when to take next steps

[Anonymous]

Hi-
We have been TTC for four months with charting and OPK's - I am positive our timing has been perfect each month. I am 33, so thought the standard was to wait at least six months to a year before next steps. However, this morning, I was re-reading Taking Charge of Your Fertility and she says that after four months of perfect charting that you should start pursuing infertility beginning with a SA. I am not aware of any issues with either of us except that I am very dry - I called my dr about that issue a few cycles ago and she had never heard of using robitussin to improve cervical mucus (we use pre-seed while TTC), but I'm going to try it anyway this month. Any other thoughts or advice? I am not panicking and probably wouldn't have thought twice about it if I had not reopened the book (to find the chapter on robitussin!)

[Anonymous]

I think you need to go with your gut. We were 30/31 and also had tried for 4 months before I talked to my OB about what we might be doing "wrong." After it didn't work the next month I made an appointment for my DH to have a SA - which revealed the "problem" and ultimately did start us down the road of IF treatments. I'm not saying you'll be in the same situation. But I think you need to trust your instinct. I also think you and your DH need to be on the same page - doing a SA can be a big deal for guys (the process itself can be very stressful) so I'd have an honest conversation with him abou this thoughts as welll. The other testing that a RE would do is primarily blood work for both of you to look at a host of factors (some of which needs to be timed with your cycle) along with most likely a HSG. Keep in mind that it can take a while to get an initial appointment with an RE (please do the testing with a RE - not a OB) and can take a while to do the testing depending on the timing of your cycle. Then depending on your clinic's size you need to wait to get in the "que" of when to start your birth control, etc. So I want to say we had the SA in August and started our first IVF cycle in January. Probably not a typical wait but we had to do a lot of extensive testing to really figure out what was going on. Good luck!

[Anonymous]

OP-here-thanks so much for your thoughtful reply. It definitely helped me to think through additional things I hadn't thought of yet.

[Anonymous]

I would advise to be proactive as much as possible. I started TTC when I just turned 34. After a few months of using OPK, nothing. I then charted for another 6 months, nothing. My GYN was like "don't worry about, just have lots of sex and make it fun." Yea, that didn't work. I finally went to a RE a few months ago. I am now staring at 36 and wish I had done something a bit sooner. I just didn't want to admit something was wrong.

[Anonymous]

OP, it doesn't sound like you need to panic at all. Isn't the rule of thumb (for trying on your own) one year for under 35 and 6 months for 35+? DepeBeing on your insurance plan, you might not have coverage for fertility tests/treatment until you've been "trying" long enough, or until your doctor suspects a problem (regardless of time trying).

[Anonymous]

My only other recommendation is to get to an RE sooner rather than later. Some OBs don't have the experience. Plus who wants to be in a waiting room with pregnant ladies and babies all the time when you're ttc?! Good luck!

[Anonymous]

OP, I tried for 10 months with perfect charting before succeeding (32 yrs old). Read TCoYF and it really freaked me out with that part, too. I was sure there was something wrong with me, but that book is sort of infuriating. For example, I have 20-day luteal phases, which means the "after 18 days of high temps you're pregnant!" was totally false for me. I couldn't trust the book because it generalizes everything -- it's really only a "bible" for women with regular cycles, not people with unusual cycles or body temps. For everyone else it's good info but don't take it too seriously.

Everyone's different, so don't be too concerned that 4 months hasn't yielded anything. Because I didn't realize that, I did the workup (SA for him, day 3 hormones and ovarian ultrasound and HSG for me). What did it find? Nothing. The only thing testing did was make me crazier (because I had NO IDEA why it wasn't happening), and poorer (all those tests ain't cheap).

Now, I do think you should be open to pursuing tests if things still aren't working after 6 months to a year, but don't let that book make you panic. If anything, get a monitor or OPKs to make sure your charts are accurate, and try to get as wet as you can on the "peak" days -- Preseed, Mucinex, get turned on as all hell, etc. If I could tell myself from a year ago anything, it's that one year is not too long to wait if you're under 35, as long as you commit to doing everything you can after that year, if need be.

Now at week 16 of a very easy pregnancy, I have been there and done that -- do keep trying! And if you want the tests, go for it (but there's always unexplained fertility, so testing might not give you all the answers, either). Just try to be patient and remain as relaxed and happy as you can (mine was conceived on vacation, so I think stress was a big factor).

[Anonymous]

OP-here- thanks to all of you for the helpful advice and anecdotes. I really appreciate it - I think I'm going to give it one more month of trying - then call and make appts (which will probably take me 4-6 weeks to get giving me 6 cycles of trying). To PP, I have a monitor and OPKs (I sound over-engineered, but I started using both when I realized my OPK was going positive for at least 48 hrs- I must have a long LH surge b/c I also don't ovulate on the peak days of the monitor either and instead on day high after two peaks at least according to Fertility Friend and my temp charts). I do also appreciate the advice to seek an RE instead of OB - I adore my OB and she's quite academic, but I was disappointed that she blew me off about the robittussin/mucinex solution that is mentioned in tons of fertility literature.

[Anonymous]

OP here again - PP I should have said congratulations!!

[Anonymous]

Just wanted to give my $0.02 on the TCOYF book, which at 34 I treated like the bible, unti I figured out it was for a small group of women with 'perfect' cycles. It really does make you feel pretty lousy if you're not having egg whites the length of a football field....
So, I chucked it 6 months into trying, went to my OB, who put me on Clomid, saying my problem was anovulation.
Fast forward six months, nothing happened, so I went to SG. 4 more months of timed intercourse with Clomid, 1 failed round of IUI, and I'm now irritated I didn't just bit the bullet and do IVF first.
I guess for us, time and months of appointments, uncertainty, worry, etc., is just not worth it.
So, I would counsel others think more of timing, when your drop-dead date is, what is going on in your life/work, etc., to round out the decision.

[Anonymous]

Thanks - my cycles appear to be normal according to TCOYF and my monitor, but I guess it's just hard to say. . .I really appreciate the advice.

[Anonymous]

Just one more bit of advice. Do some research on your insurance coverage for infertility testing and treatment before you see the doctor for the first time. Many plans require that you have been "trying" for a set period of time before they will cover any intervention. Be sure to tailor the answers in your introductory questionnaire accordingly. In other words, if your insurance requires a year of trying before you can get coverage and you want to proceed now, you probably should tell the doctor it's been a year, even if it hasn't been.

[Anonymous]

Agree w/ 21:54: pass that protocol and get to what matters. I also talked to some nurses familiar w/ The Creighton model -- they can help w/ CM (that's what they study and my problem too). I went the TCM route instead and this Chinese herb gave me CM like I've never had before. No luck yet -- but there's stuff out there w/o going to a clinic and at 33 w/ trying only a

[Anonymous]

(oops hit send) ... couple of months, you might be better off w/ a more natural, less invasive method. I wish I'd tried that first as I dread the endless poking and prodding and intrusiveness of fertility clinics.

[Anonymous]

Excellent advice on the forms - thank you!
The Creighton method sounds promising - I am not a big "herbs" person, but I hate being poked and prodded (which is probably honestly why I am thinking "hey, I'll give it another month") - so I suspect I'd prefer herbs to poking and prodding!!