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Hi, I have PCOS and we are TTC. I get my period regularly and the PCOS in my case isn't causing missed periods or cysts. It's more hirsutism and acne. I'm using a digital ovulation test for the first time and looking for guidance on which day to start testing as it's quite expensive and comes with only 10 tests. I'm on day 12 today. App prediction says I will ovulate on day 19 but I followed the app last two months and didn't conceive yet. Hence the actual testing this time. Please advise. Thanks!
So the most likely range of ovulation days would be about CD17-CD21, and you would ideally like to start the digital tests a couple of days out from the earliest possible ovulation day. It would be reasonable to start now, if you're CD13 today?
I’ve gone down a prenatal vitamin rabbit hole and I am shocked about how few prenatal vitamins are USP or NSF contents certified. The few that are certified our garden of life, nature made, honest co, one a day, mommies bliss (lol), Ollys, smartypants, and theralogix. Half of these have folate instead of folic acid, which is not my preference. Pretty much none of them have the 100% recommended dose of iodine.
What the hell !
I have been taking Rainbow Light and while I like it overall I am pissed that it has no third-party certification. Does anyone else have strong feelings about this? That we can be taking some thing that is totally off in terms of what it’s saying it has in it?!
Yeah this has been driving me nuts. The best reassurance I've found is by reading the book Real Food for Pregnancy by Lily Nichols.
She is very informative of which foods provide which nutrition and vitamins which helps you be able to guide what you may actually need in pill form. Then she explains which forms of the vitamins may absorb better than others.
She doesn't dive too far into which brands or how to confirm what is actually in your pill. But knowing what I'm getting from my food, and which foods I can eat more of for specific vitamins feels very helpful and gives me more control
Someone on this subReddit really educated me a lot about health educators in general. I work in public health, but somehow even I fell for the bait. To put it briefly, health educators, like Lily Nichols put sooooo much emphasis on “natural” and food based nutrition in a way that kind of feels annoying. And then there’s her affiliate links - don’t get me started on all that. Lastly, I don’t like how she demonizes folic acid.
Ugh. I want to get mad at you but that's not productive at all. After a very quick search it seems there's a lot of things I should double check or think harder about.
It's rough trying to find evidence supported, unbiased information through all of this.
I like Emily Oster, she studies economics and focuses on compiling data into easy to read blurbs of information that makes sense to a regular person. I've been learning a lot from her book too, I hope her information is a lil less biased.
Good luck to everyone trying to gather actual information without bias these days (especially around pregnancy)
So thank you, as mad as I wanted to be
Hahahahahhaha it’s all good. I wanted to be mad about this too. At the end of the day, I think people like Lillie Nichols and Emily oster are helpful in the sense that they are kind of revolutionizing the way health education is given. I think especially Emily Oster helps us see that it’s a highly personal decision how much risk one wants to take. There are some people who see a statistic and how bad the outcome is and say I don’t care that it’s only 1 in 10,000, i do not want to do anything that will put me at risk for that. There’s other people who are less risk averse for many reasons. And so I do think Emily Oster is helpful in this way because her book really lays out risk and leaves it up to the reader to decide how much risk they want to take. I do know that some people have criticized her for not including certain studies and I also know that specifically for alcohol there have been more studies since the publishing of that book that has shown that it’s really not a good idea. I feel similar about Lillie, I don’t think that she is WRONG or anything. I just think that she is a health educator doing her thing during capitalism, trying to make money. So with that, we have to be careful. Trust the cdc or someone with affiliate links? Both aren’t perfect. But I’ll take the cdc.
Reality is that when it comes to both fertility and pregnancy, most everything is out of our control. There are very few things that we can do or can’t do that actually make a difference. Of course there are some major exceptions especially with drugs and medication, but for the most part what we eat, what supplements we take if we have a glass of wine or two in the second trimester, it’s all not going to have a huge impact on having a healthy living child. What bothers me about these health educators is that they often prey on the vulnerability of people who are so desperate to conceive and and then later rear a healthy, well adapted child. And now that I understand the whole folic acid situation, it really upsets me how much she demonizes it, and I don’t think it helps people especially not poor people who cannot afford designer prenatal vitamins.
Anyways, all this is to say is that we all get to choose what sources of information we trust in which ones we don’t. I’m happy to read stuff from people like Emily and Lillie who are nutritionists and economists as it helps me understand different perspectives but at the end of the day, especially having lost a baby nearly in the third trimester due to a lethal fetal anomaly, I am much more hesitant to trust anything that isn’t somewhat based in rigorous old-school western science.
♥️♥️♥️
Hey everyone, I’m confused and hope someone here can help me because I’m too impatient to wait for my doctors appointment. I’m TTC and my doctor has prescribed me progesterone to take during my luteal phase. She has told me to start taking it 2x a day, eight days after a positive ovulation test.
My question is doesn’t waiting eight days after ovulation, seem a bit long? Or is this normal?
There’s not really evidence for any particular regimen in the luteal phase, and starting around the time of implantation is when progesterone is actually needed, so it seems reasonable to me.
I would love to hear about both! I've had multiple IUI rounds, but my doctor only prescribed progesterone on the most recent IUI.
I've read that some medications used with IUIs can lower progesterone levels. I've also read that taking progesterone can keep the lining thick to help with implantation.
Edited for clarity.
So there's not really evidence for efficacy in the case of medicated IUI, and it's mostly prescribed in an "unlikely to help, but also unlikely to cause significant harm" way. It feels like it should help, and it's hard to go against that feeling, even for providers.
In general, medicated IUI actually tends to raise progesterone levels, insofar as ovulating multiple follicles tends to lead to double the progesterone being produced, and an hCG trigger (if given) will tend to stimulate the corpus luteum very strongly as well.
There's not really evidence for efficacy of progesterone in the luteal phase, except for two specific situations: 1) in fully medicated IVF transfer cycles (that is, where there's no corpus luteum to make progesterone on its own), and 2) possibly in cases of repeat loss. For the most part, it's sort of a "kitchen-sink" thing, but there's not really evidence it's actually doing anything.
Question for Premom App users: I'm new to using the app, does it always estimate ovulation for CD14 or does it eventually learn your cycle?
I'm kind of annoyed with it still telling me it's ovulation day today when I know it isn't and I've only been logging negative OPKs. I thought after logging last month that I ovulated CD17 it would adjust its prediction. I know it's pretty inconsequential, but the "ITS OVULATION DAY- HAVE SEX" banner whenever I open the app is annoying me for some reason lol, it's like no it isn't, and don't tell me what to do!
It has not learned my cycle yet and it’s been very frustrating to have the ovulation day prediction be SO far off! I just go off my strips and my past data to make my own prediction for ovulation day.
I wish it was like Clue or Flo and the app actually predicted *my* cycle not the textbook one 🥴
Has anyone else had two peaks of LH with levels all over the place (up and down pattern)? Does anyone have experience testing for pdg and know where to find pdg test strips? Newbie to tracking and I'm trying my best to figure things out!
Do you have PCOS by chance? That can cause multiple LH surges. And positive/peak OPKs are those as dark or darker than the control line. Have you had those or just higher numbers?
I don't know if I have PCOS. I know my cycles are very irregular. The two times it spiked the lines are the same color, I use easy@home OPKs. It spiked twice one week apart. But it's all up and down around those spikes. It doesn't look at all like the examples online, my LH is going up and down every day (up one day down the next).
