infertility questions

[ktgrok]

Not for me, but for my best friend. She has been trying to get pregnant for over 6 months now. Her charts look pretty good, but with a late ovulation/long cycle. They are doing what needs to be done at the right times according to the chart. What is the next step? She is 33 I think, and he is close to 40. He has some diabetes issues (that are being treated) and is taking hawthorne berry. She is taking Vitex, which seem to have evened her cycles a bit.

 

Who does a guy go to to have his sperm count checked anyway? Does she go through her OBGYN? I am clueless on how to help her or what to suggest.

[happyhomemaker25]

Way back before we adopted a housefull we went through a fertility clinic. They did all that stuff with my DH. The OBGYN should be able to recommend one.

[Caroline]

I ovulated late in my cycle. It turned out that I ovulated too late in my cycle to allow for implantation and hormone level changes before my period. I took clomid, and it moved my ovulation earlier in my cycle. I was 29-30 at the time and had already had one baby.

[jewellsmommy]

Not for me, but for my best friend. She has been trying to get pregnant for over 6 months now. Her charts look pretty good, but with a late ovulation/long cycle. They are doing what needs to be done at the right times according to the chart. What is the next step? She is 33 I think, and he is close to 40. He has some diabetes issues (that are being treated) and is taking hawthorne berry. She is taking Vitex, which seem to have evened her cycles a bit.

 

Who does a guy go to to have his sperm count checked anyway? Does she go through her OBGYN? I am clueless on how to help her or what to suggest.

 

He should go to a urologist and have things checked on his side. An obgyn can certainly direct him. There is much more than just overall numbers of the little swimmers though. There is the motility which is just as crucial. There can be billions of them but if they refuse to travel far...:glare:. Then there is overall health/condition of the individual swimmers. Are the majority fully formed and functional? -That sort of thing.

 

 

 

The good thing is if it is a problem with the above and she is a regular cycler, then I would schedule an IUI (intrauterine insemination) . Not very expensive. They prepare the hubbie's swimmers (they do a 'wash' and concentrate them) and insert them high up at the entrance to the fallopian tubes. This is great if the swimmers are lazy or just have no sense of direction :tongue_smilie:.

 

ETA: I took clomid. I have PCOS and endometriosis. Dh had a bountiful harvest ;) But they are lazy or just swim in circles or something :) So we had an IUI. The insurance would not cover it, but it cost us $100. That was 10 yrs ago. Worked the first time.

Edited July 4, 2012 by jewellsmommy

[SonshineLearner]

I'd purchase Babycomp if I had it to do over.... Because I didn't.... I used a million and a half ovulation sticks. I started the day after I had my period and continued..... Babycomp would have been a heck of a lot less crazy!!

[Forget-Me-Not]

When we had DH tested, I'm pretty sure my OB/GYN just wrote the order. He did have to go to a special lab to do it.

 

Does she have a short luteal phase? It's been a long time since I did all the charting/temping business, but I do remember reading about that being an issue with late ovulators.

[Canadianmumof5]

Sorry no info/advice on the male fertility stuff but if she is ovulating late and she knows that for sure - then it makes sense that she has a longer cycle.

 

At her age & with active efforts - my dr would tell me to wait another 6 months. I know that is an eternity when you are trying to get pregnant.

 

If she is 100% sure on her ovulation date - then she should be actively trying for 5 days pre-ovulation - that is when your body is getting ready and your LH starts to surge. Sometimes doing things a few days in advance of ovulation is more helpful.

 

Oh and try not to do anything for the 5-10 days pre-ovulation just to make sure that there are lots there when the time is right.

 

If she has the $$, try the Clearblue Fertility Monitor - you can go on-line and read about it to make sure it would make sense for her. We used it for 3 of our pregnancies - fortunately it worked fairly quickly.

 

I wish her all the best.

[wapiti]

Not for me, but for my best friend. She has been trying to get pregnant for over 6 months now. Her charts look pretty good, but with a late ovulation/long cycle. They are doing what needs to be done at the right times according to the chart. What is the next step? She is 33 I think, and he is close to 40. He has some diabetes issues (that are being treated) and is taking hawthorne berry. She is taking Vitex, which seem to have evened her cycles a bit.

 

Who does a guy go to to have his sperm count checked anyway? Does she go through her OBGYN? I am clueless on how to help her or what to suggest.

 

At 33 with over six months of charting to show the doc, I'd probably not waste a whole lot more time before seeing an RE - maybe another month or two (might as well set up the appointment, you know?). I would not see an OB/GYN for fertility issues. The RE will probably repeat the basic testing anyway. My recollection is that, for the dh, most REs will perform the initial semen analysis in their office and only refer out to a urologist if it shows problems.

