Trying to Get Pregnant

Thoughts about advice in TCOYF?

Hi everyone, I've been wondering about this lately... I know it can take a healthy couple a year to conceive, and so the general advice is not to have any testing done until you've been TTC for 12 months. But in TCOYF I remember reading that you should consider testing after 6 perfectly timed cycles (even if you are under 35). By perfectly timed, I mean sex at least twice during the FW and that the FW is confirmed by temping.  Is anyone considering testing after 6 months instead of 12?
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Re: Thoughts about advice in TCOYF?

  • Thinking about it, yes. Following through with it, no. Mostly because doctors typically will still refuse. Many of them are not on board with temping, etc, so they will make you wait regardless.
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  • I'm going to try to get things looked at after 6 months (I'm on month 5 right now), but as PP said: most doctors won't do that.
  • @linnea625 I wondered about that as well when I was reading TCOYF. I get the thinking behind it, but like @LizaKate1213 said most doctors wouldn't do anything at 6 months anyway. I almost wish she had left that part out of the book. It is just one more thing to make women assume that something is wrong with them if they take a little longer to get KU. 

    Does anyone know if the 12 month requirement has to be 12 months of trying consecutively? 
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  • @PocketFullofShells   Yes, I have and we have had good timing every month. I also just found out that my thyroid levels are not where they should be when TTC, which can make it more difficult to conceive so I do have a reason to go in. But I would still consider going in after 6 months if I didn't find that out.
  • *lurker*

    I'm in Canada so it may be different, but I asked my family doctor about it at around 4-5 months. I just asked if there was any preliminary testing that we could do that could give us a clue if there was something wrong, and she did confirm that sometimes if a problem is found that way then you can be "fast tracked" to a fertility clinic.

    She had me do some bloodwork and we found that I had low thyroid and I'm now on Synthroid everyday. Apparently low thyroid can affect fertility and can impact the growing (or not growing) fetus.

    Good luck!
  • bcooke314 said:
    @PocketFullofShells   Yes, I have and we have had good timing every month. I also just found out that my thyroid levels are not where they should be when TTC, which can make it more difficult to conceive so I do have a reason to go in. But I would still consider going in after 6 months if I didn't find that out.
    Why? If you have NO reason to suspect that you might have a problem, why would you go? 

    That's just a frustrating thing to say. 


    edited for clarity
    Because the research I have read has said that most couples my age will get pregnant within 6 months, especially with good timing.  Yeah, maybe I would still get pregnant naturally after month 6, but some couples also get pregnant naturally after month 12, but it is still fine to see someone if you don't get pregnant naturally before then. I mean, if something is wrong I don't want to wait another 6 months before I can go see someone.
  • @PocketFullofShells   But with your logic, someone could naturally conceive in cycle 14 but since they decided to go after 12 months they are stealing an appointment from someone else.

    If 12 months of unprotected sex, even if it hasn't been purposefully timed, is enough reason to think something is wrong and see a doctor, why is 6 months of well-timed sex and no pregnancy not enough reason to think something is wrong?

    Have you never gone to any other doctor for a "what if"?
  • I wanted to get tested at six months but my Dr refused until 12 months. I got ku month 10 but ended in a mc. I hope it doesn't take another 10 months. Oh I had my gallbladder taken out in Oct and they found endometriosis. I really think clearing that helped me get ku. I just wish I could have discovered that sooner.

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    Me: 29 | DH: 31
    TTC #1 since January 2015
    BFP #1: 11/30/15| MC 12/16/15BFP # 2: 6/2/16 | EDD 2/16/17







  • Obviously the 6 vs 12 month “rule” isn’t a hard and fast rule that pertains to every woman. For example, my obgyn told me 6 months because of existing circumstances that affect my fertility. (This was a recommendation she made prior to us officially TTC and despite the fact that I am under 35.) That being said, if you haven’t already, I think you should talk to your regular gyn before you jump to the conclusion that you need tests at the 6 month mark. There are minimal tests that could be done there without having to schedule an appointment with an RE if your gyn deems them necessary. 

  • Okay everyone. I never said I wantto have to go through all the testing. I definitely don't want to be infertile. I want to conceive naturally, as, I'm sure, does everyone else.

    I guess I didn't realize that, even though TCOYF is hailed as the TTC bible, everyone ignores this one part.

    And I really didn't mean to offend anyone. I'm sorry that I did.
  • I'm in a similar boat, however, an RE wouldn't help you with that. You need to see an endocrinologist about your thyroid specifically. The research I've conducted indicates that your TSH levels have to be under a 2 to carry a healthy pregnancy. I'm seeing an thyroid endocrinologist this month.

    OP & other PP's - If I may make a suggestion: Please see your gynecologist AND General Practitioner before seeing an RE (unless you have a good reason to), it never hurts to make sure you're in OVERALL good physical shape (not just your reproductive organs, there are alot of other health factors that play into your fertility). You need a yearly checkup from both anyway, and you won't be taking the appointment away from a couple who has potentially been trying much longer. 
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  • I have an infertility diagnosis. I received my infertility diagnosis in October. My first RE appointment is in February. I have now been waiting more than 2 months to see an RE and have 5 weeks left. 