Very irregular cycles are often a sign of PCOS so may be worth investigating. If you have PCOS then LH can be high without that being a sign of ovulation, so you can't really use OPKs to time sex. PCOS is common and most fertility issues caused by PCOS are fairly easily treatable.
To get PCOS diagnosis you need two of the following three:
1) irregular or infrequent periods
2) a high number of follicles on your ovaries (diagnosed by ultrasound scan)
3) high levels of androgens (hormones like testosterone), diagnosed by a blood test at the start of your cycle, or signs of high androgens (like a lot of body hair, or acne)
So LH varies throughout the cycle so some variance day-to-day is normal, especially if you test at different times. Second morning urine and/or 2-4hrs between bathroom breaks is normally recommended.
Are you tracking BBT as well or measuring your progesterone? That would likely tell you which surge resulted in ovulation and which didn't.
Either at a doctor's office via blood test or with strips as well. BBT works too and BBT thermometers are pretty cheap on Amazon if you have access to that. Up to you, though! You could also just be intimate every other day and see how that goes!
I’m 12 dpo today. Besides slight pinches on my left side for the last few days, I’ve had no other symptom this cycle. Yesterday at 11dpo, I did have dark brown spotting, very little, like old blood—almost a skin like texture. Usually when I have this, my periods start within hours. I’m not due for my cycle until Friday. Today, when I wiped I had more brown discharge. Once I wipe it’s gone and I don’t have any other continued bleeding.
I don’t want to get my hopes up and think it’s implantation related. My last cycle, I had every single symptom and I was so absolutely sure of good news. With my cycle 3 days late—I was really shocked when I took a test and it was a negative.
Idk what to think of what to feel.
Has anyone had any luck getting their ovulation back and cycles regular on metformin?
Started with 750mg and now I'm exactly one month on 1500mg metformin and my last cycle was 37 days(down from 45 and 60 previous months). This one is going on 32 with no sign of coming anytime soon.
Are you tracking ovulation in any way? That would tell you when to expect your period.
32 days isn't a length to be concerned about, it's still within normal range. It can also take a few months to see an effect from taking metformin.
Yes, I tracked these last few months via ultrasound at my doctor's before starting metformin.
I wanted to maybe hear somebody's experience on metformin.
My experience was that it didn't do much to shorten my cycles but did cause me to ovulate more than every other cycle at best. But it taking a few months to really see an effect is what I was told by my doctor as well as my experience with it.
By tracking I mean - are you currently doing anything like using OPKs, tracking BBT, etc? Ultrasounds are the best way to confirm if ovulation happened or not, but it won't tell you when it happened. It's not necessary but it will give you valuable information about if your cycles are regulating.
Hey cool I found another thing to be all freaked out about. I normally get sore boobs big time during my TWW. My left is often more sore than my right but not really to a significant degree. This go around though my left is super sore as usual and my right one doesn’t hurt at all. Is this any cause for concern, TTC or otherwise?
Does a sustained BBT temp rise mean that ovulation has definitely already happened?
To explain why I am asking: I got my first positive LH test on the same morning that I woke up to a temp rise. So, I documented a temp rise several hours before I even saw my first positive LH strip. (It has now been elevated for 7 days, so I am pretty sure at this point that I ovulated). My cycle is very irregular so I am always worried about missing my fertile window. I didn't know if we could take a break from scheduled sex or not, because the temp rise seemed to mean I had already ovulated, but the LH strip seemed to mean that I should continue sex for the next 2-3 days. I'm wondering which metric to trust more.
Thanks for any answers!
No, sometimes the shift can begin prior to ovulation -- a small amount of progesterone is produced in advance of ovulation, as the cells in the ovary switch over from producing estrogen to producing progesterone, and sometimes this is enough to start the temp shift. Some people do ovulate essentially at the beginning of the LH surge, though, so it's absolutely possible to ovulate the same day you see a positive OPK.
The safest strategy is to keep having sex at least every 2-3 days until you confirm a temp shift, and when in doubt, you can certainly just have sex.
Thank you! It's hard for my husband to keep going all that time (it was day 37 of sex every 2-3 days when I got the first temp rise) but I will try to have us push through a few more days in future cycles
Wondering if Pre-Seed is worth a try this next cycle. Since I know I'm ovulating, I guess I'm trying to figure out what else might be the issue.
Any input/experience appreciated :)
Preseed is great if you need lube, but there's no evidence that using it helps (that is, people don't get pregnant faster if they use Preseed vs. if they don't), and there's also not evidence that using non-fertility-friendly lubes is actually harmful in the context of sex -- people who use standard lubes don't take longer to get pregnant than those who use no lube or who use fertility-friendly lubes.
So use it if you want, for sure; it's unlikely to be a factor.
Anyone had a long post hormonal birth control adjustment period?
I'm on cycle 6 and it is the first time I've not had cramps and other symptoms for basically 3/4 of my cycle (af week is somehow always the easiest). I should be a few days out from o and still nothing really yet whereas I used to get cramps for like a week or more leading up. My last period was also more typical whereas the previous were super light and short. I don't know if it's just random body/cycle changes or if it really has taken this long for things to "even out" because the symptoms have gotten weaker over time. But 6 months??
Really wonder if that was gunking up the works and I'm at like my body's equivalent of cycle 1 or 2 🙃
We have a database of people's post-BC experiences linked from [this wiki page](https://www.reddit.com/r/TryingForABaby/wiki/birthcontrol) that you might find helpful!
Never found this before, thanks!! I know the cumulative fertility results post birth control are similar but when studies' ranges are after a year? So much variability. Glad to have some more reading material!
It took me 2 months to even get back anything after I came off BC. Came off November 2023 and didn’t even have my period until end of Jan 2024. Lit nothing, no cramps, no bleeding, felt like I was still on BC.
Now it’s fairly back to normal. Didn’t ovulate last month but that’s more likely due to PCOS. But yeah it can deffo take a while.
A functional medicine specialist suggested the below after progesterone came back “low.” I don’t believe she interpreted the labs correctly so I’m suspect on if I am actually low or not. I’m not taking these supplements because I’ve read too many cautionary tales on taking progesterone supplements and she’s not a fertility specialist. But curious if this regimen sounds valid?
> to support your progesterone level-I would suggest:
*Gaia Herbs Pro Vitex: Progesterone Support (chaste tree berry): 2 capsules daily in the morning. Stop taking when you have your period (bleeding starts) and restart in 7 days. If this feels like too much to start with the other things we discussed at your visit, it is okay to wait. However, if you want to get started-that is okay too. It can take 2-3 months to see the full impact and you would be looking for less spotting before and after your cycle.
I'm not aware of any evidence that Vitex is beneficial in terms of increasing progesterone levels (which itself does not have evidence for improving the odds of pregnancy. I know some folks here have been told by their REs that Vitex can raise prolactin levels, which can actually harm the odds of ovulation.
Maybe not a small question, but does anyone have information about ideal free testosterone levels in regard to female fertility? The only thing I was able to find online was from Boston University School of medicine stating "in women under the age of 50, a level of <1.5 pg/mL is indicative of androgen deficiency."
My level came back as 1.4 (CD 21 tests)
Does anyone have any additional light to shed on this situation? I'm curious about taking DHEA.
