What Should I Do Next?
Question
I am 35 and my husband is 36. We have been trying to get pregnant for 14 months with no success. We are both in good health. About three months ago my gp did a full pelvic exam, blood work, ultrasound and sperm count. Everything was “normal”. My gp was going to try clomid but decided to send me to a gynoeologist. My appointment is in a couple weeks. I am concerned that three months of clomid will be another three months wasted. We have been trying for so long with nothing, I think there must be something more seriously wrong. Do you think clomid is a good next step or should we be doing more tests? I know 35 is “old” to be starting a family and that is why I don’t want to waste anymore time.
Jenz
Answer
Last Updated: February 13, 2014
Dear Jenz,
It sounds like your doctor did a good initial work up for infertility, and the referral for further testing and treatment by a gynecologist is appropriate. The gynecologist may check to see if your tubes are open, if this has not been done already. However, there is much that you can be doing to understand your own health and fertility to optimize your chances of becoming pregnant.
Learning one of the modern methods of natural family planning will help you understand your days of greatest fertility, and may help identify areas that need treatment. All of the modern methods include learning how to observe for cervical mucus. Cervical mucus plays a key role in allowing the sperm to pass, and nourishing the sperm. Sometimes being able to identify the day with the most fertile mucus will enable a pregnancy to occur, even if the sperm count is low. Also, if there is not enough mucus, measures can be taken to enhance the mucus. Even though Clomid may enhance ovulation, it can dry up the mucus, so to increase your chances of pregnancy, learning how to detect changes in your body will help guide the treatment for optimal outcomes.
Learning natural family planning can also help guide when the appropriate lab tests should be done, since charting your cycle will give you evidence of ovulation, and hormones are often best timed to the date of ovulation.
Learning the details of your own fertility will help not only this pregnancy, but will also be important for your health for the rest of your reproductive years. You owe it to yourself to invest in learning more!
Dr. Lynn Keenan
It sounds like your doctor did a good initial work up for infertility, and the referral for further testing and treatment by a gynecologist is appropriate. The gynecologist may check to see if your tubes are open, if this has not been done already. However, there is much that you can be doing to understand your own health and fertility to optimize your chances of becoming pregnant.
Learning one of the modern methods of natural family planning will help you understand your days of greatest fertility, and may help identify areas that need treatment. All of the modern methods include learning how to observe for cervical mucus. Cervical mucus plays a key role in allowing the sperm to pass, and nourishing the sperm. Sometimes being able to identify the day with the most fertile mucus will enable a pregnancy to occur, even if the sperm count is low. Also, if there is not enough mucus, measures can be taken to enhance the mucus. Even though Clomid may enhance ovulation, it can dry up the mucus, so to increase your chances of pregnancy, learning how to detect changes in your body will help guide the treatment for optimal outcomes.
Learning natural family planning can also help guide when the appropriate lab tests should be done, since charting your cycle will give you evidence of ovulation, and hormones are often best timed to the date of ovulation.
Learning the details of your own fertility will help not only this pregnancy, but will also be important for your health for the rest of your reproductive years. You owe it to yourself to invest in learning more!
Dr. Lynn Keenan
Answered By:
Lynn Keenan, MD
Lynn Keenan, MD, Immediate Past President of the CANFP Executive Board, is a Clinical Professor at the UCSF/Fresno Internal Medicine Residency Program (now retired), Board Certified in Sleep and Internal Medicine, and Vice President of the International Institute for Restorative Reproductive Medicine. She earned her BSN at UCLA, her MD at Temple University School of Medicine, and completed her Residency in Internal Medicine at UCSF/Fresno. Dr. Keenan served on the Executive Board of CANFP since 2004, as President of CANFP since 2010, and graciously agreed to continue her service to CANFP on the Advisory Board at the beginning of 2019, upon her retirement from the Executive Board of CANFP
