Time window for DTD or an IUI after +OPK?

[TenzinsMama]

I've been using both ClearBlue OPKS and it says that once a surge is detected, the egg will likely be released within the next 24-36 hours.  The instructions also say that the best time to DTD is the day of the surge, and the next day... I've also been using internet cheapie (IC) OPKs from earlypregnancytests.com, (as a 'test', to check how they compare with CB, which are so expensive--once I feel comfortable, I will just switch to the IC for subsequent cycles) which has the same info about egg release and says to DTD "anytime within the next 48 hours" after getting a +.

So here's what I did, and hence my obsessing...

Tested today at 1 pm with IC (normally I would test at 10 am as I have these other past few mornings, but I couldn't hold my pee this time for the full 4 hours to do that), and got an 'almost as dark as the control line'-- so I knew that I was on the verge of a surge... Out of curiousity, I tested later at 7 pm with CB and got a glaringly obvious +.  I never test more than once a day-- why I did it this time, I do not know what possessed me (because now I'm driving myself crazy with "what if").  Both CB and IC instructions say to test at the same time each day, and don't say anything about testing more than once a day.  So I take that to mean they expect you to test once every 24 hours...

So the issue for me is this:  If I hadn't done the second test in the evening, I wouldn't even know that I surged today... I would be testing tomorrow at 10 am, and then discovering it (from past experience, I know that the + shows up and stays a good while)... We would be DTD tomorrow and the next.  But now, I'm obsessing about whether we should DTD tonight and then tomorrow...

It is driving me crazy that with OPKs, by only testing once you could be at either the start, middle, or end of the LH surge, and with egg viability being what it is, doesn't that really make a difference when it comes to timing for DTD or IUI?  I'm not concerned about DTD so much as the IUI-- we may end up needing to go that route (we conceived our DS on Clomid/IUI #2) and I'm already thinking about asking why they don't get people to test twice a day as a rule (our clinic's protocol is to test once at the same time each day, between 10am and 3 pm, and to call the day of the surge, to be booked the following day for the IUI).

My DH thinks I should relax about the timing for this cycle, and if it comes down to it, have faith in the fertility clinic (he feels that if they truly thought it made a difference then they would change their protocol).  Any thoughts on this from those of you out there who know about this OPK business, will be much appreciated!
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Edited by TenzinsMama - 7/23/11 at 7:56am

[Jaimee]

Hopefully someone with more IUI experience can jump in here and answer your question more thoroughly, but I do have some thoughts about OPK's.  OPK's will tell you when you are surging- gearing up to O, but they cannot confirm O.  Also OPK's are not always the most reliable test for a lot of women.  You might not get a positive at all, or positives for days on end, or positives at random times in your cycle.  They can show up half positive and as you noted, it can be difficult to pinpoint the exact timing of the surge.  A lot of women take OPK's multiple times a day when they think they are peaking to try and catch the peak.  Some do see a clear increase and decrease over a matter of hours.  Some do not.  And beyond that even if you did see a clear peak window, you don't know if you'll O within the next 24 or 36 hours from that point or at all.  This is why I think the OPK companies and the clinic probably don't worry about catching the exact peak, but instead the day.  It is assumed then that you have 24 hours to get sperm to that egg.  The sperm can last longer than 24 hours, but the egg cannot.  So once a positive is detected, whether the true peak was 12 hours earlier or 12 hours later, you have pretty good chances of getting sperm to egg if it's done within the next 24 hours.  But none of it is an exact science so in the end, everyone has to rely on the averages and a little bit of luck. 

To help pinpoint things better I highly recommend temping and tracking your cervical fluid if you aren't already.  This will help you decide better when your peak day is and confirm if O actually happened or if you need to be on the look out for O again a few days later.  Now, when you're DTD vs. IUI it's much easier to ensure that sperm is present at the time of ovulation because you can DTD each day that the OPK's are darkening and you have fertile CF and a few days after.  Are you dealing with a low sperm count or other complication such that you don't want to DTD several days in a row?  If not then definitely DTD as soon as you see creamy CF and keep going until it dries up and you pass the temp spike by 3 days.  If so, and you know your fertile pattern pretty well, you could wait until the first day of eggwhite and DTD that day and every other day after until it dries up and you pass the temp spike by 3 days.  If it's really dire then you could wait until your wettest day within 24-36 hours of the OPK+ and hope for the best.

Here's a little encouraging anecdote... a friend of mine finally succeeded at conceiving her first via IVF after Clomid and IUI's failed.  With her second IUI succeeded the first time!  So the second time around it seemed that she was more fertile than the first- this seems to not be an uncommon thing.  I also become more fertile with each pregnancy.  Good luck and keep us updated!

[TenzinsMama]

Thanks, Jaimee, for your reply.  I normally track CF and temp, in addition to the OPKs... I have noticed that my CF turns to EWCM at O time, and I have secondary fertility signs that each month, too-- it corresponds to the time period when I get a + on the OPKs.  Before I get a solid positive, I can see the line getting increasingly darker, and then the odd time that I have tested a day after, I see that it is no longer dark like that.  Which I would say is reflective of the LH building up in my system and then subsiding... After O, I see the temp rise-- and even with nursing my DS and taking temps at erratic times, I have still been able to see the biphasic pattern.  I have read in TCOYF the cautions about relying too much on the OPKs, which is what you are saying, and so I've felt reassured with these other signs of O that I've experienced.  Unfortunately, for this cycle I had decided not to temp, in an attempt to relax about TTCing and see what happens, but, I'm pretty sure I would have seen a rise since I've detected one for each of my PPAF (I've had 6 cycles now).  I'm thinking positive!

My DH has no issues with sperm number, motility, etc. and I know that it would be okay to DTD each day.  The thing is that we do find that DTD for procreation takes some of the fun out of it, and while one or two days in a row is fine, it can get tiring (with our DS not being a good sleeper, I'm often pretty wiped by the end of the day and I'd much rather sleep or eat chocolate, haha).  The other thing is, I'm thinking that with possibly having to go to IUI next, I want to make sure that I'm as aware of my fertile pattern as much as possible, and I would love to be as certain as possible when the best timing is for IUI based on the OPK results.  At our fertility clinic here, a single IUI with Clomid (x 3 cycles) is the first thing they suggest-- and these aren't monitored unless you have some pre-existing issue or you haven't detected a surge after 7 test sticks (then they will do u/s or bloodwork).  So they rely on you to do the OPKs correctly and decipher them.  So this last cycle, I could really see how my timing for testing would factor into catching the surge (start, middle, or end) and when my IUI would have been done-- a whole day difference.  (They only do the sperm washing and IUIs at set times, and weekdays they do it morning and afternoon while weekends and holidays they they do it only once mid-day.)  It would seem better to test twice, that way you would catch it at the beginning and get the IUI booked sooner rather than later-- because to me it would increase the chance of conceiving with the sperm in there waiting, as opposed to the egg being released and the sperm being added after.  I was told before from a nurse at the clinic that they consider the sperm to be able to survive 3 days.  I never thought to ask about the egg, though.  On that note, you seem to be so up on all of this stuff-- what have you read?  (I read somewhere once that the egg can live 24 hours, but often only lives for 6 hours... in that case, no wonder it is so hard to get pregnant sometimes!)  Agghhh, it really is something that isn't 'exact'...

Anyway, sorry for the long post. I've been finding it hard to articulate things of late with my words, so I'm glad that the first one made sense.  Hopefully this one does too.  I look forward to hearing from you again...

Btw, I liked your story of the success, and hearing that your own fertility has increased with each pregnancy.  How could you tell that was happening?  I hope the same holds true for me!  I really don't want to have to go to IUI because if that doesn't work, they will suggest IVF (because of my age).

[Jaimee]

Originally Posted by TenzinsMama 
My DH has no issues with sperm number, motility, etc. and I know that it would be okay to DTD each day.  The thing is that we do find that DTD for procreation takes some of the fun out of it, and while one or two days in a row is fine, it can get tiring (with our DS not being a good sleeper, I'm often pretty wiped by the end of the day and I'd much rather sleep or eat chocolate, haha). 

I hear you!  The cycle we conceived dd we DTD 11 days in a row and by the end we were fighting practically while doing it.  I was new to charting and saw a patch of creamy and we started in, but I had delayed O (due to a minor car accident or the very early m/c I had the cycle before) and by the time I saw the temp rise it had been quite a long time.  It sounds like you have a much better grip on your pattern, though, and you would only be DTD maybe 5 days in a row?  You could do it every other day during that period.

It would seem better to test twice, that way you would catch it at the beginning and get the IUI booked sooner rather than later-- because to me it would increase the chance of conceiving with the sperm in there waiting, as opposed to the egg being released and the sperm being added after.  I was told before from a nurse at the clinic that they consider the sperm to be able to survive 3 days.  I never thought to ask about the egg, though.  On that note, you seem to be so up on all of this stuff-- what have you read?  (I read somewhere once that the egg can live 24 hours, but often only lives for 6 hours... in that case, no wonder it is so hard to get pregnant sometimes!) 

I've most often read 12-24 hours for the life of an egg.  For sperm I've read up to 5 days in fertile CF.  But they die quickly when not in CF.  They can also hang out in the nooks and crannies around the cervix apparently longer than 5 days.  I've heard women say they conceived with 7 day old sperm.  So it seems to me like you're right, that it's better to have the sperm in there before the egg is released.  I don't think there is any harm in testing with OPK's more than once a day, especially when so much is on the line with reproductive technology, expense, time, etc.

But I'll cross my fingers that you conceive naturally and don't have to worry about the IUI timing! 

[TenzinsMama]

Jaimee, thanks!  And yes, that sure would be wonderful if we conceived naturally and I can put all this ttcing behind me!

[Jaimee]

Originally Posted by TenzinsMama 
Btw, I liked your story of the success, and hearing that your own fertility has increased with each pregnancy.  How could you tell that was happening?  I hope the same holds true for me! 

I realized I forgot to answer this question!  With our first we TTC for several months unsuccessfully and then had an early m/c just prior to conceiving my dd.  I certainly wouldn't compare my struggles to those that have been trying for many months or years, but we really did have to try and I had to work on my LP.  With my second it was an oops.  Just after dd nightweaned and started STTN I had another early m/c.  I realized that I would need to be more careful and I also realized that I really wanted a second (but dh was not so sure).  My SIL was TTC at the time and I didn't want to accidentally get pg at the same time, so we actively avoided.  But apparently my fertility was too much and my SIL and I ended up conceiving on the exact same day!!!!  Our boys are 3 days apart.   With this pregnancy I had ONE ppAF which had a 4 day LP and the next cycle, without fertile CF, I conceived.  In what world does that create a baby?  I don't know, but clearly my fertility had other plans for our family!

[TenzinsMama]

Wow!  That's amazing, especially the bit about how you conceived your 3rd.  It's very encouraging for me to hear that.  I sure hope that I can let you know some good news in a couple of weeks...