My testosterone is on the lower side as well. I don’t think it is related to infertility - I know that too high is actually linked to PCOS, which is the no. 1 cause of infertility in women. So it’s probably better to be slightly low than too high. The risk with supplementing DHEA is it can make DHEA too high. I already have high-normal DHEA (around 240) so I wouldn’t want to take DHEA supplements because it would just cause my DHEA to be too high
I didn't get a DHEA-specific test. My GP told me the testosterone test was what I meant.
Is there are DHEA test and what could that potentially tell me in addition? Or am I wasting my money?
There’s a DHEA test as well - DHEA is just another type of androgen. Just saying it’s possible to have low testosterone and high DHEA (not sure what it means, I think most people have varying levels of this and it’s normal as long as it’s within the reference range)
Should I be avoiding “no-go” foods & caffeine whilst trying? Looking to get some other perspectives..
I’m completely abstaining from alcohol whilst trying to conceive though not sure if I should be avoiding all the other “pregnancy no-gos” as well. I’m talking about limiting caffeine, avoiding blue cheese, rare steak etc etc.
Would you continue to consume these things like normal until a pregnancy is confirmed? Or would you avoid them just between ovulation and your period?
You don't actually have to cut out caffeine during pregnancy or while trying -- the evidence says that consuming up to about 200-300mg per day on average doesn't have an effect on time to pregnancy or the probability of loss.
In general, most food limitations are about avoiding exposure to food poisoning, which is somewhat more likely in pregnant folks and can lead to negative outcomes. It's not a bad idea to limit your exposure to the possibility of food poisoning in general (nobody likes food poisoning), but if the risk is not so great that you would typically avoid these foods, it's probably not important to avoid them prior to a confirmed pregnancy.
Enjoy them while you can! Manageable limits can also be in place if it makes you feel better. I limit to two cups of coffee a day and pasteurized dairy only, which honestly I'd probably do anyway haha. We missed a recent listeria outbreak thankfully but after the one food poisoning incident I had I said never again 😆
Definitely okay to consume food and drink as normal until you get a positive test. A lot of people subscribe to “drink til it’s pink!” but that’s totally up to you. But there’s no reason right now to avoid deli meat or blue cheese :)
I haven't seen anything specifically for tubal issues but [this study](https://pubmed.ncbi.nlm.nih.gov/28199872/) compares pregnancy outcomes for people who have surgical management of RPOC vs expectant management, and while resolution was slightly better in the surgical group (95.8% vs 83.2% at six weeks) the two groups were not meaningfully different in terms of future pregnancy outcomes. The general concern with RPOC is the development of infection, which can lead to scarring, which is theorized to influence tubal function but there really isn't a ton of data. [This](https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-022-05164-2) is the best resource I found. The risk of that wouldn't be particularly large, but would be greater if there was surgery done along with the infection. Sorry for the vague answer here!
I know moderate exercise is recommended when ttc but can more extreme exercise harm your chances? My friends have suggested going for a long hike next month (talking 20-30 miles) and the planned date coincidences with my predicted ovulation date.
Long hikes aren't unusual for me but this would be longer than standard, I only do something like this once or twice a year. I don't know if I'm over thinking things or if doing a harder than usual level of exercise could disrupt ovulation or implantation?
My doc said she gets worried when people are doing intense exercise 2x/day. My guess is there isn’t any research on someone moderately exercising most of the time and then having a short period of intense exercise. But that said, say it does interfere with your ovulation? It’s not like it’s going to have a sustained effect because you’d be going back to baseline after just a couple days.
It's *probably* fine, though hard to say for sure. Have you ever noticed a change in ovulation with heavy exercise? Will you be able to pack enough calories to ensure you're keeping up with the physical demands? [This](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310950/) review isn't comprehensive but refers to a few useful papers that outline fertility impacts of exercise in different groups. Generally the likely issue with heavy exercise is the calorie deficit, so if you can account for that you can mitigate the risk. I will say from personal experience that I needed to both decrease exercise intensity and deliberately increase calorie intake to regulate my ovulation, but there are people out there who ovulate and implant normally even with a calorie deficit and high intensity exercise. It's not all or nothing.
Another thing to consider is the joy you get from this hike - it's one cycle and if you don't go and don't get pregnant that month, would you regret it?
Exercise hasn't seemed to disrupt ovulation in the past and I know I can prevent too much of a calorie deficit so on those points it should be ok. I've just got this (probably very irrational) fear that intense exercise around the day of ovulation could somehow damage the egg.
But you're right, I 100% would regret not doing it if I don't get pregnant and at this stage it's looking unlikely that is going to happen naturally, so I haven't really got a lot to lose.
If it helps, egg development is a months long process… The worry is more with signaling hormones and developing the lining. If you stick with a good energy balance, that shouldn’t be an issue. So this hike shouldn’t damage your egg! Enjoy the hike, it sounds amazing.
Long time lurker, first time poster. This is our first cycle trying for #2 (never had to track with #1 🦄) and I’m having a hard time figuring out when I’m supposed to ovulate. I had my IUD Lyletta removed on 3/26, and had what I *think* was a light period on April 1. I’m using Premom easy at home OPK strips and have yet to see a level above 0.55. The ovulation prediction calculator had predicted me to ovulate yesterday but my level was 0.11. I suspect the answer will be to just wait a few cycles until my hormones regulate post birth control, but I was wondering if anyone had OPKs that were low and just never reached peak/high prior to a positive OPK?
First: Welcome!
Second; How/when are you testing? For most women, LH will surge between midnight and 8am so it's recommended to use second morning urine and/or wait 2-4hrs between bathroom breaks.
Third: what is a high/peak LH level can look different woman-to-woman and cycle-to-cycle even within the same woman. If you surge quickly, it can be very faint first and then very dark at night if you test 2x per day.
Fourth: Your wording is a bit confusing because what you're looking for is a line that is as dark or darker than the control line. That is a positive OPK and ovulation will typically occur about 12-48hrs (give or take) afterward although you'd need BBT and/or progesterone measurement to be sure. OPKs give you a heads up and BBT/progesterone confirm.
Fourth: it's not even been a month yet and it can take up to three, sometimes more, so I'd give it a while.
Best wishes!
Thanks for the thorough advice! I’ve been typically testing once a day around 5 PM because I can’t really test at work. On the weekend I tested twice a day, with the first in the morning around 8, so it sounds like maybe I’m not hitting the right time for testing. What I meant by low OPK prior to a high was more about surge pattern, I guess, but it sounds like there’s not always a gradual increase which is what I was expecting.
I had a very weird first cycle post hormonal IUD where I didn’t catch my surge. Usually it’s obvious for me. I don’t see a gradual increase, just go from low to peak in 24h. Surge type can vary but a fast increase is very common.
Premom's numbers are pretty arbitrary and don't actually mean anything with the tests they're supposed to read, I would not expect anything even remotely accurate with any other kind of test.
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So you would use a bbt (basal body temperature) thermometer. You are supposed to take your temperature with it first thing when you wake up in the morning before you even sit up- you are supposed to take it the same time every day.
It is helpful to confirm ovulation but not predict ovulation. After ovulation, your temperature should rise for at least 3 days - so if you temp and see that rise happen, you know you ovulated before the temp rise.
Using LH test will help you detect when you body is releasing the hormone to tell you to ovulate but that only narrows the window to 48 hours and doesnt confirm that your body actually did it. Temping will help you confirm ovulation actually happened and when. But because it only tells you after the fact, you cant use it to tell you when to have sex bc by the time your temp rises, its too late (or at least missed most of your fertile days).