 

Depending on how long we are talking about, the long cycle thing is highly suggestive of some sort of issue with ovulation. I would not, I repeat not, take a clomid prescription from the OB, as OBs tend to do woefully insufficient monitoring of clomid cycles, which wastes yet more time and a potential treatment (after too many cycles in a row, like more than 3, clomid tends to have a contraceptive affect, as it was orignially designed). The RE will probably want to do bloodwork on day 3 of the cycle. The RE will also rule out a bunch of different issues that can cause ovulation problems rather than simply assume PCOS (which is probably the most likely suspect, but far from the only one).

 

However, if your friend should unfortunately have issues with premature ovarian failure, time is indeed critical, as the necessary treatments ramp up very quickly into super high tech.

 

I agree with the recommendation for the Clearblue Fertility Monitor if they're going to wait more than a few months to see the doc.

Edited July 4, 2012 by wapiti

[ktgrok]

Thank you everyone!! She is waiting now to see if this month "took", but if it didn't I'm glad to have some information to pass her way. I feel almost guilty to be pregnant myself right now, and her SIL (whom she doesn't get along with well) just gave birth yesterday. But for now. I'm holding out hope. Should know in a few days.

[Matryoshka]

Very first thing I'd do is run out and buy a copy of Taking Charge of Your Fertility by Toni Weschler. That will tell her what's going on with her cycle and help identify what any problems may be (often better than the clinics).

 

At 33 with over six months of charting to show the doc, I'd probably not waste a whole lot more time before seeing an RE - maybe another month or two (might as well set up the appointment, you know?). I would not see an OB/GYN for fertility issues. The RE will probably repeat the basic testing anyway. My recollection is that, for the dh, most REs will perform the initial semen analysis in their office and only refer out to a urologist if it shows problems.

 

Depending on how long we are talking about, the long cycle thing is highly suggestive of some sort of issue with ovulation. I would not, I repeat not, take a clomid prescription from the OB, as OBs tend to do woefully insufficient monitoring of clomid cycles, which wastes yet more time and a potential treatment (after too many cycles in a row, like more than 3, clomid tends to have a contraceptive affect, as it was orignially designed). The RE will probably want to do bloodwork on day 3 of the cycle. The RE will also rule out a bunch of different issues that can cause ovulation problems rather than simply assume PCOS (which is probably the most likely suspect, but far from the only one).

 

:iagree: with all of this. First time I saw someone about my PCOS (regular OB/GYN) she just handed me clomid and told me to come back in 6 months if I wasn't pregnant. Good thing I read up on what correct monitoring should be (mulitple ultrasounds per cycle) - that was downright malpractice-worthy.

 

I switched doctors immediately and never went back to her. Turns out clomid didn't work for me at all - I would've totally wasted that 6 months (and you shouldn't take clomid lightly). After the clomid didn't work, the new dr. sent me right to an RE.

 

Still wish I had had Toni Weschler's book when I was going through that - it's just very helpful to know as much as possible about how your body's working before heading for the drugs and injections.

[Tohru]

Vitex sometimes does more harm than good.

 

This book is excellent, however it is heavily based on TCM (Traditional Chinese Medicine).

After 10 years of trying, I used TCM and conceived and gave birth to #2 and #3.

[Matryoshka]

Vitex sometimes does more harm than good.

 

But then it often does good. Another reason to pay close attention to what's going on with your own body - so you can tell whether something's helping or hurting.

[BakersDozen]

I would not see an OB/GYN for fertility issues.

:iagree: I wasted 2 years with an OB who didn't know his FSH from his LH. :glare:

 

Going to an RE was the best thing we ever did. In just one cycle he had me diagnosed and confirmed what I had suspected - that my body doesn't respond to normal amounts of hormones. One cycle!!

 

I would have the husband tested through the RE's office because their testing is often more accurate than through a standard lab.

 

Vitex sometimes does more harm than good.

:iagree:

 

Thankfully, diagnosing fertility issues can be done in one cycle for the most part if you go to someone who actually knows what they are doing/looking for, not someone whose idea of treatment is to write a script for Clomid and wish you luck.

[Momof3littles]

Just agreeing with PPs that I would move on to an RE soon in her case. I posted in the thread about recurrent m/c that I started off with an OB/GYN and he was not great at all with infertility. My personal opinion is that OB/GYNS can sometimes handle the most basic, basic, basic of fertility issues, but they are often in over their heads and don't know it. My diagnosis was almost missed because my ob/gyn thought he knew what he was doing, when he really was giving me subpar care. He ran tests, but not the full panel he should have to rule in/out PCOS. He looked at my "higher end of normal" results and deemed them "normal' even though I was symptomatic. When I pressed, he assured me they really were "normal" and I didn't have PCOS. But I did. He wanted to just give me clomid and send me on my way, and clomid wasn't working for me. In many ways I'm thankful it didn't, because had I gotten pg, I think I would have been more likely to m/c without a proper diagnosis (PCOS), and I may have missed knowing about all of the health implications of PCOS.

