TTC: Trying to Conceive

WebMD Live Events Transcript

Are you trying to conceive? Amos Grunebaum, MD, medical director of the WebMD Fertility Center, joined us on March 14, 2005 and answered your questions about getting pregnant.

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 lost our baby at just four months gestation due to Amniotic Band Syndrome in November 2004. I had two periods in November and December of 2004 but nothing since then. My OB doesn't seem concerned with this. He said to keep trying because he believes that since I've gotten pregnant in the past without any fertility assistance that it can happen again. But, if I don't have a period I'm not ovulating, right?

DR. AMOS
I am so sorry to hear about your loss. Not having a period without being pregnant usually means that you do not ovulate. By now it's five months after the prior pregnancy and you should be ovulating. Keeping a temperature curve will also help you find out if you ovulate or not. Your doctor can do some simple tests to find out why you don't ovulate, and then try and help you to ovulate and get pregnant. Good luck.

MEMBER QUESTION
Can you help me interpret the results of my husband's semen analysis?

  • Total volume 9.0
  • Sperm count 60.0
  • Motility 66
  • Morphology 37
  • Ph 8.1 (this is abnormal)
  • Liquefication Comp 1 hr, Specimen liquefied upon request

DR. AMOS
It's impossible to completely interpret any test results online. I do not know the circumstances or your medical history. You should really discuss any results with your doctor to better understand what's going on. The results you submitted are incomplete and there is not enough information there. For example a normal volume is about 3-6 cc or not and then a count can be reported as "per cc" or "total" so it's not clear what you mean by "Sperm count 60."

"Unfortunately manufacturers of pregnancy tests are not as straightforward as I'd like them to be. They advertise with things like "Our test can be positive before you miss your period." "Can be" doesn't mean that it will be. Most tests will NOT be positive until after you miss your period."

MEMBER QUESTION
I am three months off
birth control pills, had two 28-day cycles and was due March 11. Still no sign of my period, only brownish spots when I pee (on Saturday) and cramps. Now it's as clear as day. This was the first month we are trying to conceive (TTC). I took a home pregnancy test on Sunday and it was a big, fat negative. What are the chances it was incorrect? If I'm not pregnant and I don't get a period, how will I know if I'm ovulating correctly (I did have egg-white cervical mucus (EWCM) the last 3 months)?

DR. AMOS
In general, a normal count is well over 20 million per cc and over 40 million total. If you just missed your period then you may have taken the pregnancy test too early. In general, many pregnancy tests will not be positive until several days after you miss your period. I suggest you repeat the test with first morning urine (FMU).

MEMBER QUESTION
Have you heard of tamoxifen being used if Clomid didn't work to conceive?

DR. AMOS
I have heard of it but it's experimental at the present time.

MEMBER QUESTION
Does the brand of pregnancy test make a difference (I used CVS)?

DR. AMOS
Yes, the brand makes a big difference. I suggest you carefully read how sensitive it is. If it picks up a human chorionic gonadotropin (hCG) of 20-25 milliunits (mU) then it's sensitive enough. But even the best pregnancy tests are usually not positive until after you miss your period.

Unfortunately manufacturers of pregnancy tests are not as straightforward as I'd like them to be. They advertise with things like "Our test can be positive before you miss your period." "Can be" doesn't mean that it will be. Most tests will NOT be positive until after you miss your period.

MEMBER QUESTION
I am charting my cycles using BBT and CM, but have had frequent spotting the last two cycles. Is this something I should be concerned about?

DR. AMOS
Spotting can be a first sign of hormone or other problem. I suggest that you write down when exactly in the cycle your spotting happens and how long the luteal phase lasts. This information will help your doctor decide if something needs to be done about it or not. Sometimes it's a hormone issue, other times it's the cervix or vagina or uterus. Your doctor can carefully examine you and review the BBT chart to help you find the reason.



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