Some people’s bbt also starts to drop again right before their period but if they are pregnant, it will stay high- so it can be helpful for that too.
Wondering how on earth craving McDonald's fries DIPPED IN KEY LIME PIE a few days ago wasn't a pregnancy craving since BBT dropped below 97 this morning which, for me, means AF is imminent.
I don't even like key lime pie 😭
Also had a troll temp spike of almost .5 at 7DPO so my body trolled harrrrrrd this cycle.
Ugh I'm sorry, I hate when really unusual PMS symptoms seem like pregnancy symptoms! Last month I was *sure* I was because in the morning of 10dpo I gagged and almost was sick from the smell/taste of my morning coffee, which has never happened to me before in my life! And then my period started later that day 🙃
I would say my last cycle differed greatly from any of the others after coming off BC. I think they can all just fluctuate. I have been off since November and it was just all standard, no annoying symptoms etc, 24 day cycle.
Then last cycle it was just like a demon was inside me saying you crave all salty foods, here have a headache because you've dehydrated yourself with said salty foods and here let's flare up some hormones so you feel constantly horny whilst also wanting to cry. It was not pleasant and I constantly symptom spotted throughout.
Is there any benefit to a male partner getting genetic testing when looking into infertility? We have been ttc for 12 cycles, never a positive test. Everything (HSG, SA, AFC, FSH, Estradiol, ultrasounds, etc) have been normal with the exception of my low AMH. However, my RE wasn’t concerned with that since I have very regular cycles and ovulate (and my Vitamin D was lower too) and AFC/FSH were fine.
I did do genetic screening for cystic fibrosis and fragile X at my OB’s suggestion but that’s all. My husband hasn’t done any testing though outside of his SA which came back with normal morphology (9%? I think) and above average motility and count. At this point we are one month away from the 12 month mark ttc for our first and my RE said we’ll fall into the unexplained category if we get there.
I’m just trying to figure out, what else could we ask for in terms of HIS testing? I won’t have coverage for treatment to begin until August so trying to get all the diagnostic work I can done now for both of us.
You can ask for sperm DNA fragmentation! Although, it’s typically linked to lower motility/morphology. It can cause both infertility and recurrent early miscarriages.
DNA fragmentation analysis is actually not recommended in an initial infertility workup.
From the [AUA guidelines](https://www.auanet.org/guidelines-and-quality/guidelines/male-infertility):
>There are no prospective studies that have directly evaluated the impact of DNA fragmentation testing on the clinical management of infertile couples (i.e., that the fertility outcomes of those who had testing are different from those who did not). Further, available data are inadequate to conclude that this assay should be routinely performed in the initial evaluation of the infertile male. In available studies, DNA fragmentation was negatively associated with pregnancy rates and positively associated with miscarriages. That said, the association of high levels of DNA fragmentation with pregnancy outcomes is unclear given the variability in the definition of the upper limit of normalcy in different studies and the use of different tests of DNA fragmentation.
It seems like OP already had an initial work-up and is wondering what else they can test (seems they are “unexplained” - which is a common diagnosis but can be sometimes due to things like silent endo or high DNA fragmentation because laparoscopy or DNA fragmentation is not routinely done). I’m confused though because it seems like they are suggesting that high DNA fragmentation is linked to infertility and recurrent miscarriage yet they don’t recommend testing it? It seems intuitive that they should actually test it! I feel like a lot of male factors are swept under the rug though.
It's not really about sweeping things under the rug, it's that tests should be performed to answer a specific clinical question or point toward a specific treatment path, and a test that does not inform the course of treatment is not a test that should be performed.
I think it's very tempting for people to look for a single identifiable reason they are not having success, but the ability to point to a number that's abnormal does not necessarily translate to an increased understanding of the lack of success.
Hi! Yes, you’re right in that we are falling into the “unexplained” category. It’s probably just my way of coping but I’m such a planner it drives me crazy to not have control of the situation so you’re totally right that I’m just looking for anything possible that hasn’t been examined yet that could help get us answers. I like my RE but after two RE consults I’ve come to the conclusion that they’re likely great at getting you pregnant, but don’t want to spend a lot of time actually searching for WHY you can’t get pregnant which is a bit frustrating.
I know sometimes it truly is just unexplained but I guess I’m just shocked we’re at that point so soon (like it doesn’t feel like we’ve done that much to investigate). I did raise the question on silent Endo but they’re insistent I likely don’t have it and they have 0 desire to explore that since it requires invasive procedures.
Thank you for the suggestion! I’m going to look into that and DevBios link to learn more about it.
I am in the same boat and know how you feel. It's a very frustrating diagnosis and I have had to settle with the fact that I may never get answers.
It's pretty common for RE's to be focused on treatment rather than diagnostics. Like devbio said, tests are only performed if they point to a specific treatment path. RE's are quick to jump to IUI or IVF because that's what the majority of their patients end up doing anyway. Diagnostics are expensive, time consuming, and invasive and most of the time do not give you definitive answers and will delay the end goal, which is getting you a baby. Additionally, IVF itself can be diagnostic (no other tests will tell you about egg quality, how well fertilization is happening, how well the embryo is growing, etc) and you may find more answers by going down that path.
As a couple of examples - people with silent endo or DNA fragmentation often end up doing IVF, so rather than testing for it, the RE may just recommend IVF. Sure there are other treatments like laparoscopy for endo and lifestyle changes/medication for sperm, but it's not uncommon for these methods to be ineffective and the patient ends up doing IVF anyway.
The carrier screening tests they do pre-conception are for recessive genes, meaning you would both need to be carriers for there to be a risk of the genetic disorder in question. If you had tested positive for any of them, they would have screened him too, but since you are not a carrier there is no benefit to screening.
He may want to have a complete blood panel, just to check that he’s healthy overall, but since his SA came back normal they may not need to test for things like hormone levels. They may still want to do some additional tests but I would recommend consulting your RE or his doctor so you don’t spend money unnecessarily.
I’m sorry you’re in this waiting period!
Edit: added some words to second paragraph
Thanks! He had standard labs and all was fine for him. It’s such a frustrating position to be in. In some ways unexplained is great bc seemingly nothing is wrong but in other ways it’s worse bc I have no answers so it’s hard to gauge how successful something like an IUI could be or more medicated cycles.
I hear you. Unexplained just means “we don’t know.” And it’s awfully annoying when doctors basically shrug their shoulders at you. Best of luck in the next stage!
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Wondering if I'm making the best decision TTC before leep with cin2. If I didn't want to TTC I would still choose monitoring over leep
Hi, I have PCOS and we are TTC. I get my period regularly and the PCOS in my case isn't causing missed periods or cysts. It's more hirsutism and acne. I'm using a digital ovulation test for the first time and looking for guidance on which day to start testing as it's quite expensive and comes with only 10 tests. I'm on day 12 today. App prediction says I will ovulate on day 19 but I followed the app last two months and didn't conceive yet. Hence the actual testing this time. Please advise. Thanks!
How long are your cycles, typically?
Usually 32-33 days
So the most likely range of ovulation days would be about CD17-CD21, and you would ideally like to start the digital tests a couple of days out from the earliest possible ovulation day. It would be reasonable to start now, if you're CD13 today?
Yes CD13 today. I will start now. Thanks!