    Most doctors won't see you before 1 year of actively trying. The ONLY reason I went to my doctor earlier, and the ONLY reason that she saw me at 5 months was because I have a problem that became evident once I stopped hormonal contraception.
  • @PrimRoseMama I was the one who asked about whether the 12 months had to be consecutive. Thank you for the info. I'm only counting the last couple months of actually TTC personally, but H is concerned because we were TTC a couple of years ago for around 9 months and were NTNP for over a year and a half before actively TTC again. I'm trying to reduce his stress about this as much as possible so hopefully knowing that a doc wouldn't count it will help. Thanks again!
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  • FerdieFox said:

    @PrimRoseMama I was the one who asked about whether the 12 months had to be consecutive. Thank you for the info. I'm only counting the last couple months of actually TTC personally, but H is concerned because we were TTC a couple of years ago for around 9 months and were NTNP for over a year and a half before actively TTC again. I'm trying to reduce his stress about this as much as possible so hopefully knowing that a doc wouldn't count it will help. Thanks again!

    When in doubt ask your provider & insurance company. The answer varies, but yes. Hump it out!


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  • Re: Getting fast-tracked for testing at 6 months in Canada.

    From what I understand, this is only done in cases where either a medical precedent makes natural conception unlikely, or a long TTC period can otherwise negatively affect health. Patients in this situation are under a similar protocol than patients over 35. Not sure how province-specific this is (health care is provincially regulated) so I can only speak for Ontario and Quebec.

    For me, this was the established course of action at my preconception appointment, and agreed on between my gyn and my rheumatologist. I'll be getting get referred out this month, though my appointment will likely not be until a couple of months after that.

    Like PPs said, this is a scary prospect, and I want nothing to do with riding particular this train, but an autoimmune disease can only stay untreated so long before going out of remission, and I have some worrisome medical history that is very likely to complicate conception, so here we are.
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  • smmatt08 said:

    Obviously the 6 vs 12 month “rule” isn’t a hard and fast rule that pertains to every woman. For example, my obgyn told me 6 months because of existing circumstances that affect my fertility. (This was a recommendation she made prior to us officially TTC and despite the fact that I am under 35.) That being said, if you haven’t already, I think you should talk to your regular gyn before you jump to the conclusion that you need tests at the 6 month mark. There are minimal tests that could be done there without having to schedule an appointment with an RE if your gyn deems them necessary. 

    This is my situation too.  I have PCOS and have been mostly anovulatory since having DD last year.  We didn't try any amount of time before seeing doc, because what's the point if you aren't ovulating?  If you are healthy, have normal periods, and have no reason to think you have a fertility issue, don't borrow trouble.  Just enjoy the ride and focus on being the healthiest person you can be. 
    TTC #2- November 2015




  • _darth_darth member
    edited January 2016
    bcooke314 said:

    Okay everyone. I never said I wantto have to go through all the testing. I definitely don't want to be infertile. I want to conceive naturally, as, I'm sure, does everyone else.

    I guess I didn't realize that, even though TCOYF is hailed as the TTC bible, everyone ignores this one part.

    And I really didn't mean to offend anyone. I'm sorry that I did.

    This one part does not reflect the state of the health care system in every region, or the economic situation of every patient. Reality does not line up with even the most useful guidebooks. That's not an excuse to delay care for people who actually need it because you are impatient.

    ETA: a word
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  • Thanks for all your replies. I didn't realize this would be such a hot topic. 6 months seemed early to me, but since TCOYF is so highly respected, I wanted to see what you guys thought. I'm sorry if this question offended any TTC "veterans" Looks like I'll be waiting for the 12-month mark before taking other steps.
    Anniversary
    TTC since January 2015
    3/15/2015 BFP!
    4/15/2015 MMC  :'(
    2/25/2016 BFP! Hoping for the best!
  • smmatt08 said:

    Obviously the 6 vs 12 month “rule” isn’t a hard and fast rule that pertains to every woman. For example, my obgyn told me 6 months because of existing circumstances that affect my fertility. (This was a recommendation she made prior to us officially TTC and despite the fact that I am under 35.) That being said, if you haven’t already, I think you should talk to your regular gyn before you jump to the conclusion that you need tests at the 6 month mark. There are minimal tests that could be done there without having to schedule an appointment with an RE if your gyn deems them necessary. 

