Trying to Conceive: 08/21/02: Amos Grunebaum, MD

By Amos Grunebaum
WebMD Live Events Transcript

The opinions expressed herein are the guest's 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.

Are you trying to conceive? Amos Grunebaum, MD, joins us every week to talk about conception issues, treatment options, and to answer questions from both fertile couples and couples dealing with infertility.

Dr. Amos: Hello everybody. Our moderator wants you to know that he is spreading baby dust all over this chat.

Moderator: I'm doing my best to send good baby vibes today! Let's get right to the questions.

Member: I wanted to know if an abortion 14 years ago could be a factor in our not conceiving yet after trying for over a year? I am 33 and healthy and have had excellent gynecologist reports all along. My husband was also tested and is "normal."

Dr. Amos: A safe, uncomplicated abortion does not have an impact on future fertility. If your husband's sperm count was normal then the next step is to check your ovulation and your fallopian tubes. If you don't ovulate regularly then you need to see if the fallopian tubes are open or not. Once these have been checked you should know better where the problem might be.

Member: Is it possible to ovulate without your temperature going up? I did have a dip in my temp and it went back up to 97.6 degrees, where I have been since I started taking my temp. And I did have cervical mucus (CM).

Dr. Amos: To better answer your question I would like to look at the chart. A typical ovulation chart shows a biphasic pattern. The temperature goes up within one to two days after ovulation (a dip is not needed) and the temperature stays up above coverline until AF (Aunt Flo = menstruation) comes. It's sometimes difficult to self-assess the curve. Preferably your doctor should look at the chart to see what's going on. If you do it right and there is ovulation, then some biphasic pattern should be seen.

Member: My temps have been at 97.6 since I started and went down to 97.3 then back up to 97.6.

Dr. Amos: A description of the temperatures doesn't say much to me, especially when I don't see the chart and I don't even know which CD you are on. I suggest you use one of the bbt (basal body temperature) charting sites on the web to keep a curve and let someone take a look at the end of the cycle.

Member: Related to this, do some people have temps above 98.1 degrees all of the time?

Dr. Amos: Single temperatures don't tell me anything. Some people have lower patterns, others higher patterns. It's the curve over the whole menstrual cycle that counts, not single increases or dips.

Member: I was on prednisone for three weeks and am still having my period every two weeks. Will that effect my ovulation?

Dr. Amos: Prednisone? Are you sure it's prednisone, or was it progesterone?

Member: I had an allergic reaction to some medications and was on prednisone for three weeks. That is what my ob told me could cause it -- the prednisone.

Dr. Amos: Prednisone should not have a major effect on ovulation and your menstrual period. If your periods come every two weeks or so then there may be a problem with ovulation or another problem. Doing a bbt chart helps you find out what's going on with ovulation. And if you don't ovulate then your doctor should find out why and treat it accordingly.

Member: My cycle ranges from 26-28 days. I have been trying to track ovulation by monitoring my CM. During what should be my 'peak days,' I have not had the EWCM (egg-white cervical mucus). I have had clear, sticky CM on day 18. Is it possible that I am ovulating that late in my cycle?

Dr. Amos: EWCM is seen a couple of days before ovulation and disappears a couple of days after ovulation. However, you can also see EWCM without ovulating. So in and by itself it is not the best and only way to diagnose ovulation. It's possible to ovulate "late" and have a short CL (corpus luteum) phase, the time between ovulation and the next AF. That's why doing a bbt chart will help you identify much better exactly which day you ovulate. The EWCM is too imprecise to exactly tell which day ovulation happened.

Member: Can you ovulate but not have EWCM? I have not had it any other day during my cycle.

Dr. Amos: You can ovulate without EWCM; you can have EWCM without ovulating.

Member: My husband is afraid to get a sperm analysis, but he knows he has a low sperm count. Is there any over the counter vitamin that we could get to help him? Also my doctor set me up for a hysterosalpingogram. What will that test tell me?

Dr. Amos: I wonder why you know his sperm count is low without him getting tested? An HSG is an injection of dye into the cervix to check under X-ray if the fallopian tubes are open or not. If his sperm count is low and that is the cause of your problems then doing the HSG wouldn't help much.

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