I have some questions

I've never posted in this forum before, so I'll do a quick intro. My name is Stacy and I'm the mom of 6yo b/g twins. My twins were conceived without assistance. In fact, I was on BC pills when I got pregnant.

I went on the Depo Prevara shot for BC after my twins. This caused my periods to stop completely (this is common). In August of 2010, I was due for my shot, but DH surprised me by saying we could try for a baby. So, I didn't get the shot then and my last one was probably in May of 2010 (I don't know exactly when). I talked to my doctor and knew that it could take a while for fertility to return. But, he said that I should be fertile again when my periods returned and became regular. I started my period in December 2010 and they were like clockwork from the very beginning.

Fast forward a year and I still wasn't pregnant. Because of some financial issues, DH and I decided to stop trying for a while (I'll be honest, it was really him. I would like to keep trying.). So, I planned to go back on BC after I saw my doctor in February. If I had gotten pregnant in the meantime, he would have been fine with it. So, I've started back on BC. My doctor and I decided that the Nuva Ring was the best option for me since it won't interfere with infertility long term like the shot can. So, if DH and decided to start trying again next month, I wouldn't have to wait.

But, because it has been over 14 months since I had started my period again and I hadn't gotten pregnant, I was concerned. My doctor suggested we go ahead with a semen analysis for my DH to rule him out. DH did this and his results just came back. He is fine and not the problem.

I admit that, even though I'm glad DH is fine, I am upset. I'm worried that something is really wrong with me and it will be harder to address the longer we wait. But, we can't even do anything while I am on BC. So, I'm stuck just wondering what is wrong and what we need to do.

I know that if it would require fertility treatments, DH would not be on board with that. One of the reasons he has waited so long to consider trying for another is because he is terrified we will have twins again. Don't get me wrong, he loves the kids, but having twins is hard and he is afraid of doing it again. Fertility treatments would just increase those odds.

So, while I'm stuck in this limbo, I'm just wondering some stuff. For example, if we were to decide to take the next step, what would that be? Are there some things they would rule out before starting in with treatments? If so, what would those things be?

The not knowing is just tearing me up. But, I know there is nothing I can do right now.

 

:hug: the not knowing is the worst part. My ob did a full blood work up first, and found out my thyroid was low, so i was started on synthroid as my first step. After a few months on that, and still no cycles, my ob started me on clomid, which is really easy and non invasive, it's pills for 5 days at the beginning of your cycle. It helps strengthen your eggs up and has a very low chance of twins with it. (Obviously it can happen but it's still a very low risk.) I would also suggest looking into getting/reading this book Taking charge of your Fertility, i loved this book when we were trying to get pregnant and going through our infertility journey. In it you'll learn how to take your basal body temperature (BBT), which, over the course of a few months, will show you when/if you are ovulating. This will help you time your sex accordingly

After the thyroid and clomid, I was moved onto an HSG (hysterosalpingogram I think is how it's spelled). It's a dye test, they inject it into your uterus and up through your fallopian tubes, making sure there's no blockages anywhere that's preventing your egg from coming down. It's annoying, not super painful but crampy afterwards. I also had a post coital test, which is kinda embarassing. You schedule your appt for first thing in the morning, and you have to have sex before you go, and then they examine your cervical mucus to see if the sperm are moving through it, make sure it isn't toxic to sperm. And I had an endometrial biopsy, to be sure my endometrial lining was good.

It wasn't until all this was over with, and I had moved onto a reproductive endocrinologist, that we started on the more hard core fertility meds and IUI's. The odds of having twins steadily increases with the increases in medications.

:hug: good luck to you!

 

Good Post!

I agree with the book suggestion and also some simple testing from your OB. Depending on what they find will determine where you go from there!

For DH- we went straight to IVF since both of us had issues per testing (was going to do Clomid, but if a man has concerns it is not really helpful usually). I had the HSG test and ovarian scan...both let us know that IVF was it.

I agree that clomid may be the next option for a few months. Also at the same time/before/after they may do the HSG and/or bloodwork just to check what is going on. They may also an ovarian reserve count and FSH level (the higher it goes the harder it is to get pregnant and it goes up as you get older). You may not be getting a lining, you may not be ovulating (even with regular periods), you may have low/high hormone levels ....etc. Really it could vary widely! The treatments also vary a lot. Some are easy and some are not.

Talk to your DR now and get the testing done while on BC if you can, then when you *are* ready to try again, you dont have to wait a cycle or two of tests. Fertilitywise 6 years can be a big difference unfortunately-- I had very low fertility at 26....now at 33, my OB put my chances alone (not counting for DH and his own issues) at less than 10% of natural conception, with DH taken in to the equation we have less than 1% chance. At 26 I was given a 20% chance on my own and we had a 10% as a couple- it changed that much over 6 years.


Good Luck!! I hope you get some quick and easy answers and get back to the business of trying to to expand your family!!

Also-- how old are you, have you gained/lost a great deal of weight since you were last pregnant, do you take any medication that may affect fertility? Those are all things the OB will need to know.

 

I am 32. I lost around 60 lbs a couple of years ago, but gained it back. Other than that I'm pretty much the same weight I was pre-kids. The only meds I've really taken have been and anti-depressant that I was also on pre-kids and the Depo shots. There were a few antibiotics in there and stuff, but nothing that I know effects fertility.

 

I know that when I started my infertility journey the first thing my OB wanted to figure out was if I was ovulating. It may be worth it to stop the BC and use condoms in order to get a good picture of what is going on hormone wise. Once off BC, you could start measuring your basal body temps to get an idea of your cycle length, ovulation day, luteal phase, etc. There is a site called Fertility Friend where you can input your temps and it will give you a graph and predict when ovulation occurs. You could also get your progesterone (usually measured right after ovulation, so can't measure while on BC) and thyroid checked. If there are problems with either of those, it is often an easy fix. The other thing you can do to confirm the presence or absence of ovulation is use ovulation predictors (like a hpt but measures LH surge) daily and have an idea of whether you are ovulating or not. Once you know whether you are ovulating each month, your OB can decide if you need an HSG or ultrasound or if you need to be referred to a specialist. Then, once you are ready to TTC again, you will have a plan to move forward.

 

I have read lots of info about Depo possibly being the cause of infertility in some women. I don't know if it's true but I have read posts on other message boards about it.

 

For me, we conceived DS#1 within 3 months of trying (DH felt cheated LOL) then we tried for 2 years after DS#1 turned 1 and did not get pregnant. My doctors started with bloodwork, HSG, and mapping of the uterus/lining before starting with treatments. For treatments, they tried several things. First, they tried clomid, then IUI with clomid, then IUI with injectables. When none of that panned out, we used IVF and got pregnant with twins.

It is very important that you get your medical testing done before deciding which course of treatment to take. If you are not having your period, that is a sign of a hormone imbalance and should be looked at. Call your OB and ask if they can do a fertility work up. If not, ask them to recommend an RE. The medical testing/diagnostics is usually covered by insurance, with applicable co-pays.

After we had DS2/3, we decided we didn't need to use protection since we were "infertile". That resulted in a spontaneous pregnancy and miscarriage. We are trying again and may pursue IUI soon because I am becoming older than dirt and would like to finish having babies by the time I am 40.

 

I am having my period - and very regularly - now that I am off the Depo Prevera. No periods is common on the shot and expected. But, my periods returned within 3 months and were like clockwork after I didn't get the last one.

 

If you think you are ovulating, then you can chart your cycles. The book Danielle linked above is awesome! By charting you can see if there is something going on with any of the phases of your cycle before you begin an infertility work up. Your OB can do a work up, but really you might want to have a consult with a reproductive endocrinologist. S/he can do blood work during various times in your cycle to see if your hormone levels are ok (the Nuvo ring isn't hormone BC is it?), and can talk to you about your options for treatment. Not all treatments have to increase your risk for multiples. In fact, REs do their best to achieve a singleton pregnancy.. that is the goal. Good luck and hang in there.

 

I'm not sure about much of this, but wanted to weigh in on Depo. Stacy, I was on it for 10 years and my period start back up fairly quickly after stopping my shots. The doctor put me on a hormonal BC, though, because she said that often women won't actually ovulate for awhile after coming off the shot (even with periods). I was on the pill for almost a year before I missed one and ended up with my girls.

 

Right now, I would start charting your period. Also, I use FMC app for the iphone to track my period and tell me when I am fertile. I am also using a clearblue easy fertility monitor. It is like the OPKs but supposed to be better. It's expensive but I needed to waste some FSA funds and bought it. I figure I'll do this for a short while then go see my RE.

 

Yes, the Nuva Ring is hormonal. So, no ovulation. I believe life begins at fertilization, so it was very important to me not to ovulate at all if I was on a birth control.

I have been charting my cycles every month as far as the dates of my periods. But, nothing else. Now, I can't really do anything since the ring will even control when my period happens. Sorry, that is a little bit of my frustration coming out. As I said, waiting is really my DH's idea. I understand his reasoning, but don't really agree with him. But, having a baby when both parents aren't in agreement is just asking for trouble, so I am trying to be patient.

Thank you so much for this. I did do research on the shot and knew that it could have some short-term effects on fertility. But, statistically, there is no evidence (other than anecdotal) to say that it has long-term effects. After reading the other post that said I may have made myself infertile by using the shot, I spent the rest of the day sick to my stomach and never far from tears. I needed this reassurance and hope.

Thank you all for sharing this information with me. I will probably be making an appointment for a yearly check-up with my PCP soon. I can ask him for a complete blood workup and my insurance will cover it at 100% since it is a well-check. That will help rule out thyroid (always a worry since my mom had Grave's Disease) and some other stuff. Then, I'll talk to my gyno to see if there is anything else we can do while I'm on BC.

 

:grouphug:

 

You can definitely chart cycles if you go to using a barrier method. A little more involved but really not that bad. Between my twins and my singleton I avoided OCPs because I didn't want to interfere with milk supply so we used condoms until ready to TTC again. If you went this route you could get evaluated by your gyn and once your DH okays things you could start right away.