TTC for 10 cycles - what next?

[roamingcat]

Hi everyone,

My husband and I have been trying to conceive for around 10 cycles (AF is due imminently) with no success. We're 31 and 33, normal weight, non-smokers, generally eat well, do lots of walking and run 1-3 times a week. We used to drink but have now cut it out completly. My cycle has always been super regular and my only "symptom" is my cycles are on the shorter side (26/27 days) and I get some spotting before my period starts.

We went for fertility testing two months ago and my AMH levels were good and nothing abnormal was found on my ultrasound or HyCosy. My progesterone did come back boderline low at 25.6 but the clinic said they thought it was okay - I am temped to follow this up though as the NHS guidelines say it should be 30. Prior to this I had a fertility blood test via Daye and everything was in the normal ranges. My husband's sperm morphology was low (1%), so he's been on Proxeed Plus since then. I take proceive, magnesium, folic acid and an omega 3.

We currently plan to have my husband retested in February and after that we will make a decision on next steps if we haven't conceived naturally by then e.g. do we want to try private IVF. Whilst I know it can take time, we're both proactive people so are looking for suggestions on anything else we can try in the meantime - either in terms of testing, cycle tracking devices (I'm wondering about a mira to see how my progesterone really looks throughout the month?), or other weird and wonderful things (is it worth me taking a probiotic? yoga? meditation?!) which may help. Thanks everyone!

Hi, it looks like you are doing all the right things but I did read about someone on another thread having a MTHFR gene mutation that impacts how the body breaks down folic acid and that can affect fertility, apparently it’s quite common, might be worth getting tested for that? It isn’t especially serious but will just mean you need to take a different type of folic acid. Also maybe just take one supplement (I’m going to try Ovum I think) to make sure you’re not getting too much of anything.

We are 37 and 44 so a lot older than you and have just started TTC baby no.2, I use an Oura ring to track BBT to predict ovulation. DD was a very happy surprise and so I am new to the TTC journey.

Wishing you all the best x

Was your progesterone definitely taken 7 days after ovulation?
I'm sure you know but thought I'd double check as some GPs insist on it being day 21 even though that would only be 7 days post ovulation for a women with textbook cycles with ovulation on day 14 which of course most of us don't have!

So I think it roughly was, but I don't know exactly when I ovulated that month! I am wondering whether I should try and redo the test and use ovulation sticks to pinpoint it more exactly...

It might be worth it just to be certain that you do ovulate, as 30 is confirmation of ovulation.
I had a couple of results around 25 but in hindsight they were mis-timed. Btw superdrug/randox etc do cheap-ish tests if you're happy doing your fingerprick. This helped me confirm I was ovulating a lot easier than trying to book in with GP at last minute (and of course the GP isn't open weekends so it eliminated that stress of what if I was to ovulate 7 days before a weekend).
I would say your first step should be to get some confirmation of ovulation as if not that needs treating. If you have regular cycles I'm sure you do but worth checking as obviously no ovulation means no pregnancy!
Make sure your partner takes the vitamins for at least 3 months before retesting as it takes sperm 3 months to regenerate. Assume he's also not drinking/smoking/healthy diet/restricting caffeine? And loose boxers/no saunas. I'm sure you know all that so don't want to be patronising, but from the info you gave above the most obvious cause of your lack of success would be his morphology so good to focus on that. I have heard that morphology is the least important parameter and also the most transient

Good luck! Hope you get there soon. If you do end up going for IVF I would say the actual process wasn't half as bad as I expected. In terms of needles/procedures. The waiting game is however a lot more emotional than trying naturally.

Thank you! I’m wondering about starting temp tracking to see if I can use that to track ovulation.

Yes, my partner is also doing all of the good lifestyle things with me too, and has been banned from baths!

That’s really reassuring to know re IVF - I think we’re probably going to go for it after his retest in Feb because I’m not sure what else we can do.

I would say if you can afford it then go for it if it hasn't happened for you after a year. Some people might say that's too soon but for me I wish we went for it sooner. We started IVF after 19 months trying but I wish we'd done it sooner while my mental health was stronger. It also takes longer than you think sometimes. For example I needed to freeze all my embryos as was at risk of ovarian hyperstimulation, so then had to wait for a withdrawal bleed then a period which adds delays. That's quite common. I've also now had two failed transfers so still in the process and we kicked it off in September, so it can be a long road. Not trying to sell it to you but also wanted to give the perspective that potentially a year is a good time to say it's not worked naturally and we need help. Plenty of people would recommended trying naturally for longer though I'm sure x

Thank you this is really helpful. The more I think about it the more sensible it seems to go for private IVF after a year, like you say it might not be straightforward and could be a long road. I think we will be eligible for one of the cheaper IVF packages too which is good. Do you have any tips/suggestions of things we can do now to improve our chances of IVF?

I took these (lots of evidence to say they're good for egg quality) and my partner took Impryl.
They're both only really useful if taken for at least 3 months though, but by the time you reach egg collection it may well be 3 months (stuff does take a while, paperwork etc).
I can't think of much else other than the healthy stuff you're probably doing already!
Best of luck with it if you end up doing it x