Conceive, Trying to (cont.)

MEMBER QUESTION:
Is there such a thing as implantation cramping? Could the cramping I started having seven days past ovulation be implantation? I am still having dull cramping -- more like pressure. Is that normal if pregnant?

DR. AMOS:
Most pregnant women have no symptoms at implantation. No matter what you feel, the only way to be sure that you are pregnant is a positive pregnancy test. Everything else is pure speculation.

MEMBER QUESTION:
How likely is it that you would miss your LH (luteinizing hormone) surge using OPKs (i.e. never get a positive OPK, but actually ovulate)?

DR. AMOS:
It's very unusual to not have a positive OPK and ovulate, but it's possible. If your BBT (basal body temperature) chart shows a clear biphasic pattern and/or you have elevated progesterone levels then that's your very best indication that you ovulated.

MEMBER QUESTION:
My son passed away due to a blood clot at 30 weeks. Two months ago and two weeks ago, I had blood work done to see if I have a clotting disorder. Last week the tests' results were negative for clotting. I want to get pregnant and my doctor said I have the green light to try again. I want to know the percentage of succeeding in bringing a baby to term. I have two healthy girls now -- one is 20 and the other is 7. I am 38 years old.

DR. AMOS:
I am so sorry to hear what happened. However, from your description it's unclear where the blood clot was and without knowing the full history and what happened it's impossible to provide you with more information.

I suggest you see a high-risk obstetrician -- a maternal-fetal medicine specialist. This specialist can review your history and chart and then give you the best advise on what to do next.

"I cannot emphasize this enough -- knowing for sure when and if you ovulate, preferably with a BBT chart, is crucial to help you get pregnant faster."

MEMBER QUESTION:
I have been trying for three months now. I'm actually due for my period today but I didn't get it. I took a pregnancy test this morning and it was a negative. Could it still be possible that I am pregnant?

DR. AMOS:
The most important question to answer is: Did I ovulate or not? If you did ovulate for sure and your period did not come 15+ days later, then chances are you are pregnant. If you miss a period with repeatedly negative pregnancy tests and they are negative, then chances are that you did not ovulate.

I cannot emphasize this enough -- knowing for sure when and if you ovulate, preferably with a BBT chart, is crucial to help you get pregnant faster.

MEMBER QUESTION:
I had a progesterone test done last cycle at seven days past ovulation (DPO). It came back at 9.5. This was a medicated (tamoxifen) cycle. My doctor doesn't seem to think it's a big deal that it wasn't that high. Any thoughts? I do have type 2 diabetes.

DR. AMOS:
On 7 DPO, ovulation the progesterone should be over 10. You either ovulated and tested too early or you did not ovulate at all. Keeping a BBT chart will help you identify the exact ovulation day.

MEMBER QUESTION:
I will be starting Clomid in a few weeks if I'm not pregnant by then, and I hear it is better to take it at night. Is this true?

DR. AMOS:
There is no research I am aware of that says taking Clomid at night is better than in the morning. Ask your doctor and find out her opinion, but I am not sure it will make a difference.

MEMBER QUESTION:
I am on my second month of Clomid -- the 50-milligram dose. My cycle length was 35 days. Should I expect to ovulate around the 21st day again? Or is there a possibility I won't follow the same pattern?

DR. AMOS:
How sure are you that you ovulated? As I mentioned before, it's crucial, especially if you take Clomid, to know the exact day of ovulation. Going by cycle length isn't enough when you take Clomid.

If you take Clomid on CD (cycle day) 5-9, the ovulation is expected on CD 14-18. So CD 21 sounds late for ovulation on Clomid.

MEMBER QUESTION:
I've been TTC for over a year and just had a LAP (laparoscopy) and hysteroscopy to clear mild endometriosis. My doctor suggested that I try Clomid again, but he's not concerned with blood test results even when I've heard that there could be progesterone, etc. issues. Why isn't he concerned?

DR. AMOS:
That's a very good question. I would be concerned about progesterone and whether you ovulated or not, but the very best person to answer that question is your doctor.