[beginning fertility issues]

Information for TTC Couples...

Written by TTC Couples.


Low-Tech Ways to Help You Conceive - Chapter 2

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Low-Tech Ways to
Help You Conceive


    2.1 Some General Recommendations

    2.2 Some Real-Life Success Stories

    2.3 Tales from the ONNA (Oh No, Not [my period] Again!) list

    2.4 The 1995 New England Journal of Medicine (NEJM) Report on Maximizing Fertility

    2.5 Other Overall or Miscellaneous Methods for Both Partners

2.1 Some General Recommendations

RAH - What's the single-best thing a couple can do to increase their odds of conceiving? Well, if the answer were that simple, we wouldn't need this FAQ, would we? - not to mention a shelf full of books and other references. However, if I had to pin down the one vital best-odds low-tech method, I would say: TIMING. The vital key is to find out when the egg is ready and waiting, and make sure that numerous, healthy sperm are there to greet it. How to make this happen? Well, that's the rest of this FAQ! - RAH

My husband and I had sex for the first time without any protection. The only trouble is I started my period the following day. What is my chances of getting pregnant.

To get pregnant, you need to have unprotected sex around the time of ovulation. Ovulation occurs about 14 days [in most women] before your period is due. So, if you have regular 28-day cycles, you will probably ovulate around day 14 (the first day of your ... period is day 1). Sperm can live for a few days & the egg can live about a day, so most of the experts suggest you try every other day or every day from about 5 or 6 days before you expect to ovulate, up through the day of ovulation or the next day.

The every other day thing didn't work for me last month, so this month we tried every day for 5 days...we'll see in a few days if anything happened!

I've heard that caffeine & hot baths (for either partner) can interfere with conception, as can using a lubricant. It's also good to get your husband to wear boxer shorts instead of briefs, if he isn't already, so the sperm won't get overheated...

A lot of pregnancy & fertility books explain how to chart your temperatures [Basal Body Temperature, or BBT] so you can have a better idea what your cycles are like & when you are likely to ovulate--you can do that if you want (I do, but I'm obsessive anyway!). There are also ovulation predictor kits [OPKs] you can buy to help you know when to have sex, but they tend to be a bit expensive ($20-$30).

You should have your partner's sperm count checked if you have not conceived in 1 year. He should be avoiding tobacco, drugs and alcohol completely prior to conception. All of these things lead to a reduced sperm count and/or damaged sperm. Also, he should wear loose fitting clothing, boxer shorts and loose trousers. Tight clothing increases the temperature in the scrotum and decreases the sperm production.

Your partner should also avoid cottonseed oils as found in many processed foods and salad dressings. This item is used as a birth control product in many third world countries and does lead to decreased sperm production.

You should be taking prenatal vitamins prior to becoming pregnant. Most important is taking 1 mg of Folic Acid daily to reduce the risk of certain birth defects. You also should avoid medications, tobacco products and alcohol in any form. Make sure that you are living and working in a smoke-free environment.

[In order to determine when your most-fertile time is during the month,] Start taking your Basal temperature (your core body temp after at least 6 hours of sleep) at the same time every day. You need to buy a special thermometer for this. They are found at any pharmacy. You should take your temperature VAGINALLY no matter what the instructions tell you. This is the most accurate method. Leave the thermometer inside you for 5 minutes. Take your temp at the same time every day and note any emotional difficulties, intercourse, illness, and vaginal discharge. The instructions will tell you how to interpret.

[RAH - Vaginally (or rectally) is perhaps the most accurate way to take your temperature; however, if this is difficult for you, taking your temperature orally should be acceptable for most. If you see a pattern of erratic readings with oral temperatures, vaginal or rectal readings are worth a try, to see if the pattern improves. See Sec. 9.3 for further discussion. - RAH]

Would you mind posting a summary of all the different suggestions you received [for best intercourse methods]?? I would be very interersted to read it all in one place.

Okay, here it goes. Some of the suggestions are graphic, so if you get offended or blush easily, don't read on. Now, I don't claim any of these work, but I would have tried anything (and did!), no matter how silly it sounded. These are all the ones I tried, and can remember:

    * Make love in the daytime, or with the lights on.

    * Make love in the missionary position or doggie style for deep

    * When your mate reaches orgasm, have him drive as deep into you
    as possible.

    * Also, you should reach orgasm right after him. Apparently
    when women orgasm, it opens the cervix, and the cervix sort of
    drops into the vagina and kind of sucks up the sperm. Sorry,
    I'm not explaining this properly, but I'm sure you get the

    * When you are finished, lay down with your legs and hips
    elevated for at least a half hour, or as long as possible.
    What I did was stay with the pillows under my hips for 45
    mins, then tried to lay down on the couch or kind of stay
    prone to help the little swimmers fight gravity.

