Conceive, Trying to (cont.)

MEMBER QUESTION:
Can you be on Clomid and still need to take progesterone supplements, or does the Clomid also assist with progesterone deficiencies?

GRUNEBAUM:
Whether you take progesterone or not depends mostly on your medical history.

Many doctors feel that progesterone supplementation is unnecessary most of the time and won't improve pregnancy outcome. In addition, taking progesterone at the wrong time may actually decrease your fertility. I would therefore suggest that you discuss the specifics with your doctor who knows you best.

MEMBER QUESTION:
Are there ways to test the health or viability of eggs before conception in women over 40?

GRUNEBAUM:
The "good egg" test is an FSH test done on CD 3. A low FSH on CD 3 means the eggs are good.

MEMBER QUESTION:
Does having a tipped uterus prevent one from getting pregnant?

GRUNEBAUM:
A tipped uterus is also called a "retroverted uterus." A retroverted uterus does not play a major role in fertility problems unless it's from endometriosis. Endometriosis can prevent you from getting pregnant, but not the retroverted uterus in and by itself.

"After 40 the rate of infertility decreases significantly. If you ovulate regularly then the next step is to test the quality of your eggs."

MEMBER QUESTION:
I was diagnosed with polycystic ovarian syndrome. Can you suggest a way I can conceive without taking medicine?

GRUNEBAUM:
PCOS is the leading cause of infertility in women. It is a condition associated with many different problems and each needs to be addressed individually.

Your best chance of getting pregnant with PCOS is to see an infertility specialist or reproductive endocrinologist. The RE is best trained to review your information, examine you, and decide on an optimal treatment plan.

For example, if you are overweight, then losing weight to an optimal BMI will improve your chances of getting pregnant.

MEMBER QUESTION:
Can egg whites really be used safely as a replacement for cervical mucus? A friend swears it worked for her but she's definitely not a doctor!

GRUNEBAUM:
It all depends on why you want to use egg whites. If you ovulate regularly and you don't have enough cervical mucus then pasteurized egg whites may help sperms enter the uterus.

But I would suggest you first have your doctor examine you to find out whether that's the problem. I would never suggest you use anything unless there is a clear indication.

MEMBER QUESTION:
I am 43; what are the chances of getting pregnant on my own?

GRUNEBAUM:
After 40 the rate of infertility decreases significantly. If you ovulate regularly (do you?) then the next step is to test the quality of your eggs.

This is usually done with a CD 3 FSH test. You may also want to have him do a sperm count so you won't lose unnecessary time. I also suggest that women at this age see their OB/GYN or an infertility specialist. Time is important and even waiting six months will likely decrease your chances of getting pregnant.

MEMBER QUESTION:
Does a spike in your temperature indicate ovulation? My OPK was positive on Saturday and I noticed my temperature was higher than normal on Sunday. What do you think?

GRUNEBAUM:
You can't tell anything from just one spike. For ovulation to be diagnosed you must see a "biphasic" temperature chart. It's lower then goes up and stays up for at least three days.

MEMBER QUESTION:
My period came seven days early this month and lasted seven days. Is that normal?

GRUNEBAUM:
Your period depends on when you ovulate. If you ovulate then it comes 14 or so days later. So you first need to determine exactly when you ovulate. This will provide you with the right answer.

It's not normal to get a period seven days after ovulation But if you ovulated 14 days before then, that's normal. That's why many women join the WebMD Fertility Center where you can keep a BBT chart. This will help you identify exactly what's going on each cycle.

"Keep a BBT chart and find out whether and when you ovulate. The knowledge of ovulation will help you determine each time what's going on when you miss your period."

MEMBER QUESTION:
I recently had my second miscarriage in six months. I have a bicornate uterus and for each pregnancy the zygote has been on the right or left respectively. This past miscarriage concerned me. It has not expelled and I heard the heartbeat twice in one week via transvaginal ultrasound. On March 28 it was 114 and on April 1 it was 120; then within 24-48 hours the baby died. Is this normal in a bicornate uterus or should I have any specific tests before trying to conceive again?



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