http://dcfertilitycare.com
I like Alison Contreras in this group. She will have OB suggestions.

Anonymous wrote:I've searched the forum and find lots of recs for IVF clinics and specific docs in those clinics, but I'm wondering if someone can recommend a RE who will look at BBT charts, listen to questions, and test for things beyond the obvious (blocked tubes or fibroids)? I'm feeling frustrated with my RE who has diagnosed me with unexplained infertility and jumps to IVF due to my age (40). Trying not to go down the rabbit hole of research, but reading books like 'Making Babies' and TCOYF it isn't hard to see there are many other things to test (hormones) and try (supplements), and my RE seems to shrug them off. I have had the basic blood tests (AMH, FSH, TSH, etc) and they are decent for my age but asking for anything beyond the basics and I get the feeling I'm seen as pushy and told no anyway. Anyone have a doc they love?

If you want touchy-feely talks about your charts and thoughts your best bet is to 1) go to a naturopatic specialist/acupuncturist/reiki person and 2) do the IVF at the same time.
That way you get an outlet for talking and action for having the baby.

REs are clinical staff. Charts at 40 are a crap shoot, spend 20$ and at least pee on sticks if you want to make a point about your cycles.

OP - Sorry to hijack your thread, but I have a similar question. I'm 34, DS just turned 2, and my husband and I have been TTC for the past nine months. We just started formally charting this month, and now I can see why we haven't gotten pregnant. I've been getting terrible migraines around Day 21, then heavy spotting 3-5 days later, then the regular period about 7 days after the migraine. Turns out the migraine follows six days of on-and-off eggwhite and coincides with a slow thermal shift. I ovulate much later than I thought (around Day 19), and my luteal phase is only 6-9 days. Now that I have this data, who do I go to for help?

Chart for another month or two and see if your luteal phase is really that short consistently. Then try taking vitamin b6 and vitex (a herbal supplement...you can read about how to do it online on TTC sites). I had this problem and lengthened my luteal phase from 10 to 11 or 12 days...not super long, but long enough to conceive just a few cycles later.

Anonymous wrote:OP - Sorry to hijack your thread, but I have a similar question. I'm 34, DS just turned 2, and my husband and I have been TTC for the past nine months. We just started formally charting this month, and now I can see why we haven't gotten pregnant. I've been getting terrible migraines around Day 21, then heavy spotting 3-5 days later, then the regular period about 7 days after the migraine. Turns out the migraine follows six days of on-and-off eggwhite and coincides with a slow thermal shift. I ovulate much later than I thought (around Day 19), and my luteal phase is only 6-9 days. Now that I have this data, who do I go to for help?

Slow thermal shift isn't a problem; I had one the month I got pregnant.

I don't know how you can be sure your luteal phase is 6-9 days if you've only been charting one month. It's possible that your migraines don't always happen during or right after ovulation. You could also get EWCM after ovulation -- for me personally, it sometimes takes a day or so to fully dry up after ovulation. One month's worth of data isn't enough to set off alarm bells yet.

As the PP said, give yourself a few more months of TTC with charting and excellent timing before going to an RE. In the meantime, you can look at making some lifestyle changes if necessary, like eating better, getting regular exercising, losing some weight if you're overweight. Some women also swear by B-6 to extend the luteal phase, though I found that taking a B complex vitamin actually shortened my LP.

Good luck!

Anonymous wrote:OP - Sorry to hijack your thread, but I have a similar question. I'm 34, DS just turned 2, and my husband and I have been TTC for the past nine months. We just started formally charting this month, and now I can see why we haven't gotten pregnant. I've been getting terrible migraines around Day 21, then heavy spotting 3-5 days later, then the regular period about 7 days after the migraine. Turns out the migraine follows six days of on-and-off eggwhite and coincides with a slow thermal shift. I ovulate much later than I thought (around Day 19), and my luteal phase is only 6-9 days. Now that I have this data, who do I go to for help?