Last, but most importantly, try not to be too stressed, and don't let your love life turn in to work trying to concieve! That almost happened to us, and no one needs the added stress. Try to relax, and enjoy the moment. Try to make a nice relaxing, romantic evening out of it.

There is some good information in _The New Our Bodies, Ourselves_, which has a chapter on infertility. According to that book, 50 percent of couples get pregnant in the first month, another 25 percent in the following 5 months, and another 5 to 10 percent by the end of the first year.

[RAH - These statistics seem optimistic to me, and I have not seen them repeated elsewhere in the published fertility literature. - RAH]

Have you tried charting your BBT? I discovered after starting..., that I ovulate earlier in my cycle than I had realized. Intercourse once a day is probably sufficient -- but if you have energy for twice a day, why not? The only caveat there would be that when a man's sperm count is on the low side, every other day is recommended to allow the count to increase a bit.

Also, it's important to realize that the sperm has to be in the woman's body BEFORE ovulation: the egg disintegrates within 12 to 24 hours, whereas sperm can last up to five days.

So the use of an ovulation test kit really tells you only that it's already too late.

By charting your BBT for a couple of months, you can find out when in your cycle you ovulate, and then have intercourse often in the few days before you expect to ovulate.

[RAH - While BBT monitoring can help predict time of ovulation in women who have regular "textbook" cycles, it's risky to rely on BBT alone for this purpose; see Sec. 9.3 for a discussion of the two primary purposes of BBT charting - RAH]

[Lying still for] 30 minutes in bed afterward sounds like plenty.

In terms of how long to try before a workup, it partly depends on your age. The first step should always be a sperm test (it's the simplest and least invasive test), so you can always get your husband to ask his doctor to order one of those to start. For people over 35, some doctors recommend going ahead with testing after six months.

8 months and still trying..... anyone have any ideas on how to get pregnant and quick????

Quick, huh? Well, I'll skip the detailed BBT instructions, then...

Try this: Go to the drugstore and buy an ovulation predictor kit (OPK) -- ask the pharmacist if you don't see it on the shelf. Around the middle of your monthly cycle, follow the testing instructions on the kit. Get your husband/partner to be "on call" at this time. Then, AS SOON AS you see the color surge on the test, get him home, and have sex. Use the missionary position, and put a pillow under your hips during intercourse. Get him to go as deep as possible (or as deep as you find comfortable) at the moment he starts ejaculating. If you can manage it, have your orgasm after his. Afterwards, keep the pillow under you, and try to keep your legs elevated, for at least 20 minutes.

Repeat the whole thing the next day, and again the day after that. (Well, you can skip the "on-call" part and just schedule it when it's convenient :-) ).

Any guarantees? Nope. But if you want "quick", this is probably your best-odds set of methods. If it doesn't work, you can try some not-so-quick things. Let us know, and good luck!

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2.2 Some Real-Life Success Stories

RAH - This section consists of stories from couples who had been trying (usually for some time) and eventually succeeded in conceiving. I'll let them speak for themselves; the only thing I'll add is that I hope these tales are inspirational as well as informative! - RAH

Okay, here's a composite of everything we tried towards the end of trying. We picked this up from various sources and I can't say if any of it worked for sure, but I'm pregnant now.

Make love during the day and/or have the lights on (don't ask me why on this one, but I read it somewhere and we did it anyway). Do it in the missionary position (man on top), and afterwards keep your legs in the air for at least a half hour. Make sure that he climaxes before you do as your contractions will help pull the sperm towards the cervix (yes, thinking of baseball scores really does help!) Even after you put your legs down, stay horizontal for as long as possible. The idea is to use gravity to help the little swimmers along.

Other tactics include: take some Robitussen to thin the [cervical fluid] which will make it easier for the sperm to travel. Have your partner wear boxer shorts at all times instead of briefs.

It took us 8 months to get pregnant, and towards the end my husband was known to say "Are you kidding? Okay, we'll try it but I stop short at the eye of newt!"

We started "trying" in September. That just meant throwing out the condoms. In November, I started putting my legs in the air after sex and paying more attention to the calendar. By March, my husband exchanged his briefs for boxer shorts. In April, I started charting my BBT and I finally conceived in June and our first child is due mid to late February.

We're also in a HMO, and I went to see my Gynecologist (now Obstetritian) in late April to get a complete once over. She said that they typically wait until couples have been trying for a year before doing any major testing. However, since I had a history of irregular cycles and a previous laparoscopy and my husband was 35, she said she'd go ahead and start the testing in mid-June if we hadn't had any luck. As a matter of fact, she gave me a specimen cup to have my husband bring a "sample" when we came back in June. I got a positive home pregnancy test on June 19th! Phew! :-)

My husband made a big ceremony of throwing out that cup the day after the blood test came back positive.

