First Step(s) to Take?

[filiadeluna]

edit.

[kristenok18]

The best thing that you can do is to start charting. Have you read Taking Charge of Your Fertility? By charting, and learning to read your own body and fertility signs, you will have a much greater awareness of anything that might not be "right". You will be able to tell if you have fertile cervical fluid, you can confirm ovulation by temperature rise, you can determine the length of your luteal phase to see if there is a problem there. By combining charting with opks, you will have even more information. I chart, and every cycle I have definite fertility signs followed by a definite temp shift followed by a very predictable lp, but I wasn't ovulating every cycle. I only found this out by combining my charts with opks. This way, if you aren't able to conceive on your own, you will have that much more info to take into your dr.

You can also use preseed, a sperm friendly lubricant. An SA is really not that expensive, maybe around $100 depending on your area.

I think it's normal to start worrying when you've been trying for 3,4,5 months. I know I did, and I remember feeling a little frantic about it. Now it's been almost 3.5yrs of ttc#2, and I wish I had more aggressively pursued dx and treatment sooner. Of course, not everyone who's not pg within the first few cycles will end up having fertility problems, and hopefully you won't have to endure what many of us here have gone through.

[wednesday]

Four months is maybe a little early to suspect infertility if you have NOT been charting. I agree with the PP that your first step is to read Taking Charge of Your Fertility and make sure you are TTC at the optimal times. Typically a woman may be fertile only 2-4 days a month depending on a few different factors. For us, the first two cycles when we WANTED to TTC, didn't work out because of travel/work separation and then having guests at our house (I won't do it with an adult guest in the next room ). So we could have done it every single night for the rest of those two months and still not got pregnant, because we missed my ovulation both times. On our third cycle we were home and relaxed and no one was visiting when I ovulated, we DTD, and our son was conceived.

If you have already been charting and know for certain that you have been intimate on your most fertile days, then I think 4 months of cycles is NOT premature for doing some initial exploring, like for example a SA. It's inexpensive and lets you begin ruling things out.

From what I understand, this is basically what a fertility specialist would start out telling you anyway -- figure out when you're ovulating and make sure you're DTD at that time. Before doing any other kind of testing. Might as well save your money/time on getting that piece of advice since all the information you need is out there already.

[LisaG]

At your age, I don't believe a doc would do any infertility testing until you'd been trying for a year.

I agree with the recommendation for Taking Charge of Your Fertility. If you aren't already, charting based on what's outlined in the book will give you some information.

Are your cycles regular? Do you have fertile cervical mucous?

Good luck!

[filiadeluna]

Thanks for the advice ladies.

I have already been charting, and I have read TCOYF. I've been tracking my cycle lengths and some symptoms for almost 2 years now, but I didn't know about checking for fertility signs then. I used OPKs for two cycles, and temped one cycle. However, I mistakenly took Vitex one cycle when I didn't need it and that totally screwed everything up during the cycle I was temping.

I was really stressed out and confused by all the "symptoms" I had that cycle, and my husband blamed it on "obsessing". So he asked me to stop temping and using OPKs, and I did. I know that he won't want me to start that again no matter how much I beg and plead, so my only option is to keep tracking CM and CP.

[crazyrunningmama]

This is the kind of advice I wouldn't give unless asked, but you asked. Let go. I know it's hard. Women of this generation are used to getting what we want if we want it bad enough. Concieving is not one of those things. "Obsessing" is not going to help.

However, I agree with the pp, with the added advice of losing some weight if you are overweight (this is what I am currently working on, so it's on my mind). Also, I wish I had sent my dh for a SA earlier, it is cheap and painless and the tests done on me were.... not.

Charting and knowing your o day are so important, but so is being connected as a couple and also keeping sperm production up there (it is best to wait 2-3days, but not more than 5). So get intimate 2 or 3 times a week (which might also help with the "letting go" and not obsessing part). Good luck to you.

[LisaG]

If your dh is against temping, how willing is he going to be to have a SA done?

OPKs don't necessarily provide good information (TCOYF talks about why). Your cycle length only tells you part of the picture (and not the important part of when did you ovulate?).

