Trying to Conceive: Is Something Wrong?

WebMD Live Events Transcript

If you're trying to conceive but keep getting 'big fat negatives', what should you do? How long should this take, anyway? Amos Grunebaum, MD, medical director of the WebMD Fertility Center, joined us to discuss when to worry and when to just keep trying, on Aug. 30, 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:
We have been trying to get pregnant for four months. I have noticed my menstruation cycles range from 22-28 days. Is the only way to tell when I ovulate is charting my basal temp? I have not done this yet because I thought getting pregnant would be easier! Ha!

DR. AMOS:
Menstrual cycles that differ by more than two to three days are considered irregular. Yours differ by six days, so you are considered to have irregular cycles. Just some background: The regularity of your cycle is determined by when and if you ovulate. So the first thing you need to figure out is when and if you ovulate. Finding out about ovulation helps you deciding quickly whether you should see a doctor or not.

MEMBER QUESTION:
How do I do that?

DR. AMOS:
At WebMD we have a great "Fertility Center," which allows you not only to keep a fertility chart, but we also teach you everything you need to know about fertility. No more open questions once you go through our great tutorial. After a couple of months of charting and reading you should know whether it's worthwhile to continue trying or whether you should see a doctor right away.

MODERATOR:
Go to fertility.webmd.com for more info.

MEMBER QUESTION:
So it's possible that I'm not even ovulating?

DR. AMOS:
Let's take your 22-day cycle for example. With that short of a cycle you either ovulate on CD 8, which is very early, or you ovulate later. But in that case the corpus luteum phase, the time between ovulation and the next period, is too short, and that can prevent you from getting pregnant. So it's not necessarily about not ovulating, but it's also about not normally ovulating.

"If you haven't ovulated for three to four months after stopping the pill then you should see a doctor and find out more about what's going on."

MEMBER QUESTION:
Hi, Dr. Grunebaum. I was recently diagnosed with mild endometriosis via a lap. It was removed; however, I'm wondering if there is any relation between early miscarriage and endometriosis. I've suffered two early losses over the past year. I'm currently seeing a reproductive endocrinologist.

DR. AMOS:
There is some relationship between mild endometriosis and miscarriages. Most of the time endometriosis will prevent you from getting pregnant in the first place because it prevents the egg from meeting the sperm. But it can also occasionally lead to a miscarriage or even an ectopic pregnancy.

MEMBER QUESTION:
I have a follow-up question. My doctor is suggesting we move on to an injectable IUI cycle. How successful are IUI cycles using injectable meds? All my other testing has come up normal aside from the endometriosis. Thanks!

DR. AMOS:
Not having all the medical information makes it impossible for me to be more specific. However, even with injectables your chances are likely under 10%. I am just wondering what number your doctor gave you.

MEMBER:
He said up to 30%. Right now he puts me at 10% without intervention.

DR. AMOS:
Thank you.

MEMBER QUESTION:
I was on Ortho Tri-Cyclen Lo for two years. I've now been off for two months, and on prenatal vitamins for three months. We're TTC, but even though I got what seems to be a period both months, I have no sign of ovulation. There's no clear discharge or temp changes. Also, first month was on CD 29, the next came CD 31. I've always had normal 28-day cycles prior to the pill. Could I have had two periods with no ovulation? I've had sex every other day for the past two months with no luck! Can you offer any advice?

DR. AMOS:
If I understand you correctly, then you did keep a temperature curve and I hope that you had someone experienced look at that curve and confirm that there was no ovulation.

MEMBER:
Yes, it always seemed to be 97.9.

DR. AMOS:
Again, I hope you showed it to someone experienced, but let's assume you did not ovulate for a second (though I am not sure about this). Yes, it's possible to have these cycles and not ovulate. In that case you may want to wait another couple of months, because that's what it sometimes takes for your body to recuperate from the pill and to start ovulating on your own again. If you haven't ovulated for three to four months after stopping the pill then you should see a doctor and find out more about what's going on.