So basically, I'd say they might make you wait [to get a fertility workup] if you have no other risk factors involved, but it doesn't hurt to start asking now. Like us, that just might be the impetus to success! :-)

Here's what we did this month for anyone who is interested. I was having luteal phase problems and I took vitamin B complex, 100 mg. every day. I also took folic acid. I took Clomid (the "real" brand Clomid) on days 3-7, 150 mg. I knew that I usually surge (LH) on day 16 so we had "fun" on days 15, 16, 17 and I propped my hips up with a pillow for 30 minutes afterward.

I took Robitussin starting on day 15-18. I took 2 teaspoonfuls 3-4 times a day.

Also make sure you have a sinus infection, schedule a laparoscopy, schedule an RE appointment and basically give up all hope!!

After trying to get pregnant for several months, we succeded!!! What we did different this time-we had sex daily for a week or so before/during/after ovulation. Also my hubby has been wearing boxers for the past couple of months.

There are a couple of books that explain BBT: _Your Fertility Signals_, [by Merryl Winstein] _Taking Charge of Your Fertility_, [by Toni Weschler]

Hi all - Well, after a miscarriage at 10 weeks 8/94 and concentrated trying since then, I am finally pregnant again, almost 6 weeks LMP. To me, the interesting thing is that this cycle we tried a few ideas I read on this NG....

BTW, I had an HSG [hysterosalpingogram - a diagnostic procedure to determine whether the Fallopian tubes are open and clear] (armed with great advice from this group) in late October that was all clear, and we also had a post-coital test a week later that was pretty so-so. The doctor said my cervical [fluid] was not as abundant as he would like to see and that too many sperm were dead. We decided not to rush into any more testing at this point and just continue on our own for another year or so.

Until then, I just decided to go on the layperson's assumption that I don't have enough [cervical fluid] and my husband's sperm could be a little better. This is what we did:

1. My husband started taking 1000 mg. of Vitamin C about three months ago and 50 mg. zinc about two months ago.

    2. Starting day 1 of this cycle, I drank two gallons of water per day!
    3. The day we conceived, I actually tried the egg white [for lubrication] technique (just a tiny dribble!).
    4. I used an OPK - good thing too, because I ovulated on day 18 instead of my usual day 14.
    5. [omitted]
    6. We used the [intercourse] every-other-day schedule (during fertile period) instead of the grueling every day routine (routine is right!!!) we've used for 15 months.

These are all things I read about on this group, so thanks!

I should also note we were successful the cycle immediately following the cycle I had the HSG, which may have had something to do with it. It was also the first time in 15 months I did NOT bother to elevate my legs - I am so tired of that!

I have seen a thread the last few weeks on BBT and pregnancy. I have kept my BBT for seven months. Each month, my temperature was 97.5 - 97.9 pre-ovulation and 98.2 - 98.4 post ovulation, and it dropped the day of my period on Day 25-27. This cycle, the usual pattern appeared until Day 27, when it rose from 98.4 to 98.6, the opposite direction of what I was expecting. It then continued to rise and has fluctuated between 98.8 and 99.1 since then (Day 41 now). This was so odd, I didn't bother to take a pregnancy test until yesterday to confirm.

[RAH - Actually, there's nothing "odd" at all about the temperature pattern -- in fact, this is a classic triphasic temperature pattern! - RAH]

I hope this information can help someone who is struggling with what my doctor calls subfertility....

The best "fertility method" I have heard comes from an infertility support group, and is based on the fact that many couples do not realise how much sex is necessary for conception. They say couples should have sex every couple of days, around 3 or 4 times a week. "Good sex, and often" they say. There is also evidence that the female orgasm may increase fertility, as does the old "missionary position". After intercourse, the woman should raise her bottom on a small pillow, and lie on her back with her knees up for at least 20 minutes, and should avoid getting up for the toilet etc.

As a friend said "It might not work, but it's fun trying!" :-)

Another tip was that the man should go swimming regularly, preferably in a cool sports pool as cold water on the testicles improves the quantity and quality of sperm. Scuba diving in a cold sea is supposed to be even better!:-) (the couple I know who recommended this went diving in the North Sea).

Holding other people's babies is supposed to help women with hormonal problems become more fertile, especially if they sniff that baby's clothes (some pheromones in the sweat it is thought). The sweat of pregnant women is supposed to have much the same effect (you'd have to be desperate though).

The most certain "method" however, is to be a 15 y.o. girl with a "fly-by-night" boyfriend, who absolutely mustn't get pregnant or "her dad will kill her".

