Taking Charge of Your Fertility
It’s been 3 ,6…12 months since you began trying to conceive and each month you are greeted with 1 line on the home pregnancy test. You are not sure if it is time to go see a doctor yet or if you are just being a pessimist.
It’s OK to be concerned! And it is OK to voice that concern!
Step 1: Are you ovulating and do you know when?
An average cycle lasts 28-30 days and one ovulates 14 days before the next period. However, many women ovulate and cycle on their own unique schedule.
In case you’re wondering: An ovulation home test monitors your hormones to detect ovulation by testing the levels of the luteinizing hormone (LH) in your urine. Basically, starting after the last day of your period every morning you will urinate on a stick (or in a cup and put the stick in) to test for the presence of LH. Some of these kits will have 2 lines to indicate ovulation others will have a smiley face. When the test detects a rise in this hormone called the LH surge, it indicates that ovulation will occur and this is your fertile window.
Keep in mind: According to most research sperm can survive in your body for up to 3 days.
Practically speaking: Once you know your pattern, it can help to have intercourse a day or two before you ovulate and then again the day of and day after you get a positive ovulation test.
If you are not ovulating consult your doctor to determine the cause and if necessary, request a referral to a Reproductive Endocrinologist and move on to step 2.
If you are ovulating before going to the Mikvah, consult with your doctor and Halakhic adviser to discuss options.
If you are ovulating regularly, use this new information to ensure that you are having intercourse during your fertile window. If after trying for a few months you are still not pregnant, move on to step 2.
Step 2: Make an appointment with your OBGYN
Discuss your concerns with your OBGYN about not yet conceiving, despite trying for multiple months. You should request a full blood workup.
Did you know that you are born with all your eggs? Interesting fact, your egg production peaks in utero at 20-weeks gestation with approximately seven million eggs. Each month when you cycle that number diminishes. And for each woman this process varies and the quantity and quality of eggs remaining may diminish faster for some without you evening knowing. To get a better picture of your ovarian reserve your doctor will likely order a blood panel including but not limited to those listed in the Blood Work Up of hormones to test your egg quality and quantity as well as ultrasound imaging of your ovaries to determine your fertility.
Learn more about ovarian reserve testing from the American Society of Reproductive Medicine.
Step 3: Review your results with your OBGYN
Schedule a time to discuss the results with your OBGYN and create a plan to move forward. Some OBGYN’s will continue to treat fertility challenges. You may request a referral to a Reproductive Endocrinologist (RE) who is trained to specifically treat reproductive challenges.
It is now time to get ready for your first appointment with your Reproductive Endocrinologist.
Step 4: Check in with yourself
This can be stressful! Who are your supports? What are you doing to practice self care?
It is understandable to not be ready yet to address the next steps…be kind to yourself.