The bedroom. Now you know when you're ovulating! Try to get it done during your window. If it doesn't happen in 3-6 months then make an appointment with an RE. There are a lot of options (everything from heavy monitoring to triggering and what not)

OP - Sorry to hijack your thread, but I have a similar question. I'm 34, DS just turned 2, and my husband and I have been TTC for the past nine months. We just started formally charting this month, and now I can see why we haven't gotten pregnant. I've been getting terrible migraines around Day 21, then heavy spotting 3-5 days later, then the regular period about 7 days after the migraine. Turns out the migraine follows six days of on-and-off eggwhite and coincides with a slow thermal shift. I ovulate much later than I thought (around Day 19), and my luteal phase is only 6-9 days. Now that I have this data, who do I go to for help?

OP, I know it's not what you want to hear, but I agree with the others. You are 40 and if it hasn't happened and you want a baby, it's time to explore other options.

You might be able to find a doctor who will do whatever hormones tests you want. And they might find a reason for your infertility. That might make you feel better. But at the end of all that, then what? You still have a very good chance of needing IVF, even if they DO find out exactly what is wrong. IVF is the treatment for most issues. Is finding out the exact reason more important than having a baby? Time is of the essence, that's why your RE is pushing you to IVF. I'm sorry it feels you aren't being heard, that is really tough. But he's pushing you because he's seen your story MANY times before and knows how it ends. It ends with a baby from IVF.

If you don't like your RE's approach, get a 2nd opinion for sure. But I think you'll find any RE will recommend IVF.

Good luck. It's not easy.

Do you want to have a baby, or do you want to sit around and talk about charts?

Anonymous wrote:I think you can dick around with charts, or you can try to have a baby. You are 40 and are having problems conceiving. Why on earth are you wasting your time? Time for IVF.

I agree. Sorry OP. Unexplained just means that you are old. If you are trying for your first, I'd go straight to IVF if it's not happening with well timed intercourse.

I think you can dick around with charts, or you can try to have a baby. You are 40 and are having problems conceiving. Why on earth are you wasting your time? Time for IVF.

The dye test to the PP above is an HSG. It's ok for detecting blocked tubes but less for uterine anomalies (like a septum or a bicornuate uterus), for that a pelvic MRI or a 3D sonogram are a bit better. I think if you're worried about mullerian anomalies (the technical term for malformation of the uterus, tubes etc), talk to your doc and say you want to be tested for them. Also, there's s great yahoo group called mullerian anomalies.

I don't think that you'll find an RE who is going to look at BBT charts at your age. They're suggesting IVF because you're already 40. At your age, only 1/10th of your eggs are genetically normal. IVF gives them the opportunity to retrieve more eggs, get more embryos, and do genetic tests to see how many of them are any good.

But you are in charge of your own fate. If you want certain tests (I'm thinking of the dye tests that checks for blocked tubes and other issues in the uterus; I can't recall the clinical name of it) or to try certain hormones, you'll have to ask. I doubt that you'll find an RE who is willing to try a natural approach with you at 40, so if that is what you want, you'll have to push for it. If everything shows up normal on the rest of your tests, you can always keep trying on your own with well-timed intercourse.

OP at your age I wouldn't meSs around...

If you want a natural approach to fertility go to Tepeyac Family Center.
They will closely examine BBT charts, test hormones, etc.

I've searched the forum and find lots of recs for IVF clinics and specific docs in those clinics, but I'm wondering if someone can recommend a RE who will look at BBT charts, listen to questions, and test for things beyond the obvious (blocked tubes or fibroids)? I'm feeling frustrated with my RE who has diagnosed me with unexplained infertility and jumps to IVF due to my age (40). Trying not to go down the rabbit hole of research, but reading books like 'Making Babies' and TCOYF it isn't hard to see there are many other things to test (hormones) and try (supplements), and my RE seems to shrug them off. I have had the basic blood tests (AMH, FSH, TSH, etc) and they are decent for my age but asking for anything beyond the basics and I get the feeling I'm seen as pushy and told no anyway. Anyone have a doc they love?