We conceived without any major trauma. Once we "put our minds to it" I was pregnant within 5 or 6 months---and my OB said he didn't even know if I *could* conceive because of all my fibroids. We did a few minor adjustments to help things along: He quit taking hot jacuzzis and long hot baths and he switched to boxers. I cut down on my caffeine intake, began taking prenatal vitamins, would take Robitusin cough medicine around the middle of my cycle, and used an ovulation predictor kit. None of these are that troublesome and they seem to have led to our success.

I've got quite a few friends in their very late 30s up to 45 who are pregnant right now. Good luck to you and happy trying!

- Your and your partner's ages at the time(s) in question;
29 for both

- How many times you've conceived so far, if any;

- Whether any particular pregnancy was planned or accidental;
both planned

- If planned, how long you "tried" before conception;
1x each

- Whether you would say you had "trouble" conceiving.

B Did either avoid, or cut down on, alcohol? tobacco?
I'm allergic to both; he never smoked, seldom used alcohol, didn't change behavior.

B Did either exercise moderately?
Him yes, me no, due to health problems

B Did either or both have a normal body-fat ratio?
Him 10% or lower, me 25%

B How long in advance of trying to conceive was contraception abandoned?
10 days (1st); 3 months (pill) (My husband was away until just before the day I ovulated with 2nd)

B Did intercourse take place at any particular time of day?

B What was the position of intercourse?

M Did he continue thrusting movements during ejaculation, or stay still?
Unknown - but he _always_ froze, so...

B Did intercourse take place on a hard or soft surface?

What I remember of them: No orgasm for me, put in a clean diaphragm immediately afterwards, I knew the morning after conception, 1st pregnancy ended in missed abortion followed by D&C at 11 weeks post-gestation, cause known & not medical; 2nd ended in live ceasarian delivery at 10 months, 2 weeks post-gestation.

The most significant factor in my unscientific opinion was that he had no, and I only one, previous sexual partner.

I did stop my prescription meds dead (with permission) before conception.

I'll be glad to share our story. First, the statistics: Three successful (so far!) pregnancies -
Baby # 1: Conceived in 1st month (him = 35; her = 32).
Baby # 2: Conceived in 3rd or 4th month (him = 38; her = 35).
Baby # 3: Conceived on 1st try! (him = 41; her = 38).

My wife has always used cervical [fluid] as her primary cycle- monitoring method, and it's always been a very reliable indicator - she also has an extraordinarily regular, 30-day monthly cycle (the kind you can set your clocks by - you know, "we'd better go home now, sweetie, my period's gonna start in 17.5 minutes" :-)). She has never charted BBT or used any other signals.

During each of our three successful times conceiving, we basically started trying by just getting rid of the condoms, and having sex at least once per day, for the week preceding ovulation, plus a few days before & after. In hindsight, I think the only reason we took longer to conceive the 2nd time is that we just couldn't manage the every-day frequency that time, due to the presence of an active 2.5-year-old with insomnia :-). FWIW, we always did it at night.

Concerning intercourse, our pattern has always been that [my wife] cannot reach orgasm through just intercourse -- intercourse is not as stimulating to her and is occasionally painful. So, we always have made sure she "finishes" afterward by oral sex or by hand. This was definitely true for all three conceptions. We followed a particular pattern each time, which seems to have been successful.

Specifically in those cases where we were trying to conceive, we would usually use the rear-entry position, with her either on hands & knees or else lying on two or three pillows. She has a tipped uterus, and we had heard this position was best. As someone else mentioned, I would try to go deep at the moment of ejaculation. (This was always difficult because going *too* deep was painful for her, and every once in a while caused some minor bleeding when I touched her cervix too much, but you kind of learn each other's limits after a while...:-) ). After I ejaculated, I would not withdraw, so as to keep everything from getting expelled during her orgasm. She would stay on her knees or stomach (pillow under hips), so her vagina was tilted toward her upper body. She would reach orgasm, and only after she was completely finished would I withdraw. After, she made sure to lie on her stomach with one or two pillows under her hips for at least a half-hour, usually considerably longer, since we would fall asleep! The lying-on-stomach was also due to her tipped uterus; usually the advice is to lie on your back.

One other factor that might be relevant - I always keep up the thrusting all throughout my orgasm - I think most guys stop and remain still at the moment of climax. Maybe the thrusting gives the sperm an extra push :-) -- at any rate it didn't seem to do any harm.

The only thing that might be different - in the first conception, we might have conceived with the missionary or face-to-face position, with a pillow underneath her butt during sex, and falling asleep on her back afterwards. Otherwise the same pattern.

We did it this way on purpose. Our goal was to get everything as close to the egg as we could, and to prevent any semen from getting back out the other way, so to speak. This was all very tricky and not especially "romantic", but it worked in all three cases, and very quickly in two.