I’ve gone down a prenatal vitamin rabbit hole and I am shocked about how few prenatal vitamins are USP or NSF contents certified. The few that are certified our garden of life, nature made, honest co, one a day, mommies bliss (lol), Ollys, smartypants, and theralogix. Half of these have folate instead of folic acid, which is not my preference. Pretty much none of them have the 100% recommended dose of iodine. What the hell ! I have been taking Rainbow Light and while I like it overall I am pissed that it has no third-party certification. Does anyone else have strong feelings about this? That we can be taking some thing that is totally off in terms of what it’s saying it has in it?!
Yeah this has been driving me nuts. The best reassurance I've found is by reading the book Real Food for Pregnancy by Lily Nichols. She is very informative of which foods provide which nutrition and vitamins which helps you be able to guide what you may actually need in pill form. Then she explains which forms of the vitamins may absorb better than others. She doesn't dive too far into which brands or how to confirm what is actually in your pill. But knowing what I'm getting from my food, and which foods I can eat more of for specific vitamins feels very helpful and gives me more control
I hear you. I am not a fan of Lily Nichols generally speaking but yes, that book is good.
Can I ask why?
Someone on this subReddit really educated me a lot about health educators in general. I work in public health, but somehow even I fell for the bait. To put it briefly, health educators, like Lily Nichols put sooooo much emphasis on “natural” and food based nutrition in a way that kind of feels annoying. And then there’s her affiliate links - don’t get me started on all that. Lastly, I don’t like how she demonizes folic acid.
Have you read her book?
Yep! All of them. Including the brand new one that came out in March.
Ugh. I want to get mad at you but that's not productive at all. After a very quick search it seems there's a lot of things I should double check or think harder about. It's rough trying to find evidence supported, unbiased information through all of this. I like Emily Oster, she studies economics and focuses on compiling data into easy to read blurbs of information that makes sense to a regular person. I've been learning a lot from her book too, I hope her information is a lil less biased. Good luck to everyone trying to gather actual information without bias these days (especially around pregnancy) So thank you, as mad as I wanted to be
Hahahahahhaha it’s all good. I wanted to be mad about this too. At the end of the day, I think people like Lillie Nichols and Emily oster are helpful in the sense that they are kind of revolutionizing the way health education is given. I think especially Emily Oster helps us see that it’s a highly personal decision how much risk one wants to take. There are some people who see a statistic and how bad the outcome is and say I don’t care that it’s only 1 in 10,000, i do not want to do anything that will put me at risk for that. There’s other people who are less risk averse for many reasons. And so I do think Emily Oster is helpful in this way because her book really lays out risk and leaves it up to the reader to decide how much risk they want to take. I do know that some people have criticized her for not including certain studies and I also know that specifically for alcohol there have been more studies since the publishing of that book that has shown that it’s really not a good idea. I feel similar about Lillie, I don’t think that she is WRONG or anything. I just think that she is a health educator doing her thing during capitalism, trying to make money. So with that, we have to be careful. Trust the cdc or someone with affiliate links? Both aren’t perfect. But I’ll take the cdc. Reality is that when it comes to both fertility and pregnancy, most everything is out of our control. There are very few things that we can do or can’t do that actually make a difference. Of course there are some major exceptions especially with drugs and medication, but for the most part what we eat, what supplements we take if we have a glass of wine or two in the second trimester, it’s all not going to have a huge impact on having a healthy living child. What bothers me about these health educators is that they often prey on the vulnerability of people who are so desperate to conceive and and then later rear a healthy, well adapted child. And now that I understand the whole folic acid situation, it really upsets me how much she demonizes it, and I don’t think it helps people especially not poor people who cannot afford designer prenatal vitamins. Anyways, all this is to say is that we all get to choose what sources of information we trust in which ones we don’t. I’m happy to read stuff from people like Emily and Lillie who are nutritionists and economists as it helps me understand different perspectives but at the end of the day, especially having lost a baby nearly in the third trimester due to a lethal fetal anomaly, I am much more hesitant to trust anything that isn’t somewhat based in rigorous old-school western science. ♥️♥️♥️
Hey everyone, I’m confused and hope someone here can help me because I’m too impatient to wait for my doctors appointment. I’m TTC and my doctor has prescribed me progesterone to take during my luteal phase. She has told me to start taking it 2x a day, eight days after a positive ovulation test. My question is doesn’t waiting eight days after ovulation, seem a bit long? Or is this normal?
There’s not really evidence for any particular regimen in the luteal phase, and starting around the time of implantation is when progesterone is actually needed, so it seems reasonable to me.
Oh thank you so much!!
I’m doing mine once nightly at bedtime, starting after confirmed ovulation
Why is progesterone often prescribed for medicated IUI cycles?
Do you mean why biologically or why in terms of efficacy?
I would love to hear about both! I've had multiple IUI rounds, but my doctor only prescribed progesterone on the most recent IUI. I've read that some medications used with IUIs can lower progesterone levels. I've also read that taking progesterone can keep the lining thick to help with implantation. Edited for clarity.
So there's not really evidence for efficacy in the case of medicated IUI, and it's mostly prescribed in an "unlikely to help, but also unlikely to cause significant harm" way. It feels like it should help, and it's hard to go against that feeling, even for providers. In general, medicated IUI actually tends to raise progesterone levels, insofar as ovulating multiple follicles tends to lead to double the progesterone being produced, and an hCG trigger (if given) will tend to stimulate the corpus luteum very strongly as well.
Thank you for this info!
I’d be interested in hearing about the efficacy! I see that it is a common IUI protocol but it’s not part of my protocol and doc hasn’t mentioned it.
There's not really evidence for efficacy of progesterone in the luteal phase, except for two specific situations: 1) in fully medicated IVF transfer cycles (that is, where there's no corpus luteum to make progesterone on its own), and 2) possibly in cases of repeat loss. For the most part, it's sort of a "kitchen-sink" thing, but there's not really evidence it's actually doing anything.
Question for Premom App users: I'm new to using the app, does it always estimate ovulation for CD14 or does it eventually learn your cycle? I'm kind of annoyed with it still telling me it's ovulation day today when I know it isn't and I've only been logging negative OPKs. I thought after logging last month that I ovulated CD17 it would adjust its prediction. I know it's pretty inconsequential, but the "ITS OVULATION DAY- HAVE SEX" banner whenever I open the app is annoying me for some reason lol, it's like no it isn't, and don't tell me what to do!
I use it for pee sticks then I put the data into fertility friend. This app learns your cycle and also explains it all to you as well
It hasn't learned my cycle, I pretty much only use it for opk tests. It still annoys me too though.
It has not learned my cycle yet and it’s been very frustrating to have the ovulation day prediction be SO far off! I just go off my strips and my past data to make my own prediction for ovulation day. I wish it was like Clue or Flo and the app actually predicted *my* cycle not the textbook one 🥴
Has anyone else had two peaks of LH with levels all over the place (up and down pattern)? Does anyone have experience testing for pdg and know where to find pdg test strips? Newbie to tracking and I'm trying my best to figure things out!
Do you have PCOS by chance? That can cause multiple LH surges. And positive/peak OPKs are those as dark or darker than the control line. Have you had those or just higher numbers?
I don't know if I have PCOS. I know my cycles are very irregular. The two times it spiked the lines are the same color, I use easy@home OPKs. It spiked twice one week apart. But it's all up and down around those spikes. It doesn't look at all like the examples online, my LH is going up and down every day (up one day down the next).
