Doctors Lounge - Fertility Answers
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Forum Name: Fertility
|jbrunson5 - Thu Apr 16, 2009 1:23 am||
My husband and I have been trying to conceive for the last six months unsuccessfully. I am 24, he is 26. I have no significant medical history with the exception of a term gestation in 2007. Our daughter was the result of an unplanned pregnancy while using natural family planning. I have used OCP's and Implanon in the past for contraception. The implanon was removed six months ago and I resumed my regular cycle that month. I have regular 24-26 day cycles and I am pretty sure I am ovulating every time around day 10 or 11. Ovulation is verified by abdominal discomfort and positive LH surge. I went to my regular OB to rule out infertility last month. On day 3 we did an ultrasound to observe my ovaries which appeared normal and had good reserve. All my bloodwork came back normal. My OB prescribed clomid 50mg days 3-7. On day 14 we did another ultrasound due to abdominal discomfort. There were 7 follicles over 20mm, 4 on the left and 3 on the right and my uterine lining looked "very good". I was advised to continue with daily intercourse and to make sure my husband was gentle with me due to my extreme discomfort. The next day I ovulated and the discomfort on both sides resolved. My OB is planning on continuing with another round of clomid 50mg if I am not pregnant this month and did not seem interested in referring my husband for screening. He basically told me it is the woman's problem most of the time. I am curious if I even need clomid or is my doc trying to give me a magic bullet? What are the chances of concieving this month? Am I at high risk for multiple gestation? Does working the night shift affect fertility? Should I insist on having my husband tested or should we just relax and let nature take it's course. I went to my OBGYN expecting for him to say don't worry just give it some time and now I feel like a science lab. Isn't trying to have a baby supposed to be fun? Please give me your opinions.
|Debbie Miller, RN - Fri Apr 24, 2009 2:41 pm||
At your age, the recommendation is to try on your own for a year. In that time 885% of fertile couples will conceive unassisted. Clomid is frequently used and your doctor knows your situation better than I do but it seems he perhaps jumped the gun a little. It is possible he sensed impatience for pregnancy on your part so wanted to help in this way.
Yes, you are at risk for multiples, which is the primary reason we recommend unassisted conception if it is possible and unless you are not ovulating on your own. As you surely know, multiples do carry considerable risk in morbidity and mortality. If you have PCOS or some other condition, clomid can help and most of the time a singleton pregnancy is the outcome, but you definitely have a higher risk of twins or more on this drug.
I know many women who take one round of clomid, then stop. Often within a few months they are pregnant - without the assistance of ovulation stimulation.
Discuss this with your doctor but you would certainly be in the norm to just give it time to happen on its own. You can always resort to intervention after a reasonable time. I know we like to think we can totally control this and conceive in exactly the month we desire, and we're often short on patience. It's good to plan for pregnancy so you can be in top physical condition when conception happens, but try not to overdo the attempts at control. Most women , even when trying to conceive, are caught a little off guard when it actually happens - a fun surprise.
You did not mention if your husband is the father of your other child. If so, you can be quite confident there is no need for testing him right away. Unless he had chemotherapy or some trauma that might have interfered with his fertility, it is unlikely he has developed it since then.
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