A few other aspects of our situation:

    - Neither of us has ever smoked, and neither of us drink alcohol
    more than once every couple months or so;

    - I drink a LOT of coffee, maybe 6-7 cups a day; she was
    drinking about 4-5 Cokes a week (regular, not Diet Coke),
    until pregnancy. So whatever caffeine does to decrease
    fertility for others, it doesn't work for us!

    - Vitamins: Both of us have taken a regular multi-vitamin for

    - Nutrition: I think the only noteworthy thing is that I really
    like milk and dairy, and probably eat more than I ought to (no
    cholesterol probs, though!) I have cereal every morning,
    cheese sandwich or yogurt for lunch, cereal again if I have
    dessert, etc. [My wife], on the other hand, stays away from
    most dairy, except cheese.

    - Underwear: I have this habit of wearing all kinds of
    underwear -- boxers, briefs, and those kind that look like
    bike shorts -- more or less randomly. I am not sure what this
    does to sperm, except maybe to confuse them :-)

    - I always take showers and only rarely baths, either hot or
    cold. No hot tubs, either.

    - For exercise I do go swimming in a cold pool, but I wear a
    tight Speedo swimsuit - maybe this cancels each other out...?
    She goes to aerobics and does weights 2x or 3x a week, and
    swims recreationally.

    - Contraceptives: Condoms w/ spermicide only.

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2.3 Tales from the ONNA (Oh No, Not [my period] Again!) List

RAH - The ONNA List is a mailing list (email) of women who are trying to conceive, and are having some degree of difficulty in doing so. The list's purpose is to offer technical advice and emotional support to help each other through the sub-fertility jungle. You can find out more information about the ONNA List, including how to subscribe, at: http://www.directiondesigns.com/onna/ The following are a few selected stories forwarded to me (with permission) from the List. - RAH

Okay here's what we did:

Starting taking [vitamin] B6 as soon as I heard about it from you guys. Last months [luteal phase] was 11 days which is borderline so maybe it helped. Hubby has been using boxers for about 6 months now and he now LOVES them. He can't stand briefs anymore.

Sex 6, days, 4 days and 1 day before the big O [ovulation]. We were shooting for every other day but 2 days before we were laying in bed and I said to hubby "We are supposed to have sex tonight but I just don't want to. How about you?" Even if he had been in the mood, I guess that comment took care of it. It turned out well though, maybe it gave the little guys an extra day to build up. We always used the lights on, missionary position, my orgasm before and after his, hips up for as long as I could stand it afterwards, routine.

We had sex on day 10, day 12, and day 14. I had an almost-positive result from the OPK on day 14, and a definite positive on day 15, so I think I ovulated on day 16. Usually my cycles are fairly short, but I was seriously stressed from day 10 to day 13, so that probably delayed ovulation. So much for "just relax and you'll get pregnant"!

We were hoping to try again on day 16, but that morning my back went out and I spent the next 4 days on the heating pad and sex was out of the question. I was also popping Advil like mad but weaned myself off of them by day 25. When I made my doctor's appointment today, I asked about that and they said that the only real problem would be if I were to miscarry while taking Advil, because of its affect on bleeding. So that makes me feel a lot better. I'm still a little worried about the heating pad but there's nothing to do about it now. Unfortunately I didn't feel like I had a choice but to use the heating pad at the time, and since I thought we'd missed again...

We tried several new things this month. I don't know which one (if any) of these was responsible, or if we just got lucky:

1. Started [vitamin] B6 on day 1 of this cycle. My luteal phase prior to the B6 appeared to be 14 days but I figured there was no harm in taking it.

2. Did Robitussin on day 14 and day 15. Can't remember how many I did, but it wasn't a lot since I've had adverse reactions to cough medicine before.

3. Used an OPK for the first time this month, so I knew when ovulation happened although we weren't in a position (no pun intended) to take advantage of it.

4. (boy this is embarassing!!) On the suggestion of a friend who finally got pregnant after a year of trying, we had sex "doggie style", for lack of a better description. Penetration was much deeper that way, and it seemed to decrease spillage significantly. My orgasm first, then his. Stayed in bed for a good half hour afterwards. (For those of you with recurrent bladder infections, I've noticed that the only time I get one is when we have prolonged sex in the missionary position. So guess what we don't do anymore?)

I think I'm still in shock. This month seemed the unlikeliest month to me, but there it was, that beautiful pink line!! Here's the details:

1. No OPKs, no BBTs (till the last few days of the cycle), so I can't pinpoint ovulation. However, it usually comes day 14 or 15, so my best guess is Dec 23 (so maybe baby was concieved on Christmas Eve -- I like that idea!).

