The corpus luteum phase is the time between ovulation and the next period. The CLP should be at least 12 days. If it's less than 12 days then you have difficulties getting pregnant. You should see your doctor and find out whether and how you should get treated.

MEMBER QUESTION:
So is it not a concern that my menses are only two to three days?

DR. AMOS:
A short menstrual period is usually not a major concern. What is important is that you ovulate regularly and have a normal luteal phase.

MEMBER QUESTION:
How soon after a miscarriage can you begin trying to conceive again?

DR. AMOS:
Ovulation can happen as early as two weeks after a miscarriage, and usually happens two to six weeks after a miscarriage. Most doctors usually suggest waiting for at least one period before starting to try getting pregnant again.

MEMBER QUESTION:
We have been trying since January 2004 with no luck. I had two periods in February. The first one was at 28 days and the second was at 25 days. The next one was at 28 days. Then in April it came on day 30. In May it was on day 37. I am very confused because I have never been this irregular before. I had one live birth 10 years ago and two miscarriages in 2000 and 2001. During the month of May I had several symptoms of pregnancy and then my period was very light and spotty for three days only. I'm not sure if it was really a period. Home test was negative two times. Help!

DR. AMOS:
Irregular periods are usually a sign of an ovulation problem. You can check your ovulation by doing a basal body temperature chart. The chart will help you identify when and if you ovulate, and within a couple of cycles you should find out if this is a problem needing treatment. You can chart your temperature at the WebMD Fertility Center.

"A menstrual period is usually a reflection of ovulation, so it all revolves around ovulation. If there is no period and no pregnancy then it's likely because there was no ovulation."


MEMBER QUESTION:
Will taking the drug prometrium stop me from getting pregnant? I have been taking it for three months.

DR. AMOS:
Prometrium is not a contraceptive medication. After you stop taking it then its effect on your body is gone and it won't influence your future fertility.

MEMBER QUESTION:
What is the purpose of taking prometrium? I was put on it for irregular periods. Is it supposed to help regulate my periods?

DR. AMOS:
Prometrium induces bleeding; it does not "regulate" your period. Regular periods come from ovulating regularly. Prometrium has no effect on your periods. If you have irregular periods and you want to get pregnant, you first must start ovulating regularly in order to improve your chances of getting pregnant.

MEMBER QUESTION:
We are not trying to get pregnant yet, but we are really close. Our finances are just coming around and we're finally getting to a place where I think we're comfortable starting. I am 28 and my wife is 21 but last month she skipped her period and it scares her. She has a little more college to go till she graduates but her family history for trouble getting pregnant has us worried. If we wait as planned and start next spring are we asking for trouble in getting pregnant?

DR. AMOS:
A menstrual period is usually a reflection of ovulation, so it all revolves around ovulation. If there is no period and no pregnancy then it's likely because there was no ovulation. You may want to start checking when and if ovulation happens. Once you have this information you will know if this affects your fertility.

MEMBER QUESTION:
What's the procedure called when a urologist has to put a tube up your urethra and scrape because of urinary retention, and is it a "normal" operation? I ask this because I have to have this done on Friday. Should I be concerned? I am a male, age 32. Will it have any effect on fertility in the future?

DR. AMOS:
I am not a urologist, and it's not clear what kind of a procedure this is. You may want to ask your urologist who did this procedure and knows exactly what was done whether it may impair your fertility.

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MEMBER QUESTION:
Is it normal to have ovulation pain on one side every month consistently (and never on the other ovary)?

DR. AMOS:
Ovulation does not necessarily always happen on different sides, and it is possible to ovulate regularly from one side. As long as you ovulate regularly, this should not be a problem. However, having pain on one side does not necessarily mean ovulation happens on that side. A better way to check the side of ovulation is by ultrasound. You may want to discuss this with your doctor. The ultrasound is usually done shortly before ovulation and the developing egg (follicle) is usually watched until ovulation happens.

MEMBER QUESTION:
I have been told that I don't O on a regular basis but DH is reluctant to try any fertility options. Is there a natural way to help with this issue?

DR. AMOS:
There are some herbal solutions available which may help a couple trying to start off naturally. In circumstances where there may be a hormonal issue, some studies have shown that an herb called Vitex, or chasteberry, may help regulate your hormones. There is one product I know of which contains both all necessary vitamins and herbs to help your fertility. The product is called "FertilAid." You may want to use Google and find it online. Good luck.

MEMBER QUESTION:
Dr. Amos, what are the odds of a false negative on a home pregnancy test? I'm 21dpo and negative on the home pregnancy test. Would you suggest this late in the game to take a blood test or would you consider the HPTs to be correct? If something is stopping me from starting my period after I have ovulated, what could it be?

DR. AMOS:
False negatives are rare. The HPT is usually positive 16-17+ days after ovulation. How sure are you that you are on 21 dpo and that you actually ovulated?

MEMBER QUESTION:
Is there anything that can be done to improve the quality of a woman's eggs, like certain vitamins, or anything else? I am 36 and have miscarried twice in the last year, so I am worried that maybe my eggs are not good quality.

DR. AMOS:
As I mentioned before, there is one herbal supplement that includes all prenatal vitamins, folic acid, and chasteberry, which may help you with your fertility as part of your overall lifestyle. It's called FertilAid and it includes a combination of herbs and vitamins that may help.

MEMBER QUESTION:
I chart and with the temps and CM it was pretty clear that I ovulated.

DR. AMOS:
Not seeing your chart makes it impossible for me to address this question, but it is a very interesting question and I'd LOVE to see the chart. If you sign up at the WebMD Fertility Center I will make a point looking at the chart as soon as you post it.

"If you are now ovulating regularly and you did not get pregnant for about a year the next step would be to check his sperm count and your fallopian tube patency."

MEMBER QUESTION:
Is it normal for a woman not to have ovulation every cycle?

DR. AMOS:
It's not normal to ovulate irregularly. Some women may not ovulate maybe once a year, but if it happens more often than once a year then you may want to check it out. Have your doctor do some tests and find a possible reason.

MEMBER QUESTION:
I have a question regarding my history of pregnancies. I have been pregnant twice and both were unplanned. My first pregnancy ended when I had a miscarriage. My second pregnancy ended through an abortion. Although my husband and I haven't been trying per se, we are also not preventing pregnancy. I was on the Depo shot for seven years, and have now been off for 14 months. Will my history affect my chances now for pregnancy?

DR. AMOS:
Your history of one miscarriage and one safe uneventful abortion is unlikely to affect your fertility. If you are now ovulating regularly and you did not get pregnant for about a year the next step would be to check his sperm count and your fallopian tube patency.

MEMBER QUESTION:
I'm 42, highest FSH was 14.4, and have slight hydrosalpinx on left side. RE attempted repair but wasn't able to during a laparoscopy due to the tool not reaching the tube. I've tried injections and IUIs but no luck. My insurance coverage for IVF doesn't kick in until January 2005. Would it be worthwhile to repair the tube through laparotomy or wait until January for IVF? At my age, I haven't much time. I am also looking into doing the acupuncture/TCM/herbs route.

DR. AMOS:
Sounds to me that your very best success rate will be with IVF. Doing surgery and trying to get pregnant without IVF has, statistically speaking, a much lower chance of getting you pregnant. Good luck to you!

MEMBER QUESTION:
I had a miscarriage this January and have been trying the past three months, but no luck. Is there any problem with my ovaries? I had a missed abortion at six weeks due to fetal anomaly. I am 26 and my hubby is 30 and we are desperately trying to have a baby.

DR. AMOS:
Three months is really not much time to be concerned about your fertility. If you are ovulating normally without other problems it's generally suggested to wait a year until you start testing. In the meantime, you may want to make sure you take a prenatal supplement to make sure you decrease the risk of a miscarriage or fetal malformations.

MEMBER QUESTION:
How does freezing abnormal cells affect ovulation?

DR. AMOS:
Freezing of the cervix can destroy the glands producing mucus. After freezing you may want to make sure that there is enough cervical mucus. This becomes especially important if you have trouble conceiving. Your doctor can examine you at the time of ovulation and verify that there is enough fertile mucus.

MEMBER QUESTION:
My periods vary between 29-30 days. I haven't been able to chart my ovulation time. How do I do it?

DR. AMOS:
The very best place to chart is the WebMD Fertility Center. At the WFC you can chart, you can send in the chart, and I can provide you feedback. In addition there are many, many more fertility tools there that can help you get pregnant. You can go to fertility.webmd.com for more info on the Fertility Center.

MODERATOR:
Unfortunately, we have to wrap up for today. As always, far too many excellent questions to get to!

DR. AMOS:
Thank you very much for visiting today.

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Reviewed on 11/15/2004 6:14:00 PM

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