I truly would encourage you to do some cycles monitoring CF and CP, if temping is out of the question. Monitor when your CF changes from EWCM to creamy/sticky (which typically marks the date of ovulation). Get a sense for how long your post-luteal phase is. If you do decide to pursue testing, this is valuable information to be able to tell your doctor.

I hope this doesn't sound patronizing, but you're so young and you've only just begun ttc. Testing opens up a whole can of worms and interventions when I really think you don't have enough information to warrant any of that yet.

Docs may seem like the magical solution, but believe me, a lot of them are idiots. The whole testing process can bring huge stress and worry. Let alone the stress of finding a doc who knows what the h*ll they're talking about. And if you're truly interested in pursuing infertility testing, you want to be working with a reproductive endocrinologist (RE). I don' t know how your insurance handles it but a lot of them require a referral from your doc before they will pay for a specialist.

Also, the most common first level of intervention is clomid. And again, it just seems way to premature to do something like that in my opinion.

As someone who's just arrived at the 4 year ttc mark, I really would encourage you to take a deep breath and give it a little bit more time before opening Pandora's box.

Lisa

[filiadeluna]

Thanks again for the advice guys. I do already check CP & CM, and I know all about the changes in it & have a pretty good idea of when I ovulate now.

My husband already said he wouldn't object to getting an SA done, whether it's over-the-counter, or at a doctor's office. He just doesn't like the temping for some reason and he's very stubborn about it.

[Julia'sMom]

I would agree with those that advised you to track your own cycles and wait a little while. If you do say you've been trying for over a year, I've found that doctors do jump right into the medication and intervention route, which can screw up perfectly normal cycles. Also, I must admit that lying doesn't sit well with me. Maybe it's because I did have to wait a year before getting help even though I wasn't able to cycle (have af) at all in that year. Hence, we knew there was no chance of conceiving, but still had to wait. The one thing I did learn from my journey was not to structure my life around ttc. I turned down too many opportunities because I was always worried that I would be pregnant when the time came. I wish I had just lived my life to the fullest and dealt with it when it came. I do know it is hard to wait.

[Voltige]

Originally Posted by Julia'sMom

The one thing I did learn from my journey was not to structure my life around ttc. I turned down too many opportunities because I was always worried that I would be pregnant when the time came. I wish I had just lived my life to the fullest and dealt with it when it came. I do know it is hard to wait.

Wow. Thank you for posting this. It's just what I needed to hear today.

[barose]

Originally Posted by Julia'sMom

The one thing I did learn from my journey was not to structure my life around ttc. I turned down too many opportunities because I was always worried that I would be pregnant when the time came. I wish I had just lived my life to the fullest and dealt with it when it came. I do know it is hard to wait.

YES! Even fun, simple things like buying summer and winter clothes became a heartbreaking chore because I structured my life around ttc. I still plan in a way (financially, health insurance, etc) but we no longer put other plans on hold (vacations, some major purchases, where we will live etc).

In terms of only ttc four months, I think the other ladies said it best. It can also take several cycles just to get the HANG of charting. I've been doing it on and off since the first edition of TCOYF and I STILL have questions, make mistakes, and so on. If you have a local FAM class your money would probably be better spent taking it together. Why is your DH against charting? Sorry if I missed that part.

If you haven’t already, I would spend this time getting more healthy: losing or gaining needed weight, consuming nutritionally dense foods, taking supplements, getting adequate amount of exercise, rest and so on.

[quantumleap]

I'm a little concerned that your partner doesn't want you to chart. It feels like he's forbidden you to do and now you aren't *allowed*?!?
Anyway, everyone has an opinion on when to seek treatment, etc, and mine is that you should get tested asap if you feel that there's a problem. People are intuitive, and I think women need to take ownership of their self-knowledge. ou need to know the difference between fear and self-knowledge, but, if you really think something is wrong, you should take that seriously. It could be nothing, but it could also be something, and the sooner you know, the sooner you can make relevant choices with accurate information.
I agree, get your partner a SA. It's quick and simple and not really that expensive, in the scope of ART. There is also simple bloodwork that can be done on you to check a few key things (thyroid, FSH, and a few other hormones). Charting really is key though. If you decide to seek further treatment, everyone from an ND to an RE will want copies of your charts.
FWIW, I stretched the truth to get testing done earlier. We get the "you're so young, just relax and give it time" party line from people all the time, but the reality is that DH is not physically capable of producing healthy sperm. This would be the reality if we were 30 too.