2. I had a rotten cold and upper respiratory infection, and was on antibiotics. So although I was eating yogurt like crazy, and drinking lots of juice (and Robitussin), I doubt my [cervical fluid] was 100%. And since I felt crummy, we only had sex maybe 3 times. And one of those times, I was on top (easier to breathe). So I guess gravity doesn't carry them off *too* fast. ;-) I came after he did. all three times.

3. Christmas break probably had a lot to do with it -- though I did go in to work, I was on my own schedule, so I probably got more sleep and was more relaxed. And not charting helped some -- I decided to follow all that well-meaning advice and "not think about it". Which (of course) only works if the only thing going against you is statistics (and not an underlying physical problem). So, as always, YMMV.

[RAH - "YMMV" stands for "your mileage may vary" -- a Net
shorthand term meaning "your experience may be different." -

according to my bbt i ovulated on day 17 this month 2 days later than last month. the only thing we did different this month was to have intercourse (almost) everyday the 6 days before. we missed day 14 but hit 11, 12, 13, 15, 16 and the morning of the rise on day 18. my temps rose rather slowly for 8 days. it was weird actually. no real big jumps. then on day 25 it began to hover around 98.4 which is very high for me 9 days after ODAY. last month it fell right away and stayed below 98.0 almost immediately so i knew something was up.

[RAH - As noted in the previous section, this isn't a "weird" temperature regime for someone who's pregnant -- it's another example of a classic triphasic pattern! - RAH]

the other strange symptom which got me wondering was the amount of sleep i seemed to need. i was at my folks so there was no need to get up for anything but still, i can't remember the last time i slept for 12 hours straight...woke up tired and....headed to the couch by 2 to take a nap!!! it was bizzare and a little exciting thinking that something was going on. my mom, of course, said she knew all along....:) yeah.

[both of us] are in our late 20's and had been trying about three months so i guess we were lucky even according to the statistics.

OK, group. I am now officially 7 weeks LMP. Here's what I did, but I don't recommend your duplicating the whole thing: All month: ate healthy but reduced calories. I was trying to lose weight before the holidays (and I did, about four pounds), so I ate about 1700 calories a day. I worked out aerobically (bike, treadmill or class) about 6 days a week and lifted weights 3 times a week. I took a multiple, a vitamin C (500 mg.), a B-complex (containing 100 B-6) and 2 Caltrate every day. During o-week I took a swig of Robitussin twice a day. Husband had a vitamin C every day for a while but then put his foot down.

Doing it: Days 10-14, every day, once a day. This was based on the recommendation in the New England Journal [of Medicine, Dec. 1995] article. Each time, I went to sleep afterward, sometimes with legs up but usually just flat, and once I'm asleep I roll around a lot. Temp rose on Day 15 and we were so tired, we didn't do it again until Day 35! The every day thing was a real drag, but we lived. Previously we were going for every other day.

Got Really Sick: this is the part I'd avoid if I were you. I got a horrible cold on Day 12, followed by a horrible bladder infection on Day 13, for which I had to take 10 days of antibiotics. Now I drink my cran every day.

Temps: ... My coverline is 98; I had a temp spike to 98.9 on day 20, a low point of 98 on day 21 (but I slept really badly that night) and another spike (98.9) on day 35. I used OPK to predict ovulation; it showed positive on day 13 but my temp didn't rise until day 15. Once I saw that my temps were staying up, I started to wonder, but I didn't really believe until I had the test, especially because of the cycle I had recently where I was 5 days late.

For all of you who aren't comfortable "just relaxing," I'd like to point out that I was charting even more faithfully than usual and that I was absolutely obsessed with my temps all month. The relaxing thing hadn't worked at all.

When I went to the RE, he said that my uterus was tipped forward some. I had read the "rear entry" often worked best when this was the case. So, of course, that's what we did (but it's not like we hadn't tried that before!). We had sex on day 10 and day 12 just for good measure. Then, I started testing with the OPK on day 13 like I usually do since I've never had a surge earlier than day 14 or later than day 16. Well, lo and behold, it was positive on day 13! So we had sex again that night. Oh, as usual, all three times I stayed horizontal for 30 minutes afterwards. I hadn't been taking temps this month, but I took it the morning of day 14 just to see for sure if I'd really ovulated. Yep, the temp was 98.1, a fast jump up for me! So, that was it--we didn't have sex again that night since I thought it was too late.

As mentioned above, I didn't do bbt this month (since it worked for you!). I didn't use Robitussin either--gave it up since I didn't think it did much. But I was trying to drink lots and lots of water to improve [cervical fluid] (which, by the way, has always been far from eggwhite near O-day). This was also my second cycle taking 100 mg of B6.

Oh, and I had been on the pill for 18 years before going off at the end of Jan. 95. Started trying in March 95, so this was month 11. And I'm 36.