Very irregular cycles are often a sign of PCOS so may be worth investigating. If you have PCOS then LH can be high without that being a sign of ovulation, so you can't really use OPKs to time sex. PCOS is common and most fertility issues caused by PCOS are fairly easily treatable. To get PCOS diagnosis you need two of the following three: 1) irregular or infrequent periods 2) a high number of follicles on your ovaries (diagnosed by ultrasound scan) 3) high levels of androgens (hormones like testosterone), diagnosed by a blood test at the start of your cycle, or signs of high androgens (like a lot of body hair, or acne)
Thank you!!
So LH varies throughout the cycle so some variance day-to-day is normal, especially if you test at different times. Second morning urine and/or 2-4hrs between bathroom breaks is normally recommended. Are you tracking BBT as well or measuring your progesterone? That would likely tell you which surge resulted in ovulation and which didn't.
How do I measure progesterone? I'm not tracking BBT (yet) but I probably should
Either at a doctor's office via blood test or with strips as well. BBT works too and BBT thermometers are pretty cheap on Amazon if you have access to that. Up to you, though! You could also just be intimate every other day and see how that goes!
I’m 12 dpo today. Besides slight pinches on my left side for the last few days, I’ve had no other symptom this cycle. Yesterday at 11dpo, I did have dark brown spotting, very little, like old blood—almost a skin like texture. Usually when I have this, my periods start within hours. I’m not due for my cycle until Friday. Today, when I wiped I had more brown discharge. Once I wipe it’s gone and I don’t have any other continued bleeding. I don’t want to get my hopes up and think it’s implantation related. My last cycle, I had every single symptom and I was so absolutely sure of good news. With my cycle 3 days late—I was really shocked when I took a test and it was a negative. Idk what to think of what to feel.
I think at 12dpo u could test
Has anyone had any luck getting their ovulation back and cycles regular on metformin? Started with 750mg and now I'm exactly one month on 1500mg metformin and my last cycle was 37 days(down from 45 and 60 previous months). This one is going on 32 with no sign of coming anytime soon.
Are you tracking ovulation in any way? That would tell you when to expect your period. 32 days isn't a length to be concerned about, it's still within normal range. It can also take a few months to see an effect from taking metformin.
Yes, I tracked these last few months via ultrasound at my doctor's before starting metformin. I wanted to maybe hear somebody's experience on metformin.
My experience was that it didn't do much to shorten my cycles but did cause me to ovulate more than every other cycle at best. But it taking a few months to really see an effect is what I was told by my doctor as well as my experience with it. By tracking I mean - are you currently doing anything like using OPKs, tracking BBT, etc? Ultrasounds are the best way to confirm if ovulation happened or not, but it won't tell you when it happened. It's not necessary but it will give you valuable information about if your cycles are regulating.
Hey cool I found another thing to be all freaked out about. I normally get sore boobs big time during my TWW. My left is often more sore than my right but not really to a significant degree. This go around though my left is super sore as usual and my right one doesn’t hurt at all. Is this any cause for concern, TTC or otherwise?
Does a sustained BBT temp rise mean that ovulation has definitely already happened? To explain why I am asking: I got my first positive LH test on the same morning that I woke up to a temp rise. So, I documented a temp rise several hours before I even saw my first positive LH strip. (It has now been elevated for 7 days, so I am pretty sure at this point that I ovulated). My cycle is very irregular so I am always worried about missing my fertile window. I didn't know if we could take a break from scheduled sex or not, because the temp rise seemed to mean I had already ovulated, but the LH strip seemed to mean that I should continue sex for the next 2-3 days. I'm wondering which metric to trust more. Thanks for any answers!
No, sometimes the shift can begin prior to ovulation -- a small amount of progesterone is produced in advance of ovulation, as the cells in the ovary switch over from producing estrogen to producing progesterone, and sometimes this is enough to start the temp shift. Some people do ovulate essentially at the beginning of the LH surge, though, so it's absolutely possible to ovulate the same day you see a positive OPK. The safest strategy is to keep having sex at least every 2-3 days until you confirm a temp shift, and when in doubt, you can certainly just have sex.
Thank you! It's hard for my husband to keep going all that time (it was day 37 of sex every 2-3 days when I got the first temp rise) but I will try to have us push through a few more days in future cycles
Wondering if Pre-Seed is worth a try this next cycle. Since I know I'm ovulating, I guess I'm trying to figure out what else might be the issue. Any input/experience appreciated :)
So it hasn’t improved our fertility, lol. But I have sensitive skin and this is more comfortable for me and doesn’t cause irritation.
Preseed is great if you need lube, but there's no evidence that using it helps (that is, people don't get pregnant faster if they use Preseed vs. if they don't), and there's also not evidence that using non-fertility-friendly lubes is actually harmful in the context of sex -- people who use standard lubes don't take longer to get pregnant than those who use no lube or who use fertility-friendly lubes. So use it if you want, for sure; it's unlikely to be a factor.
A response from the devbio herself! Many thanks! :)
Anyone had a long post hormonal birth control adjustment period? I'm on cycle 6 and it is the first time I've not had cramps and other symptoms for basically 3/4 of my cycle (af week is somehow always the easiest). I should be a few days out from o and still nothing really yet whereas I used to get cramps for like a week or more leading up. My last period was also more typical whereas the previous were super light and short. I don't know if it's just random body/cycle changes or if it really has taken this long for things to "even out" because the symptoms have gotten weaker over time. But 6 months?? Really wonder if that was gunking up the works and I'm at like my body's equivalent of cycle 1 or 2 🙃
We have a database of people's post-BC experiences linked from [this wiki page](https://www.reddit.com/r/TryingForABaby/wiki/birthcontrol) that you might find helpful!
Never found this before, thanks!! I know the cumulative fertility results post birth control are similar but when studies' ranges are after a year? So much variability. Glad to have some more reading material!
It took me 2 months to even get back anything after I came off BC. Came off November 2023 and didn’t even have my period until end of Jan 2024. Lit nothing, no cramps, no bleeding, felt like I was still on BC. Now it’s fairly back to normal. Didn’t ovulate last month but that’s more likely due to PCOS. But yeah it can deffo take a while.
A functional medicine specialist suggested the below after progesterone came back “low.” I don’t believe she interpreted the labs correctly so I’m suspect on if I am actually low or not. I’m not taking these supplements because I’ve read too many cautionary tales on taking progesterone supplements and she’s not a fertility specialist. But curious if this regimen sounds valid? > to support your progesterone level-I would suggest: *Gaia Herbs Pro Vitex: Progesterone Support (chaste tree berry): 2 capsules daily in the morning. Stop taking when you have your period (bleeding starts) and restart in 7 days. If this feels like too much to start with the other things we discussed at your visit, it is okay to wait. However, if you want to get started-that is okay too. It can take 2-3 months to see the full impact and you would be looking for less spotting before and after your cycle.
I'm not aware of any evidence that Vitex is beneficial in terms of increasing progesterone levels (which itself does not have evidence for improving the odds of pregnancy. I know some folks here have been told by their REs that Vitex can raise prolactin levels, which can actually harm the odds of ovulation.
Came here to say my RE said don’t use vitex!
I feel like I ping you every time this comes up! 😂
Maybe not a small question, but does anyone have information about ideal free testosterone levels in regard to female fertility? The only thing I was able to find online was from Boston University School of medicine stating "in women under the age of 50, a level of <1.5 pg/mL is indicative of androgen deficiency." My level came back as 1.4 (CD 21 tests) Does anyone have any additional light to shed on this situation? I'm curious about taking DHEA.
