FREQUENTLY ASKED QUESTIONS

I have been trying to conceive for the 12 months, should I consider fertility testing and what does this entail?
If you are under 35, 12 months of unprotected sex during your fertile period without conception is an appropriate time to seek professional help. If you are over 35, experts suggest seeking help after 6 months of trying to conceive or if you have irregular cycles.

Tests may include the following:

During the first week of your cycle, baseline tests for follicle stimulating hormone (FSH) and luteinizing hormone (LH) . This must be done on Cycle Day three.
It is important that your spouse have a semen analysis done.
An Endometrial Biopsy may be performed between 11 and 13 day past ovulation to determine if you have ovulated or have a luteal phase defect. This procedure involves scraping a small amount of tissue from the endometrium shortly before menstruation is due. This can only be performed after an negative HCG blood test.
Prior to ovulation, your doctor may elect to perform an (HSG) Hysterosalpinogram to examine a woman's uterus and fallopian tubes. A radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. The dye appears white on the x-ray, and allows your doctor to see any abnormalities in the uterus such as tumors, scar tissue or blockages in the fallopian tubes.
During your fertile phase or when OPK detects an LH surge your doctor may want to do a Post-Coital. This is when the doctor removes a sample from your cervix after intercourse to determine whether the sperm is penetrating the cervical mucus.
If a uterine abnormality is suspected after the HSG, typically, early in your cycle, your doctor may perform a Hysteroscopy. A hysteroscope, which is a telescope type device mounted with a fiber optic light, is inserted through the cervix into the uterus and enables the doctor to see any uterine abnormalities. Images are taken by the device during examination for future reference.
If you have Endometriosis or if your doctor suspects Endometriosis or other Pelvic adhesions, he may elect to perform a Laparasopy. This procedure entails a narrow fiber optic telescope is inserted through a woman's abdomen to look at the uterus, fallopian tubes, and ovaries. This test us usually done two or three days before menstruation is expected, and only after an HCG beta blood test is negative.

What is the best position for baby-making sex?
There is no true expertise on this question, however many healthcare providers say the missionary (man on top) position and doggy style (rear vaginal entry) allows for deeper penetration getting the sperm closer to the cervix.

When is the best time to have intercourse?
Intercourse closest to the time before ovulation and within 6 hours after ovulation gives you your best chances for conception.

I tested positive on pregnancy tests at 11-14 days past ovulation, yet my period still came. Why?
What you are describing is most likely a chemical pregnancy. This is a very early miscarriage that occurs around the time the menstrual cycle is due or a few days after. What happens is the egg is fertilized and starts to implant and release hCG hormone which will give you a positive on a very sensitive home pregnancy test. Unfortunately implantation does not complete. Almost every woman will experience one or many of these in their fertile years. It is said to happen 40%--50% of all conceptions. Many times you think your period just came late, but you were actually briefly pregnant. The causes range from chromasomal problems, missed implantation or a luteal phase defect because of low progesterone or inadequate uterine lining. Here is a great article on Chemical Pregnancies from Conception-Tips.com

What is a blighted ovum?
A blighted ovum is a miscarriage characterized by the absence of an embryo by ultrasound. They are primarily due to chromosomal abnormalities. B.O.'s show fertilization and the development of preembryonic cells but a failure to form the embryo. These pregnancies form a placenta but the placenta is not formed normally. They often have large fluid filled vesicles of placental tissue. A high incidence of chromosomal abnormalities in blighted ova are consistent with the many first trimester miscarriages.

I was just diagnosed with Polycystic Ovarian Syndrome. What is this and can I still conceive?
It is estimated that 6-10% of woman have this affliction. PCOS can be treated, however it cannot be cured. The symptoms include irregular or absent menses, numerous cysts on the ovaries in many, but not all, cases, High blood pressure, Acne, Elevated insulin levels, Insulin Resistance, or Diabetes, Infertility, Excess hair on the face and body, Thinning of the scalp hair (alopecia), Weight Problems or obesity that is centered around your midsection. As far as your ability to conceive depends on the criteria used to diagnose PCOS. If a main criterion is anovulation, then by definition women with PCOS would not be able to conceive without Reproductive assistance, you need to ovulate to conceive. It is possible to have the appearance of polycystic ovaries and be fertile, but having the syndrome usually does impact fertility adversely. You will need to discuss your fertility options with your healthcare professional.

