I’m new here and wondered if you could answer some questions for me. My husband and I have been trying to conceive for about a year now. The problem is I don’t ovulate for some unexplained reason. In the past year and a half, my cycles have run anywhere from 14 to 72 days long. In the past 8 or 9 months, they’ve all been excessively long. I started seeing an OBGYN who eventually put me on 50MG of Clomid. He did an ultrasound on CD13 and there was a mature follicle. He said it was a little smaller than he’d like but he still thought it was a good sign. He said it was “ready to pop.” He told me to test in three weeks (this past Thursday) if I hadn’t gotten my period. Well, I still have no period (CD 36) and HPTs are negative. I thought I would either have a positive result or a period by now. What is an average cycle length on Clomid? I still don’t completely understand what all of this means and what all is happening.
Also, I’m not sharing with people we know that we are trying. The last thing I want is people making me feel like it’s my fault for not doing some trick they read about. So, I’m wondering what your thoughts are on finding a good doctor. The office I’m with now is not good with communication. I have to call repeatedly for 3 weeks to get test results, etc. What’s the best route to take in finding a doctor who understands how emotionally painful this is and is prompt and attentive? Is there a good rating site you know about?
Thank you all so much for your help.[/quote]
Babyprayers2011: :welcome:!!! My experience has shown me that Ob/Gyn’s are not the best at getting women pregnant. Reproductive Endocrinology really is very complicated and the fact that you are not understanding your treatment is only further evidence to me that your Doc isn’t giving you the best possible chances for a successful cycle.
You shouldn’t have to wait for a period. Chances are if you have to wait for a period your progesterone is likely low because you did not ovulate like you should have. You could have ovulated, but maybe the follicle wasn’t as mature as it could have been thus resulting in lower than ideal progesterone levels.
A small lesson here just in case you are unaware or someone reading can benefit: What happens in your cycle is you have the first phase which is the follicular phase because you are maturing follicles. Then once you have ovulated you have the later half of the cycle which is called the luteal phase. During the luteal phase the collasped follicle that is left over from you having ovulated (called the corpus luteum) gives off the appropriate levels of progesterone which is used to help aid in sustaining a pregnancy should you become pregnant. However, if pregnancy is not achieved then the progesterone drops drastically and this prompts your period.
Therefore, if you do not ovulate or you ovulate a less than ideal egg then the corpus luteum either isn’t there or lacks the ability to produce the rise and fall of progesterone needed for a successful luteal phase and thus there is no drop in progesterone telling your body it is time for a new cycle. The more this happens the worse the problem gets because it is cyclical in nature. Meaning that if one cycles hormones are disrupted it will not set up the hormones properly for the next as so on. This is why when the proper treatment is given the response to the meds usually get better as treatment continues (with some exceptions).
What concerns me is that your Doc could have done a cycle day 21 progesterone test to confirm or deny your ovulation for this cycle. This is a very simple and straight forward test with little to no ambiguity. You either ovulated or you didn’t and the stronger the number the better the ovulation/more mature and viable the egg.
Sadly, even if an Ob/Gyn does ultrasound and bloodwork they sometimes just don’t have the expertise to know what the results actually mean so instead they go by if the lab said it is within normal ranges or not, but labs are not consistent from lab to lab with ranges and some results depend entirely on where you are in your cycle which often labs do not take into consideration. This could be why your Doc has no explanation for why you aren’t ovulating. Also, it is worth mentioning that 30% of PCOS patients do not show up as polycystic on ultrasound.
Therefore, I recommend a Reproductive Endocrinologist (RE) for anything female reproductive organ, hormone, and/or fertility related. Ob/Gyn can be great Docs, but where fertility and hormones are concerned RE’s are a much better option. They will do more testing to find out exactly what the problem is and tailor their treatment based on their findings rather than guessing like many Ob/Gyn’s do.
Many Ob/Gyn’s will hear you and just try to placate you by throwing meds at you and doing a little monitoring and sometimes the patient gets lucky with a pregnancy, but there are better, more productive ways to treat and usually those methods that an RE uses not only boosts fertility, but also the women’s overall and future health.
Okay so–you may be wondering what if I have to stay with my Ob/Gyn due to money/insurance issues and my answer would be that…1.) I completely understand because I have been there and 2.) in this case–the best thing you can do is educate yourself as much as possible about infertility testing, diagnosis, and treatments so that you know exactly what questions to ask the Doc and how to advocate the best care for you. Sometimes all it takes is the patient simply asking if they can try this or that or if the Doc is willing to do the CD21 progesterone test? Often all you have to do is ask for and expect more.
The downside that you cannot remedy with an Ob/Gyn is that because they are not in the business of getting you pregnant they are not always going to be available when your cycle demands their attention and this can be a huge hindrance and thus take you much longer to get that pregnancy or to even sustain the pregnancy once you get it because they just lack the education needed to be as specialized as fertility really requires. Of those that are successful, in my opinion, it was more about luck than skill.
Hope this helps! :flower: