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Conception

When's the best time to get pregnant? Use our interactive ovulation calculator to work out when you're most fertile and most likely to conceive.

Original poster

What would you do next?

29 replies

hopelesslydevotedtottc · 10/01/2024 16:54

Hi all, looking for some advice. Background:

  • DH and I have been ttc baby number 1 for 14 months. Never been pregnant.
  • I’m 31, DH is 32
  • Semen analysis normal
  • Semen DNA fragmentation normal
  • Ultrasound normal - have PCO but not PCOS
  • Regular(ish) cycles (between 27-34 days)
  • Day 21 progesterone normal but on the low side (25) - OPKs and BBT show I’m ovulating
  • AMH is good
  • Hycosy is normal
  • Only red flag is spotting before period, sometimes for 7 days

We fall into the infruriating ‘unexplained’ category and I don’t know what to do next. Feel like I have tried everything: acupuncture, preseed, fertilily cup, reflexology, you name it.

Would you:

a) keep trying naturally and hope we have just got unlucky so far?

b) push for more tests, and if so which ones?

c) ask for Letrozole and / or progesterone (just to try something?!)

d) cry into some white wine and galaxy chocolate?!?!

OP posts:
Outliers · 10/01/2024 17:52

@hopelesslydevotedtottc I (personally) think doc is right in that OPKs are a more scientific way of establishing ovulation. BBT, while it works for many, is a very flawed metric system, as there are a host of factors that can affect basal temp.

Doc is right regarding spotting as well, I think it depends how early. if it's circa days before period is due, I don't think it's much to worry about.

The unscientific suggestion would be to ensure your orgasms and keep legs raised afterwards😅

A good friend of mine experienced unexplained issues for a long time, over 2years trying. Eventually they randomly had a son. They didn't both with contraception given their issues, and 6 months later conceived another even though they weren't TTC. From what I've seen can be quite frustrating as there's no obvious remedy. But a positive is that there's physiological barrier, it's just about chance and luck facilitating. I hope though, you don't have to wait much longer.

thehurtingheart · 10/01/2024 17:34

I second the post ovulation progesterone... I'm sure I've read about that somewhere for people with spotting pre period. I think maybe it was the PROOV testing kits that had some blog articles about that. I wonder if pco without pcos would still be positively impacted by treatments with either or both metformin / inositol. I only ask because I was shown to have PCO on scan and with no further testing my specialist just said it is likely PCOS (I do have some symptoms) and put me on both of those. It may be worth looking into. I wouldn't suggest waiting further purely because the longer it takes it may impact of future plans if you were hoping to have more than one little one. If you wait another year and then progress with other testing / treatments you might wish you'd started earlier. Wishing you all the luck.

Original poster
hopelesslydevotedtottc · 10/01/2024 17:22

Hi @Outliers thanks for the reply. I actually had all the tests done privately as waiting times where I live are pretty ridiculous. My region also has very strict IVF criteria (only one NHS-funded round, must be between 30-34, if unexplained must have been trying for two years) and very long waiting times so wanted to get the ball rolling as quickly as possible just in case.

My doctor has been pretty dismissive of BBT and says just to use OPKs so I’m trying to step back on the tracking. We already DTD at least every other day over fertile window so I’m sure we aren’t getting the timing wrong.

That’s what I’m worried about with the spotting too. My doctor just dismissed it and said lots of women spot before their period, but looking at my BBT my temps do seem to drop from about 8 or 9DPO / a week before my period which I’m worried is affecting implantation…

OP posts:
Outliers · 10/01/2024 17:02

I'd have a private fertility assessment (assuming all assessments have been under the NHS). I'd probably DTD every other during fertile window, and try to avoid overtracking as I'm sure you've exhausted all tracking options by now.

I'd speak to doctor to explore post-ovulation progresterone supplementation, considering it's on slightly low side, just to see if it helps. Spotting early may indicate earlier shedding of endometrial lining. So you never know, worth a shot. Caveat being that it may result in late periods, which some find more tortuous for obvious reasons.

I'd try another year at least natural.