Some more books to add to your reading list:
Nutritional Healing (Balch & Balch)
Wise Woman's Herbal for the Childbearing Year (Susun Weed)
I have another, but it's loaned out and I can't remember the exact title/author - I'll get back to you.

Best,
Katia

[veganmama719]

Luna, even if you are the most fertile a couple could possibly be (30% chance per cycle of being PG), then there is statistically only a 75% chance that you would be PG within 4 cycles.

I would suggest you stay away from the fertility specialists for awhile longer. My experience with them has not been great.

My RE told me (after 4 months of TTC but I am 40, not in my 20s) that I only had a 5% chance per cycle naturally. After my follow up visit, and more bloodwork, she suggested I "move on to injectibles and iui right away", but that my chances would still only be 8% per cycle.

This was on Feb 11th. I was very disheartened by this. DH and I talked and about 10 days later, we decided to take a 5 cycle break from TTC and re-evaulate then whether we would continue or not. I was thinking probably not as I'd be 41 by then and the age gap with my other kids would be getting really big.

On Feb 28th we found out that we are PG. So we conceived 4 days after that appointment. It took us 8 cycles. Which is not very long but is much longer than I tried for my other 2 and quite honestly, being constantly told you are old and sub-fertile is very depressing and makes you feel desperate.

I don't know that you want to subject yourself to that at this point. And if you lie to them and they think you've been TTC for over a year, they probably will want to do all kinds of interventions.

By all means go ahead with the SA. It's cheap, easy and if there is a problem, there are lots of things you can try (vitamins and supplements, acupunture) to increase his counts.

Concentrate on making yourself as healthy as possible but try (I know this is hard) to "let go" as others have suggested, a little bit.

Chances are very good that you will be PG within a year of TTC. Try to trust that.

Good luck.....

[filiadeluna]

Originally Posted by Julia'sMom

Also, I must admit that lying doesn't sit well with me.

Lying doesn't "sit well" with me, either, but I guess I felt differently about lying to a stranger (doctor/whomever) when it isn't going to hurt them any and has to do with my body.

Originally Posted by selkat

I'm a little concerned that your partner doesn't want you to chart. It feels like he's forbidden you to do and now you aren't *allowed*?!?

He hasn't *forbidden* me from it, but he asked me nicely to stop because he was worried about my mental state if I kept obsessing and worrying all the time. His concerns were genuine, but I just can't get it through his thick (stubborn) head that temping and whatnot can be worthwhile. I haven't brought up doing that stuff since I stopped though. I haven't discussed with him if he cares if I do it again, but I guess I just don't feel like having to explain it to him again. It's not worth arguing with him over it.

Thanks guys. Sometimes I just want to say "I am so over it" (trying to get pregnant). It seems like a lost cause. Sometimes I think about how young I still am and feel a guilty twinge of relief because my life can still revolve around my needs. Maybe I should just enjoy being young and forget about it? Maybe I'm just bitter. :

[kristenok18]

Originally Posted by filiadeluna

Thanks guys. Sometimes I just want to say "I am so over it" (trying to get pregnant). It seems like a lost cause.

But you've only been ttc 4 months. That is a drop in the bucket, it really is. Is there a reason that you want to investigate infertility testing now? Do you suspect something, or are you just impatient to get things going? Because infertility testing doesn't happen quickly. It can take months and months, even years. And it can be expensive, inconvenient, and painful both physically and emotionally. The stresses and strains infertility treatments can take on a marriage are significant. Way more stressful than just charting, imo. If you truly feel that there might be a problem, then by all means try to see someone. There is something to be said for intuition. I felt strongly that there was something going on with me after observing my charts over the course of a year, and I was right (pcos). Along the way we also found out we have male factors as well (surprise!). But just taking the step to seek treatment is not going to open any magical doors to having a baby. Starting treatments isn't a guarantee that you will get pregnant. Many of us here have tried quite a range of fertility treatments. Some work for us, many don't.