PCOS Links

When can I test to see if I am positive on an home pregnancy test?
In order to test positive on a home pregnancy test, there must be hCG present in your blood stream. hCG production starts at an early stage of development, just a few days after conception, before implantation in the uterus, but you will not be able to read until after implantation. hCG enters the circulation almost immediately after implantation of the embryo (blastocyst) on about 7 days past ovulation, producing 5mIU-50mIU of hCG and doubles every two days. Many women are able to get a positive reading at 10 days past ovulation. I recommend waiting until 12 days past ovulation to test. Here are averages:

DPO	Amount of hCG in mIU/ml
7	5 - 50
14	4 - 426
21	19 - 7,340
28	1,080 - 56,500

Just because there may be 5-50 mIU in your bloodstream doesn't mean that your body has processed it in that strength in your urine. Every woman is different and even cycles can be different.

I have heard that you can use a Ovulation test to test for pregnancy.
An Ovulation kit detects a surge in Luteinizing Hormone, LH and hCG have the same composition with the exception of BETA which is what a home pregnancy test is looking for. If you happen to have some extra Ovulation tests lying around and want to test for pregnancy, you can use them. It is only positive if the test line is the same color or darker than the qualifying line:

If you get two lines and one is lighter than the other, then it is NOT positive. If you get a positive LH surge more than a week post Ovulation, there is a possibility of pregnancy or you may have timed your cycle incorrectly and you are about the ovulate. If you get a true positive, follow it up with a pregnancy test the next day. Our tests are made specifically for LH detection and will not give you a positive for pregnancy.

I have little or no fertile quality cervical mucus, what can I do? Some women have had success using real egg white. (Talk to your physician prior to doing this). Sperm can move freely in egg white . If you are going to do this and your doctor okays it, make sure you do the following:

Wash your hands and the egg thoroughly before cracking it open.
Be careful not to get even the tiniest amount of yellow in it.
Use a fresh egg
Place approximately 1/4tsp. of egg white on the tip of the penis.

Another solution is Pro-Seed. This is a Sperm friendly vaginal lubricant that can be ordered from drugstore.com for about $20. It is important that you DO NOT use any other personal lubricant. Most personal lubricants and even saliva can harm
sperm!

Can I take aspirin or an anti-inflammatory while I am trying to conceive?
From: FertilityPlus.comNSAIDS, Aspirin & Infertility

Doctors may not mention this to women who are trying to get pregnant, but the use of non-steroidal anti-inflamatory drugs, including Advil and Aleve, and aspirin cause ovulation problems. Specifically, the use of these medications can cause a failure of the follicles to burst and release eggs -- called luteinizing unruptured follicle syndrome (LUF or LUFS). Below are some abstracts on the subject. Full journal articles may be ordered through Medline or found at medical libraries. Read More>

I am 11 days past ovulation and I seem to have a lot of egg white cervical mucus. Am I ovulating again?

Towards the end of your cycle, if you are not pregnant, progesterone plummets and estrogen rises. This may bring on a couple days of EWCM. You may notice that this correlates with a drop in your BBT.

I have diarrhea when I am due to ovulate, is that normal?
Yes, it's due to the surge of estrogen around the time of ovulation. Many women also get diarrhea at the end of their cycle or at the onset of AF.

What is an "evaporation" line on a pregnancy test? An evaporation line develops when the urine on the test area begins to dry, leaving a faint, usually colorless line or very faint colored lines. Many tests give an evaporation line after the specified time for results. If you the directions on your pregnancy tests say do not read after 10 minutes of throw away after ten minutes, any line that shows up is NOT reliable. You must read it at the specified time.

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