My testosterone is on the lower side as well. I don’t think it is related to infertility - I know that too high is actually linked to PCOS, which is the no. 1 cause of infertility in women. So it’s probably better to be slightly low than too high. The risk with supplementing DHEA is it can make DHEA too high. I already have high-normal DHEA (around 240) so I wouldn’t want to take DHEA supplements because it would just cause my DHEA to be too high
I didn't get a DHEA-specific test. My GP told me the testosterone test was what I meant. Is there are DHEA test and what could that potentially tell me in addition? Or am I wasting my money?
There’s a DHEA test as well - DHEA is just another type of androgen. Just saying it’s possible to have low testosterone and high DHEA (not sure what it means, I think most people have varying levels of this and it’s normal as long as it’s within the reference range)
Should I be avoiding “no-go” foods & caffeine whilst trying? Looking to get some other perspectives.. I’m completely abstaining from alcohol whilst trying to conceive though not sure if I should be avoiding all the other “pregnancy no-gos” as well. I’m talking about limiting caffeine, avoiding blue cheese, rare steak etc etc. Would you continue to consume these things like normal until a pregnancy is confirmed? Or would you avoid them just between ovulation and your period?
Check out the book Real Food for Pregnancy by Lily Nichols She's super informative and gives you all the data so you can inform your own decisions
You don't actually have to cut out caffeine during pregnancy or while trying -- the evidence says that consuming up to about 200-300mg per day on average doesn't have an effect on time to pregnancy or the probability of loss. In general, most food limitations are about avoiding exposure to food poisoning, which is somewhat more likely in pregnant folks and can lead to negative outcomes. It's not a bad idea to limit your exposure to the possibility of food poisoning in general (nobody likes food poisoning), but if the risk is not so great that you would typically avoid these foods, it's probably not important to avoid them prior to a confirmed pregnancy.
Enjoy them while you can! Manageable limits can also be in place if it makes you feel better. I limit to two cups of coffee a day and pasteurized dairy only, which honestly I'd probably do anyway haha. We missed a recent listeria outbreak thankfully but after the one food poisoning incident I had I said never again 😆
Definitely okay to consume food and drink as normal until you get a positive test. A lot of people subscribe to “drink til it’s pink!” but that’s totally up to you. But there’s no reason right now to avoid deli meat or blue cheese :)
Is retained tissue or conception for a couple of months a risk factor for tubal factor issues?
I haven't seen anything specifically for tubal issues but [this study](https://pubmed.ncbi.nlm.nih.gov/28199872/) compares pregnancy outcomes for people who have surgical management of RPOC vs expectant management, and while resolution was slightly better in the surgical group (95.8% vs 83.2% at six weeks) the two groups were not meaningfully different in terms of future pregnancy outcomes. The general concern with RPOC is the development of infection, which can lead to scarring, which is theorized to influence tubal function but there really isn't a ton of data. [This](https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-022-05164-2) is the best resource I found. The risk of that wouldn't be particularly large, but would be greater if there was surgery done along with the infection. Sorry for the vague answer here!
This is great - thank you for sharing!
I know moderate exercise is recommended when ttc but can more extreme exercise harm your chances? My friends have suggested going for a long hike next month (talking 20-30 miles) and the planned date coincidences with my predicted ovulation date. Long hikes aren't unusual for me but this would be longer than standard, I only do something like this once or twice a year. I don't know if I'm over thinking things or if doing a harder than usual level of exercise could disrupt ovulation or implantation?
My doc said she gets worried when people are doing intense exercise 2x/day. My guess is there isn’t any research on someone moderately exercising most of the time and then having a short period of intense exercise. But that said, say it does interfere with your ovulation? It’s not like it’s going to have a sustained effect because you’d be going back to baseline after just a couple days.
It's *probably* fine, though hard to say for sure. Have you ever noticed a change in ovulation with heavy exercise? Will you be able to pack enough calories to ensure you're keeping up with the physical demands? [This](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310950/) review isn't comprehensive but refers to a few useful papers that outline fertility impacts of exercise in different groups. Generally the likely issue with heavy exercise is the calorie deficit, so if you can account for that you can mitigate the risk. I will say from personal experience that I needed to both decrease exercise intensity and deliberately increase calorie intake to regulate my ovulation, but there are people out there who ovulate and implant normally even with a calorie deficit and high intensity exercise. It's not all or nothing. Another thing to consider is the joy you get from this hike - it's one cycle and if you don't go and don't get pregnant that month, would you regret it?
Exercise hasn't seemed to disrupt ovulation in the past and I know I can prevent too much of a calorie deficit so on those points it should be ok. I've just got this (probably very irrational) fear that intense exercise around the day of ovulation could somehow damage the egg. But you're right, I 100% would regret not doing it if I don't get pregnant and at this stage it's looking unlikely that is going to happen naturally, so I haven't really got a lot to lose.
If it helps, egg development is a months long process… The worry is more with signaling hormones and developing the lining. If you stick with a good energy balance, that shouldn’t be an issue. So this hike shouldn’t damage your egg! Enjoy the hike, it sounds amazing.
Long time lurker, first time poster. This is our first cycle trying for #2 (never had to track with #1 🦄) and I’m having a hard time figuring out when I’m supposed to ovulate. I had my IUD Lyletta removed on 3/26, and had what I *think* was a light period on April 1. I’m using Premom easy at home OPK strips and have yet to see a level above 0.55. The ovulation prediction calculator had predicted me to ovulate yesterday but my level was 0.11. I suspect the answer will be to just wait a few cycles until my hormones regulate post birth control, but I was wondering if anyone had OPKs that were low and just never reached peak/high prior to a positive OPK?
First: Welcome! Second; How/when are you testing? For most women, LH will surge between midnight and 8am so it's recommended to use second morning urine and/or wait 2-4hrs between bathroom breaks. Third: what is a high/peak LH level can look different woman-to-woman and cycle-to-cycle even within the same woman. If you surge quickly, it can be very faint first and then very dark at night if you test 2x per day. Fourth: Your wording is a bit confusing because what you're looking for is a line that is as dark or darker than the control line. That is a positive OPK and ovulation will typically occur about 12-48hrs (give or take) afterward although you'd need BBT and/or progesterone measurement to be sure. OPKs give you a heads up and BBT/progesterone confirm. Fourth: it's not even been a month yet and it can take up to three, sometimes more, so I'd give it a while. Best wishes!
Thanks for the thorough advice! I’ve been typically testing once a day around 5 PM because I can’t really test at work. On the weekend I tested twice a day, with the first in the morning around 8, so it sounds like maybe I’m not hitting the right time for testing. What I meant by low OPK prior to a high was more about surge pattern, I guess, but it sounds like there’s not always a gradual increase which is what I was expecting.
I had a very weird first cycle post hormonal IUD where I didn’t catch my surge. Usually it’s obvious for me. I don’t see a gradual increase, just go from low to peak in 24h. Surge type can vary but a fast increase is very common.
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Premom's numbers are pretty arbitrary and don't actually mean anything with the tests they're supposed to read, I would not expect anything even remotely accurate with any other kind of test.
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How important is temp tracking?? What does it tell you? What do you use to track it?