[barose]

[quote=kristenok18;10474670]But you've only been ttc 4 months. That is a drop in the bucket, it really is. Is there a reason that you want to investigate infertility testing now? Do you suspect something, or are you just impatient to get things going? Because infertility testing doesn't happen quickly. It can take months and months, even years. And it can be expensive, inconvenient, and painful both physically and emotionally. The stresses and strains infertility treatments can take on a marriage are significant. Way more stressful than just charting, imo. If you truly feel that there might be a problem, then by all means try to see someone. There is something to be said for intuition. I felt strongly that there was something going on with me after observing my charts over the course of a year, and I was right (pcos). Along the way we also found out we have male factors as well (surprise!). But just taking the step to seek treatment is not going to open any magical doors to having a baby. Starting treatments isn't a guarantee that you will get pregnant. Many of us here have tried quite a range of fertility treatments. Some work for us, many don't.[/quote]

Well said!

[RunnerDuck]

Originally Posted by filiadeluna

Maybe I should just enjoy being young and forget about it?

They're not mutually exclusive.

I have PCOS. Diagnosed at age 22 or 23. Spent a lot of time and energy then fretting over whether or not I could have kids... resenting pregnant women... etc. Wasn't TTC - just fearing it wouldn't happen when we wanted it to. Lo and behold got pregnant a month shy of my 26th birthday... while on birth control pills! Total shocker. And I was thrilled!!! And I love my son - but man having a kid really does change your life and while I would never say NOT to try just because you are young you should still enjoy all the young and childless things you can while you can.

I would not worry about not being able to get pregnant yet. 4 cycles is NOTHING. You have a 15-20% chance per cycle of getting pregnant. Human beings are remarkable infertile as a species. You don't even need to be neurotic about temping - you can tell a lot just by cycle length and cycle signs, for starters - to try to figure out if you are Oing. If your cycles are wildly irregular - it's a reason to go to a doctor. If not - temping or OPKs will give you more input but do you need to be that focused just yet? Up to you. Personally I find temping to be a PITA and would just as soon try to rely on OPKs which work very well for most women. In some cases they don't but you'll never know till you try.

Skip ahead a few years... I have been through 3 cycles of clomid, 3 miscarriages, 5 cycles of Bravelle injectables, 1 cycle of femara/Bravelle/Menopur injectables, and 1 cycle of menopur injectables before a successful pregnancy has come my way again. Got pregnant with triplets - was encouraged to reduce the pregnancy to twins. Whole new world of heartache. Infertility treatment is stressful. It takes so much out of you. Really, nothing you are saying makes it seem like you need to jump into the testing or treatment - I would enjoy being young, try to focus on being in love, try to let it happen naturally... give it at least a few more months.

[crazyrunningmama]

Originally Posted by RunnerDuck

Really, nothing you are saying makes it seem like you need to jump into the testing or treatment - I would enjoy being young, try to focus on being in love, try to let it happen naturally... give it at least a few more months.

I'm gonna say it again. Have a lot of sex. Every 3 days, all month long. I am not even being flippant, there are a lot of good reasons for this.

[filiadeluna]

kristenok18 -

I guess because I used to have DEBILITATING cramps as a teenager (not so bad anymore), and because I had an eating disorder for years... those two things always made me paranoid that I'd have problems having children. Then again, I don't really want to go through treatments if I don't have to. I didn't realize that most doctors are so quick to get you started without even doing proper testing/evaluation first.

RunnerDuck -

Sorry you have been through so much. Congrats on your pregnancy!

I think I *might* ovulate. I always have fertile CM and plenty of it, and my luteal phase is usually 13-14 days. Still doesn't guarantee that I ovulate, though.

Originally Posted by crazyrunningmama

I'm gonna say it again. Have a lot of sex. Every 3 days, all month long. I am not even being flippant, there are a lot of good reasons for this.

Every 3? I thought it was supposed to be every other day?

[barose]

Regarding the eating disorder, it may be a good idea to get some basic blood work done to check for possible deficiencies. I don’t know that much about the effect of ED on the body but I know it can cause some nutritional deficiencies even years after those ED habits are done.

For me, since I have PCOS AND have been bulimic on and off since I was a teenager (this is a LOT for me to admit online). I have done well by adding nutritionally dense foods to my diet to support my reproductive health and any future pregnancies. My cycles are just about as normal as they ever been in my life.

Chances are, you’re probably OK especially if your cycles are normal now, but some blood work might be a good idea.