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2.4 The 1995 New England Journal of Medicine (NEJM) Report on Maximizing Fertility

RAH - This study concerns the most recently-published major research on how to improve the odds for conception through timing and frequency of intercourse. The study's essential points are summarized nicely in the first subsection below; the article citation follows in the next subsection . - RAH

After getting different nonsensical news reports about the New England Journal of Medicine article, I went and got the real thing. The study was done with fertile couples only. They tried to answer 4 questions: (1) how long is a woman fertile (assuming normal sex, no insemination), (2) How often can/should a couple have intercourse, (3) if a couple has intercourse early in the fertile period, is the sperm so old at conception that the kid has problems and (4) can a couple influence the sex of the baby by altering the time of intercourse.

With regard to (1), they found that fertile women are fertile for roughly six days. That means that if they have intercourse during that time, they might get pregnant. The probability of pregnancy was only 8% on the first day, and went up to 36% on the day of ovulation. Given the normal rate of miscarriage, this means that the baby rate with sex at ovulation is about 25%.

This seems to reinforce what all of us know all too well: If you want to make a baby, your best bet is the have the sperm waiting right when the eggs pops out. For those of us lucky enough to do this via intercourse, start early and keep trying.

The report said nothing about the LH [luteinizing hormone] surge kits [also known as ovulation predictor kits or OPKs], but my understanding of them is that they predict when ovulation will occur. You need to have sex (or insemination) within 36 hours or so. My guess would be to have relations close to the surge as the sperm have to fight their way to the end of the tubes. Since sperm delivered via insemination have a shorter way to swim and fewer obstacles (no [cervical fluid]), insemination, according to my RE needs to be done a few hours before ovulation. I would imagine that none of this matters to those of us on metrodin as the estradiol and ultrasounds tell us when to take profasi which determines when we'll ovulate.

As far as frequency of [intercourse], with fertile couples, there is no difference in pregnancy rates between those who had sex every day and those who didn't. So with fertile folk, frequent sex doesn't seem to diminish the sperm. Or maybe it's just that fertile folk don't need too many.

They didn't find any correlation between sex early in the fertile period and defects in the baby.

They also didn't find any correlation between timing of intercourse and sex of the child. So much for the idea that the guy sperm swim faster than the gal sperm (or vice versa?): at least not enough to matter in the uterus under "normal" conditions.

[RAH - I don't agree with this last conclusion, based on what I think is flawed methodology on the researchers' part. - RAH]

By the way, they monitored the couples in the study quite closely and estimated time of ovulation based on chemicals in the daily urine specimens.

I'm not an expert on all of this by any means, but this article is fairly straightforward. 7 Dec 1995, NEJM, vol 333, no 23 pp. 1517-21. There's an accompanying editorial pp. 1563-1564.

The NEJM citation is as follows:

A.J. Wilcox, C.R. Weinberg, D.D. Baird (1995) Timing of sexual intercourse in relation to ovulation--Effects on the probability of conception, survival of the pregnancy, and sex of the baby. NEJM vol. 333 no. 23. Publ date 12/7/95

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2.5 Other Overall or Miscellaneous Methods for Both Partners

RAH - This section is miscellaneous, so it's pretty hard to summarize! I'd suggest reading through it, for hints on what else you might consider trying . - RAH

I have long irregular cycles, usually 34-36 days but sometimes longer and occasionally shorter. I figured out by charting them that I most often ovulate on day 19. We were casually trying. Neither of us knew anything about low-tech fertility methods so we were just living as usual with no concerns about type of underwear used or positions or whatever. I was just casually trying to hit my most fertile day. Day 19 came and went withoug intercourse because we had houseguests and a lot going on. The houseguests left on day 21, and we were in the mood then so made love. I recall thinking "oh well, too late this month." Turns out I was wrong.:) I did not expect to get pregnant so didn't realize it for about 2 months. We had a beautiful little boy.

Since I have been on the pill for so long... I can't remember any [cervical fluid] pattern before the pill, but it may have been there and I either didn't notice it or just thought it to be a discharge, not associated with fertility (since I didn't really know how this stuff worked, embarrassingly enough). I can tell you one thing which I can say is true with me - before the pill I had heavy strong periods, cramps, etc. On the pill, I had light, scant periods with the number of days going from five (originally) and ending up where I would have NO periods for up to four months (another reason I decided it was time to go off, after they changed me to a lower dose pill). NOW, since going off the pill entirely, my period has returned with a vengeance!

I am hoping this month's cycle is somewhat normal. I really don't think I ovulated last month.

