Question About Infertility W/ 2Nd Pregnancy...

Although my situation isn't the same as yours, I HIGHLY recommend buying and reading Toni Weschler's "Taking Charge of Your Fertility" and/or going to www.fertilityfriend.com.

Many people on this site swear by the book and, quite literally, within two months of getting and reading the book I got pregnant. My history goes a little something like this: I have PCOS and I did about 3 years of fertility treatments and we NEVER saw more than one ovum dominate, even though we did varying levels of Clomid and injectables. Throughout the process we did conceive once but subsequently miscarried. On a break from fertility treatments we managed to get pregnant and now have a 2 year old son. Fast forwarding to the present, my husband I knew we wanted to start trying again but I wouldn't be able to do fertility treatments til summer. I bought the book and started using the fertility friend website to chart my cycles. On only my second cycle of charting temperatures, I got pregnant without any intervention. I know I ovulated on day #43 of my cycle and, although I was skeptical I thought I might be pregnant after 18 days of high-temperatures post-ovulation. I'm currently 8 weeks pregnant and still amazed that simple temping/charting worked.

If you choose to go the fertility treatment route, I would make one recommendation. Ask your OB/GYN for a referral to a fertility specialist or a reproductive endocrinologist. While your doctor is equipped to handle fertility issues, you will want to see a specialist who deals with these sorts of things all the time. It's sort of like asking a GP to do your open heart surgery. Sure, they could do it but it isn't their specialty. Also, a qualified and ethical fertility specialist will listen to your concerns about multiples and be truthful with you about the chances of having them. During the fertility treatment process, you will DEFINITELY know how many primary follicles (eventual ova) will be surging/dominating and can make your decision to fertilize based upon the data you see on the ultrasound screen. You will know whether or not there is a single egg or multiple eggs and you can decide how to progress at that point.

Good luck to you.

I would recommend using ovulation predictor tests to see if you're ovulating. If you're not, then clomid is probably worth considering. My cycles spaced out longer and longer and eventually got to be 4 months apart and extremely heavy. I initially went on Clomid to regulate my cycles, becuase I was open to having a child but not trying yet. It quickly turned to trying and still took 9 cycles to conceive my son.
Fortunately, clomid only minorly increases the chance of multiples, and if you're not ovulating, it's the best way to regulate things and help you have a chance of conceiving.

I use www.fertilityfriend.com It is super helpful. We are trying to conceive our second and have actually started using Clomid. Like you we had no trouble concieving our first, but we have been actively trying for our second for 11 months now, (2 months on Clomid). I am a little different than you since I don't have the added risk of multiples in my family. I had 7 months of charts to show my OB before we tried the Clomid and I am continuing to chart while taking the Clomid. I also agree that you should read Taking Charge of your Fertility.

Chrissy - You don't say how old you are. I am in a fertility support group and have become aware of how many women even in their early 30s start experiencing ovarian failure due to age of eggs or lack of quantity of eggs. That would be my first concern. The only way to find out if this is an issue is to go to a reproductive endocriniologist and get your FSH tested - follicle stimulating hormone. But this is only one indicator. My FSH was good, but we later found out I had diminished eqq quality and quantity.

You mentioned thyroid level as being "normal." Do you know what your TSH level is? There is a lot of controversy surrounding what is considered a normal thyroid level. It used to be .5 to 5, but the American Association of Clinical Endocrinologists have since lowered that recommendation to .3 to 3. However, MANY doctors are not aware of this. This is especially important for women trying to conceive. Women who are trying to get pg should have a TSH below 3 and below 2 is ideal.

I know this because my RE was saying my TSH was normal when it was 4.7 (this is considered high for someone ttcing and with the new standards of .3 to 3 it is not normal) but because she was using the old standard she never mentioned it and told me my thyroid was normal. After two miscarriages I even asked her if there were any tests we should do, etc. Nope. I was supposed to start my third fertility cycle and went in for my annual physical - my doc discovered my TSH was now 5.6. She put me on synthyroid to lower my level and told me not to do fertility treatments until I was below 3. My RE STILL insisted that it was fine to proceed with my cycle - with a 5.6! But when I asked around in my support group and did some online research, I saw a LOT of information relating to thyroid levels and infertility/miscarriages. My RE, when I pressed her, admitted that under 3 was ideal for fertility treatments. I left that clinic (Fertility Centers of Illinois) and am now with Randy Morris at IVF1 (www.ivf1.com) in Naperville. He felt very firmly that my thyroid level is what caused my miscarriages. My thyroid is now under three and continues to drop and I am expected to have my next cycle at the end of June/beginning of July.

Anyway, I would find out what your TSH number is and if it isn't in the ideal range, don't take no for an answer, get on medication and get it into the ideal range.

I'm not saying this is your problem, but after my experience I am very concerned when someone says their doc said their thyroid was "normal."

Have you read the book taking charge of your Fertility? (Toni Weschler I belive) Anyways, her book deals with fertility awareness method. You may be having a different cycle since your last pregnancy and simply not catching thing in the right spot. This is NOT rhythm method. I have used her method to both prevent and aquire pregnancy. Both my pregnancies were "one timers" I have worked with several women now who have struggled fr over a eyar and within a few months of gaining this information they have been able to concieve. Good luck!

My sister-in-law had a similar problem. She used acupucture. Actually she is still using it and she is 14 weeks pregnant after trying for 2 years! She actually HATES needles but is positive this is helping her body! Maybe a better alternative that your husband would be ok with :)

I will start this by saying I have 3 beautiful single births after clomid use. I also followed a diet for PCOS(polycystic ovarian syndrome) which alters when you ovulate. Here are my suggestions if you are a little heavier than when you conceived before lose a few pounds and if you are lighter gain a few...the best diets for this type of situation are low carb diets as the insulin/testosterone and all the bodies hormones react wildly to carbs and mess up your fertility. If you have a little belly fat on you, have an extra hair or 2 or many in places you'd rather not, have thinning hair. This is a big possiblity. I don't see your age but would suggest doing an actual fertility doc, not a OB trying to just prescribe a drug..as they test to make sure you don't have too many follicles ready to release that could be fertilized. My fertility doctor would not let a cycle go if they thought it result in heavily multiple births.

Almost the same stuff-Taking Charge of Your Fertility, so you have a chart you can take to the doctor, showing ovulation symptoms, etc.

Also, if you haven't been trying, start trying. I conceived twins on Letrozole-a step down from Chlomid with only a 5% chance of twins. I think Chlomid is closer to 13%. I don't know if I could do it again and it sounds like you're not sure you want to, so I'd shy away from those fertility drugs.

The other usually stuff-good diet, exercise, etc. I'd just be careful about jumping into fertility treatment with a history of multiples. (we have no history of multiples and I had two singletons before the twins).

Also, feel free to talk with another doctor. I disagree with the ovulation info and it sounds like you do too. Talk with friends and see who they recommend in your area.

Good luck!