Conceive, Trying to (cont.)

MEMBER QUESTION:
I've been off the pill since March 5 of this year and still have not menstruated, but I'm not pregnant. I've been pregnant two times before, after the pill, and without a problem. Do you think this is still postpill amenorrhea or another problem?

DR. AMOS:
After four months you should have started to ovulate again. I usually suggest seeing your doctor after four to five months off the pill to find out why your period hasn't come. You also want to make sure that you are not pregnant.

"The best pregnancy tests are those that have a low sensitivity, usually around 20-25."

MEMBER QUESTION:
I'm 37 with three failed pregnancies (two unexplained ectopic). Should I skip IUI (intra-uterine insemination) and go for IVF (in vitro fertilization) if finances are not a factor?

DR. AMOS:
After two ectopic pregnancies there is a very high chance to have another ectopic. With IVF your chances improve significantly to not have an ectopic, so I agree that IVF sounds like the best solution.

MEMBER QUESTION:
What do you think about Preseed and other CM (cervical mucus) enhancing products?

DR. AMOS:
Preseed, as far as I know, is the only "approved" lubricant that's sperm-friendly. Most other lubricants are known to destroy sperms. I am not sure what you mean by "other CM- enhancing products."

MEMBER QUESTION:
My OB said that if I get pregnant before one to two cycles after a miscarriage, I may have spotting or light bleeding during the first trimester. Does this cause any harm or pose any risks?

DR. AMOS:
I am not sure I agree with that statement. As I mentioned before, there is no scientific evidence that getting pregnant early after a miscarriage increases your future pregnancy risks.

MEMBER QUESTION:
What is the best early pregnancy test to take and how soon can you take it?

DR. AMOS:
The best pregnancy tests are those that have a low sensitivity, usually around 20-25. That means they turn positive earlier on. Most pregnancy tests are not positive until the time when you expect your period, about 13-14 DPO. Good luck.

MEMBER QUESTION:
Can going on a low-carb diet and putting your body in ketosis affect fertility?

DR. AMOS:
There is not much research on this issue, but when you are TTC it's recommended to have the same healthy diet as if you were already pregnant. You can do damage by not keeping a healthy diet around the time of ovulation/implantation. It's also important to take a daily folic acid supplement with around 600 mcg folic acid a day.

MEMBER QUESTION:
I went off BCP (birth control pill) in January and have had fairly regular 28-day cycles ever since. I temped this month, so I believe I ovulated, but I get red spotting for about five to six days before my period fully arrives. Is this "normal," and could it prevent me from conceiving?

DR. AMOS:
Early spotting before ovulation is usually not a major fertility issue. To make sure you may want to confirm that your progesterone levels are OK around 7 dpo. Levels above 120 are usually considered good.

MEMBER QUESTION:
Is there any truth to lying in a certain position to conceive? My uterus is tilted downwards.

DR. AMOS:
The best position is usually considered the "missionary position" -- she on her back and he on top. This position allows the vagina to slightly tilt backwards and for sperms to flow towards the cervix and enter the uterus.

The woman should also try and stay on her back for about 10-15 minutes afterwards.

"There are many herbals available which can improve your chances of getting pregnant. The one that's been researched the most is called Vitex."

MEMBER QUESTION:
I recently starting suffering from irritable bowel syndrome (IBS) and also have lots of hypothyroid symptoms. I had my TSH (thyroid stimulating hormone) tested and it came back at 2.38. My doctor didn't seem concerned, but I have been trying to conceive for five months after a loss and am afraid I won't get pregnant if suffering from hypothyroidism, which runs in my family.



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