 

I had a strong hunch I was in fact dealing with PCOS and was diagnosed right away by an RE. He did a full hormone panel, and that showed markers that were missed because the Ob/GYN didn't know what he was doing. From reading infertility boards for years, that type of scenario is not uncommon. At all.

 

My husband had to have testing, and he did it at the RE's office. I'm sure a urologist could do it as well if they want to rule that in/out before proceeding to the RE.

Edited July 4, 2012 by Momof3littles

[eloquacious]

Fascinating thread. Been TTC for over a year. I'm 32 and pretty much everything you described (including late ovulation) applies. The "problem" (if you can forgive the use of the word) is my husband is perfectly happy with the two we have, so an RE or any sort of intervention is out. Working on "fixing" my cycle through diet, but we'll see. Perhaps two is our lucky number. :)

[momtoamiracle]

I was a late ovulator as well. I charted for several months and found I didn't ovulate sometimes until day 21.

 

 

I used Fertile Aid for a few months and that got my cycle more regular, a 28 day instead of 35 - 40. But I didn't get pg on it.

 

 

 

My OB had fertility issues herself and went to an RE so she did for me what her RE did for her and I didn't have the cost. I took Femara for three months, being monitored very closely. I can't tell you how many internal u/s I had to check my ovaries. The third month (I have only one tube so it takes longer) was successful and I had my son nine months later. It was the only pregnancy out of five to be successful.

 

Six months isn't that long really. It takes on average a year for a couple to conceive. yeah some people get pregnant right away, but often it's longer. A dr may not be concerned with only six months, unless you're 35 - 40 yrs old.

 

If she does go to an RE, she will need to expect a whole lot of blood tests and possibly an HSG. That's one of the first steps, to check tubal blockage.

 

 

ETA - if she takes Vitex she needs to take red clover or red raspberry with it. The progesterone needs to be countered with an estrogen.

[hollyh]

The aforementioned Taking Charge of Your Fertility book is a great suggestion. I learned so much from it! Google short luteal phase for ideas on how to fix that problem b/c that could definitely be the reason. - I remember I had that when TTC but don't remember why... I quickly googled just now and saw stuff about Vit B6 supplements...??

 

Get a referral for a RE if possible, too! :)

[BakersDozen]

I quickly googled just now and saw stuff about Vit B6 supplements...??

 

Taking B6/Complex moved my ovulation from cd21 to cd 14 and it stopped my preAF spotting (which had been up to one week long). Amazing.

[Sevilla]

I agree about moving to an RE. They can to the more extensive testing/treatment.

 

I would also HIGHLY recommend that she research all of the lifestyle/diet changes that promote (or inhibit) fertility. For someone whose fertility is strong, those diet things don't make much difference. But for someone of more marginal fertility even little changes in eating habits can push you from 'not conceiving' to 'conception'. If you google you will find information on what kind of dairy inhibits conception (nonfat dairy is baaaaaad), etc...

 

How is her weight? Is it a healthy weight? Is she insulin-resistant at all or have other health conditions (those can make healthy ovulation/conception more difficult until it's addressed)? The later ovulatin is a concern from a hormonal level. B vitamins and Zinc are important for healthy conception in a woman too. Is she a vegetarian/vegan or does she eat meat? Red meat is an excellent source of those things so vegetarians/vegans need to be extra intentional to get them regularly.

[Matryoshka]

ETA - if she takes Vitex she needs to take red clover or red raspberry with it. The progesterone needs to be countered with an estrogen.

 

Vitex is not progesterone, nor does it act as artificial progesterone. It helps regulate the hypothalamus in the brain, and can help balance either low or high levels of hormones.

 

I have to say that it took much less time to conceive the 2nd time with TCYOF (the book), Vitex and other herbs, and diet changes than it did for the whole medical route the first time. But I was way too scared to trust things like that when I was childless.

 

I'd definitely see an RE if I were her - it could be her dh, or something mechanical. But if it's just cycle tweaking that's needed, the other methods can be very effective, and she should look into that at the same time.

Edited July 4, 2012 by matroyshka

[ScoutTN]

Treatment through a RE can be very expensive (IVF runs about 20K, if it gets to that.) and it is not always good for your body or your soul. Western medicine has some major weaknesses in the infertility area. TTC is an emotional rollercoaster that involves the whole person (of two people!) and not just an organ or two not performing well.

 

If your friend is open to it, she might visit a Traditional Chinese Medicine practitioner and ask about IF issues. Acupuncture and Chinese herbs (which are prescribed by the practioner and not the same as over the counter items) can be very effective for IF. Diet can play an important role too. A reputable TCM practioner will have a good website and be happy to answer questions and will ask a zillion.

 

We have two wonderful kids because of TCM - after a long, expensive, damaging journey on the IF road of Western medicine.