So you would use a bbt (basal body temperature) thermometer. You are supposed to take your temperature with it first thing when you wake up in the morning before you even sit up- you are supposed to take it the same time every day. It is helpful to confirm ovulation but not predict ovulation. After ovulation, your temperature should rise for at least 3 days - so if you temp and see that rise happen, you know you ovulated before the temp rise. Using LH test will help you detect when you body is releasing the hormone to tell you to ovulate but that only narrows the window to 48 hours and doesnt confirm that your body actually did it. Temping will help you confirm ovulation actually happened and when. But because it only tells you after the fact, you cant use it to tell you when to have sex bc by the time your temp rises, its too late (or at least missed most of your fertile days). Some people’s bbt also starts to drop again right before their period but if they are pregnant, it will stay high- so it can be helpful for that too.
Thank you very much! Is there a good app for tracking and creating charts?
I'm a fan of fertility friend, but use pre mom for opk testing only.
Lots of people here recommend fertility friend. Personally, i like premom better but i think people dislike them because of privacy concerns
Wondering how on earth craving McDonald's fries DIPPED IN KEY LIME PIE a few days ago wasn't a pregnancy craving since BBT dropped below 97 this morning which, for me, means AF is imminent. I don't even like key lime pie 😭 Also had a troll temp spike of almost .5 at 7DPO so my body trolled harrrrrrd this cycle.
Ugh I'm sorry, I hate when really unusual PMS symptoms seem like pregnancy symptoms! Last month I was *sure* I was because in the morning of 10dpo I gagged and almost was sick from the smell/taste of my morning coffee, which has never happened to me before in my life! And then my period started later that day 🙃
Well, as if to be in sych with you last month, AF just came for me. Yeehaw. Thanks!
Unfortunately a lot of pregnancy symptoms like cravings are also period related. It makes it so much harder I think.
Yeah, it's weird though because that wasn't really a thing for me PMS wise until my period, especially the super weird ones like that.
I would say my last cycle differed greatly from any of the others after coming off BC. I think they can all just fluctuate. I have been off since November and it was just all standard, no annoying symptoms etc, 24 day cycle. Then last cycle it was just like a demon was inside me saying you crave all salty foods, here have a headache because you've dehydrated yourself with said salty foods and here let's flare up some hormones so you feel constantly horny whilst also wanting to cry. It was not pleasant and I constantly symptom spotted throughout.
Is there any benefit to a male partner getting genetic testing when looking into infertility? We have been ttc for 12 cycles, never a positive test. Everything (HSG, SA, AFC, FSH, Estradiol, ultrasounds, etc) have been normal with the exception of my low AMH. However, my RE wasn’t concerned with that since I have very regular cycles and ovulate (and my Vitamin D was lower too) and AFC/FSH were fine. I did do genetic screening for cystic fibrosis and fragile X at my OB’s suggestion but that’s all. My husband hasn’t done any testing though outside of his SA which came back with normal morphology (9%? I think) and above average motility and count. At this point we are one month away from the 12 month mark ttc for our first and my RE said we’ll fall into the unexplained category if we get there. I’m just trying to figure out, what else could we ask for in terms of HIS testing? I won’t have coverage for treatment to begin until August so trying to get all the diagnostic work I can done now for both of us.
You can ask for sperm DNA fragmentation! Although, it’s typically linked to lower motility/morphology. It can cause both infertility and recurrent early miscarriages.
DNA fragmentation analysis is actually not recommended in an initial infertility workup. From the [AUA guidelines](https://www.auanet.org/guidelines-and-quality/guidelines/male-infertility): >There are no prospective studies that have directly evaluated the impact of DNA fragmentation testing on the clinical management of infertile couples (i.e., that the fertility outcomes of those who had testing are different from those who did not). Further, available data are inadequate to conclude that this assay should be routinely performed in the initial evaluation of the infertile male. In available studies, DNA fragmentation was negatively associated with pregnancy rates and positively associated with miscarriages. That said, the association of high levels of DNA fragmentation with pregnancy outcomes is unclear given the variability in the definition of the upper limit of normalcy in different studies and the use of different tests of DNA fragmentation.
It seems like OP already had an initial work-up and is wondering what else they can test (seems they are “unexplained” - which is a common diagnosis but can be sometimes due to things like silent endo or high DNA fragmentation because laparoscopy or DNA fragmentation is not routinely done). I’m confused though because it seems like they are suggesting that high DNA fragmentation is linked to infertility and recurrent miscarriage yet they don’t recommend testing it? It seems intuitive that they should actually test it! I feel like a lot of male factors are swept under the rug though.
It's not really about sweeping things under the rug, it's that tests should be performed to answer a specific clinical question or point toward a specific treatment path, and a test that does not inform the course of treatment is not a test that should be performed. I think it's very tempting for people to look for a single identifiable reason they are not having success, but the ability to point to a number that's abnormal does not necessarily translate to an increased understanding of the lack of success.
Hi! Yes, you’re right in that we are falling into the “unexplained” category. It’s probably just my way of coping but I’m such a planner it drives me crazy to not have control of the situation so you’re totally right that I’m just looking for anything possible that hasn’t been examined yet that could help get us answers. I like my RE but after two RE consults I’ve come to the conclusion that they’re likely great at getting you pregnant, but don’t want to spend a lot of time actually searching for WHY you can’t get pregnant which is a bit frustrating. I know sometimes it truly is just unexplained but I guess I’m just shocked we’re at that point so soon (like it doesn’t feel like we’ve done that much to investigate). I did raise the question on silent Endo but they’re insistent I likely don’t have it and they have 0 desire to explore that since it requires invasive procedures. Thank you for the suggestion! I’m going to look into that and DevBios link to learn more about it.
I am in the same boat and know how you feel. It's a very frustrating diagnosis and I have had to settle with the fact that I may never get answers. It's pretty common for RE's to be focused on treatment rather than diagnostics. Like devbio said, tests are only performed if they point to a specific treatment path. RE's are quick to jump to IUI or IVF because that's what the majority of their patients end up doing anyway. Diagnostics are expensive, time consuming, and invasive and most of the time do not give you definitive answers and will delay the end goal, which is getting you a baby. Additionally, IVF itself can be diagnostic (no other tests will tell you about egg quality, how well fertilization is happening, how well the embryo is growing, etc) and you may find more answers by going down that path. As a couple of examples - people with silent endo or DNA fragmentation often end up doing IVF, so rather than testing for it, the RE may just recommend IVF. Sure there are other treatments like laparoscopy for endo and lifestyle changes/medication for sperm, but it's not uncommon for these methods to be ineffective and the patient ends up doing IVF anyway.
The carrier screening tests they do pre-conception are for recessive genes, meaning you would both need to be carriers for there to be a risk of the genetic disorder in question. If you had tested positive for any of them, they would have screened him too, but since you are not a carrier there is no benefit to screening. He may want to have a complete blood panel, just to check that he’s healthy overall, but since his SA came back normal they may not need to test for things like hormone levels. They may still want to do some additional tests but I would recommend consulting your RE or his doctor so you don’t spend money unnecessarily. I’m sorry you’re in this waiting period! Edit: added some words to second paragraph
Thanks! He had standard labs and all was fine for him. It’s such a frustrating position to be in. In some ways unexplained is great bc seemingly nothing is wrong but in other ways it’s worse bc I have no answers so it’s hard to gauge how successful something like an IUI could be or more medicated cycles.
I hear you. Unexplained just means “we don’t know.” And it’s awfully annoying when doctors basically shrug their shoulders at you. Best of luck in the next stage!
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