As far as preconception and my husband, we are getting him used to wearing boxers instead of briefs. I thought this to be beneficial especially since I want to conceive in the "hot" months. We analyze my charts together and we decided I should start on prenatal vitamins so I've got them in me, if NFP should fail and we get pregnant now, and because we've learned it's important to have the folic acid in you up to three months before conceiving. My husband has never been one for hot showers/baths, so we don't have to worry about that factor impairing sperm. We have no preference for the sex of our child, so we won't be trying Shettle's methods [Dr. Landrum Shettles, author of the best-known and most useful book on sex predetermination, _How to Choose the Sex of Your Baby_]...

Check with your doctor- ask about best conception dates. I had sex 12 days after the first day of my period, in the morning, after my husband had been "saving up for days", in the missionary position, and then stayed in bed, laying down, for about 10-15 minutes, waiting for the spermies to do their work.

Docs say stress and worry make it worse, and harder to get pregnant. But it is so hard not to stress! Check with doc on diet, exercise,vitamins, position, time of month, etc. The female body is very sensitive- it won't be fertile and get pregnant if it's under stress- that comes from our hunter and gatherer days- if food was scarce, or if we had to go on a long trek, etc., we wouldn't be fertile.

Birth control for 2 years ending one month before conception attempts. Pregnancy #1 6 mos later using the "just relax" method :-) Miscarriage 1.5 mos later, no known cause.

Pregnancy #2 about 10 mos after miscarriage, again not using any particular method. Second miscarriage at 1.5 months later, but doctor said I was only a few weeks pregnant, and probably skipped an ovulation and a build-up of hormones gave me pregnancy symptoms before I was actually pregnant.

Pregnancy #3 2 mos later using every-other-day intercourse just before ovulation. Ovulation predicted using kit + observation of cervical [fluid]. I'm about 2 weeks pregnant right now, also using progesterone suppositories, 100 mg/day.

I hate to be a downer, but I think herbs are useless and a coincidence if they work. Most people need DOCTORS if they need help conceiving.

I've not answered you before, but I went through some hormone high-tech stuff that make me feel sick - so I quit and tried to conceive on my own. But I had still needed [the doctor] to wipe out my endometriosis, so he was important too.

The time I conceived, finally, is the time we accidentally had sex on the day BEFORE I ovulated and the day after - instead of on that particular day. Before we had always done it on the day the [ovulation predictor] test turned pink the way the doctor said.

I had given up on high-tech, because the hormones made me feel sick, plus, we did pay out of pocket for them. My doctor thought I was crazy to try to do it on my own because I was almost 40. But the mistake we made of NOT doing it on the day of ovulation seemed to be the key since we did it the day before and the day after. I have since heard that the day before is probably the one that "took".

[RAH - In this case, it was almost certainly the day before ovulation that did the trick. Intercourse the day after is usually too late. - RAH]

When people ask me what worked, I say, "more sex" - but we sure didn't waste sperm trying to do it everyday as some recent literature seems to imply. The sperm needs to be fairly fresh, but if you have sex everyday, the count goes down. (Unless new literature comes out from a doctor's office stating otherwise. :-))

[RAH - Most recent studies indicate that every day is best for men with normal sperm counts - i.e., most men; but every other day is best for men with low or marginal sperm counts. - RAH]

There is a recent article in the Reader's Digest, or some other layman magazine that says to have sex every day of the month and you will get pregnant. I just don't know if that would work for older couples, who are just a bit less interested in sex than they were in their twenties.

I know my eggs or follicles were less than perfect because of my age. I would wonder what kind of effect age has on sperm.

Anyway, thanks again. I was a little sarcastic about the herbs. That was the result of everyone telling me to do this and that, yet nothing happened for 6 years. I felt like I had tried all the "simple" techniques.

My wife's BBT charts (the last 6-8 months) have shown a large temperature variation from 96.3 to 99.7 and is pretty erratic. She had an ultrasound scan to test for follicles and she did have some live rounds in there..:-) in the doc's own words.

We have been using Ovulation Predictor Kits and she is ovulating and we have been timing intercourse as well. I have switched to boxers... quite an adjustment to make, :-) :-) This is the feminine equivalent of the difference between a Wonderbra and NOT wearing a bra, with no disrespect intended. :-) :-)

She does have these large blood clots just about every other cycle which is a heavy flow. The doctor thinks that this is because the uterine lining is not sloughing off completely during one cycle but does so on the following cycle. Strange... She also thinks that my wife's progesterone levels are too low to allow for implantation of the fertilized eggs in the uterus.

God! Coming from a poverty-stricken country of a billion souls (India), where fertility is obvious, infertility in the USA is hard to understand !!

Thanks, everyone for responding again to my original question. I would like to wish everyone else in the group Good luck and Godspeed as me and my wife start out what I hope will lead to one of life's greatest gifts being bestowed upon us. If we are not blessed with a child then I hope our marriage is strengthened by this ordeal, and maybe just maybe, we will both come out of this stronger and wiser.....

Alea jacta est (Latin for "The die is cast")

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