Q&A

At SpringCreek Fertility, we understand that, for couples experiencing difficulty achieving a pregnancy, the ability to conceive is elusive; the uncertainty can at times be overwhelming, and the questions are numerous. Here is a list of questions that we commonly get:

At what time of the month is a woman most fertile?
The day you start your menstrual period is “Day 1.” Around “Day 14″ you may ovulate and release an egg. The egg is viable for 24 hours; this is your most fertile time. However, not all women ovulate on “Day 14.” Some ovulate earlier and some later. Some women do not ovulate at all. Your ovulation pattern can vary month to month. Even if you are getting your period, that does not mean you are ovulating.

How can a woman tell when she ovulates?
One way of determining when you ovulate is to take your basal body temperature every morning and record it on a chart. Three or four months should be adequate to share with your doctor. You can also buy an ovulation predictor kit.

How often should we have intercourse?
Sperm can live for approximately 48 hours in the woman’s reproductive tract. It is important to have sexual intercourse at this time. It is a good idea to have intercourse every other day around the time you ovulate. (Day 10, 12, 14, and 16.) Remember that every woman ovulates at a different time. To increase your chances of becoming pregnant, do not douche or use lubricants immediately before or after intercourse.

How long should we try before we see a doctor?
Most physicians advise you not to be concerned unless you have been trying to conceive for at least one year and are under 35. If you are over 35 and have been trying for 6 months, you should consult a physician. If you are over 30 and have a history of pelvic inflammatory disease, painful periods, miscarriage, irregular cycles, or if you know that your partner has a low sperm count, do not wait one year. Consult your OB/Gyn.

Is it possible that we are not getting pregnant because we are too stressed about the whole process?
Significant stress can cause ovulation abnormalities, but if ovulatory function is normal, there is no firm evidence that worrying about becoming pregnant is a cause of infertility.

I am in my early 40s. Is it too late for me to have a child?
Because egg quality declines with advancing age, it takes longer for women to conceive as they get older, and the risk of miscarriage is higher. However, that does not preclude the possibility of having a successful pregnancy. The medical risk of pregnancy does increase with age, including the risk of gestational diabetes and pregnancy-induced hypertension.

I have been told that I cannot conceive because of poor egg quality. Where does one find an egg donor?
Egg donors may be either anonymous or designated. Most IVF programs have a list of young, fertile women who are willing to donate eggs anonymously. An egg donor is chosen by the couple based on physical characteristics, age, and other non-identifying characteristics. Some couples choose to use a relative or friend as an egg donor.

How does endometriosis cause infertility?
If severe, endometriosis can distort pelvic anatomy so that the pickup of eggs by the fallopian tube is difficult. The connection between milder endometriosis and infertility is less clear. Some experts believe that substances produced by endometriosis may be toxic to eggs, sperm, and/or embryos.

How does PCOS cause infertility?
In women with PCOS, the ovary doesn’t make all of the hormones it needs for an egg to fully mature. The follicles may start to grow and build up fluid but ovulation does not occur. Instead, some follicles may remain as cysts. For these reasons, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent. Plus, the ovaries make male hormones, which also prevent ovulation.

At what time of the month is a woman most fertile?
The day you start your menstrual period is “Day 1.” Around “Day 14″ you may ovulate and release an egg. The egg is viable for 24 hours; this is your most fertile time. However, not all women ovulate on “Day 14.” Some ovulate earlier and some later. Some women do not ovulate at all. Your ovulation pattern can vary month to month. Even if you are getting your period, that does not mean you are ovulating.

How can a woman tell when she ovulates?
One way of determining when you ovulate is to take your basal body temperature every morning and record it on a chart. Three or four months should be adequate to share with your doctor. You can also buy an ovulation predictor kit.

How often should we have intercourse?
Sperm can live for approximately 48 hours in the woman’s reproductive tract. It is important to have sexual intercourse at this time. It is a good idea to have intercourse every other day around the time you ovulate. (Day 10, 12, 14, and 16.) Remember that every woman ovulates at a different time. To increase your chances of becoming pregnant, do not douche or use lubricants immediately before or after intercourse.

How long should we try before we see a doctor?
Most physicians advise you not to be concerned unless you have been trying to conceive for at least one year and are under 35. If you are over 35 and have been trying for 6 months, you should consult a physician. If you are over 30 and have a history of pelvic inflammatory disease, painful periods, miscarriage, irregular cycles, or if you know that your partner has a low sperm count, do not wait one year. Consult your OB/Gyn.

Can uterine fibroids cause infertility?
Fibroids located on the outer surface of the uterus or within the muscle wall of the uterus are unlikely to be the sole cause of a couple’s infertility. Fibroids within the internal cavity of the uterus are much more likely to make it difficult to become pregnant and may also increase the risk of miscarriage.

I had a miscarriage recently. Does this increase my risk of miscarriage when I become pregnant again?
Women who have had one miscarriage have no increased risk of miscarriage in future pregnancies. If a second miscarriage occurs, there does appear to be an increased risk of pregnancy loss, and this risk substantially increases after three miscarriages.