    I think this is a good compromise. I had concerns with long and irregular cycles and my PCP ran some bloodwork even before we officially started trying before prescribing Provera. I think she checked my thyroids, LSH, FH and prolactin? I don't know if there are others you can get tested for by your PCP or OBGYN - I don't think she ordered the full gamut of infertility bloodwork because that's not really what I was concerned about at the time. Could the men get their SA done through their PCP or urologist ahead of going to an RE? Personally, I wouldn't want to preemptively jump to the conclusion of infertility, and I do get feeling anxious and wanting to make sure something isn't wrong, but I also respect that there are limited resources and the specialists should be left available for those that actually need them. I think if there are simple tests that can be done by PCPs or OBGYNs to rule things out, that would be the first step and that may be enough to put people's minds at ease for the time being.
  • It all depends on your health. My OB/GYN told me to start getting infertility testing done since we've been actively trying for at least 8 months and NT/NP for 5 months before that and I've been off BCP for a few years. So she's recommending it. There are two ways to look at it if you're thinking about going in:
    1. You could be jumping the gun and find out nothing is wrong with you. You waste some money and time but you know you're good.
    2. You find out there is something wrong. Now you have the information of what can and can't be done so now you can prepare for alternatives. 
    Talk to your OB/GYN first and see what they say, if you have medical conditions that may make it difficult they may recommend it. Or they may tell you to wait a few more months.
    Me: 27 | DH: 26
    Married: 05/22/2015
    TTC #1: 04/2015


  • edited January 2016
    ^ this. I had basic blood work through my OB. My husband's SA was done with a Urologist.

    Eta we really only saw the RE for IUIs.
  • I agree with @crownedj, I think it depends on your health history and your financial situation. 

    So this might be TMI but I'm going to share anyway. I made some bad choices in college and caught a certain infection (please don't ask me what it was, I'm so embarrassed as it is. I refuse to say it) that went unnoticed for up to 10 months before I was finally diagnosed. Got back together with the same guy at one point and guess what came back (again undiagnosed for like 2 months). I was high risk for tubal damage because of this infection and how long it went unnoticed, so I had an HSG done VERY early in my TTC journey just to rule out structural tubal issues. My logic was if my dumb ass mistake caused a problem, I wanted to know about it NOW and was fine paying through the nose for the test - i.e., if my previous choices created an issue, I wanted to catch it early, and figure out if it would be treatable. I didn't want to go through hell every month worrying it was my fault for an entire year. My stress levels were really through the roof worrying over this, and I'm sure doing nothing good for our TTC efforts. My regular obgyn was able to order the test, and I just went to another facility for the actual HSG. Don't worry, I called 2 days before I wanted to schedule the test and they had like 3 time slots open, so I wasn't stealing appointments from anyone! 

    But this was MY choice to spend MY money so I could stop worrying that not getting pregnant was all MY fault. I also struggle with anxiety and depression, so for me having the test done was worth 100x the actual dollar amount for the sake of my emotional health. I'm more comfortable trying now, and any unsuccessful cycles I can just chalk up to chance. 

    All that being said, I don't plan to seek out an actual RE for additional testing unless we are still struggling for a take home baby this summer, and will be nearly at our 1 year mark.  No one wants to join the infertility camp, but I understand wanting the peace of mind that test results can offer, or getting a jump on treatment if necessary. 

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  • skilouiseskilouise member
    edited January 2016


    smmatt08 said:

    Obviously the 6 vs 12 month “rule” isn’t a hard and fast
    rule that pertains to every woman. For example, my obgyn told me 6 months
    because of existing circumstances that affect my fertility. (This was a
    recommendation she made prior to us officially TTC and despite the fact that I
    am under 35.) That being said, if you haven’t already, I think you should talk
    to your regular gyn before you jump to the conclusion that you need tests at
    the 6 month mark. There are minimal tests that could be done there without
    having to schedule an appointment with an RE if your gyn deems them necessary. 


    This is my situation too.  I have PCOS and have been mostly anovulatory since having DD last year.  We didn't try any amount of time before seeing doc, because what's the point if you aren't ovulating?  If you are healthy, have normal periods, and have no reason to think you have a fertility issue, don't borrow trouble.  Just enjoy the ride and focus on being the healthiest person you can be. 

    ***ETA QBF***

    I agree with this. Most women should wait a year, but if you have a known issue that can cause infertility that may be a reason to go earlier.

    I'm in month 7, but I have PCOS and therefore am seeing an RE tomorrow morning. I wasn't expecting to be referred so quickly, but both my GYN and the RE's office said I should be seen now.

    However, I also am fortunate to live in an area with roughly eleventy billion REs. It took me less than two weeks to get an appointment. I was fully expecting to get an appointment 2-3 months down the road, meaning I would have been seen in month 9 or 10.


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    Again TTC#1: Dec 2015
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  • I had the same thought as OP when I read that in TCOYF, but then I really thought about it.  As much as I hate waiting, I watched my sister deal with IF and 5+ years of treatment before she got to #1, and it's rough.  I'd rather hope I'm just going to be one of those late people then start playing that game early for a lot of the reasons PPs (who have been there themselves) have said.  

    Watching her though is why I decided to start temping on my second cycle. Just confirming O is, to me, hugely reassuring on the it's just taking a while vs. IF debate.

    I'm worried this may not have been coherent, but I'm clicking "post reply" anyway because today has been rough and it isn't going to get more coherent...
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    TTC #2: April 2018 ~~ BFP: May 2018 ~~ EDD: January 2019





  • TCOYF is a great resource, but it doesn't have to be right about everything. You can't say the book (or almost any other book) is 100% accurate and can't be disputed in any way. After 6 months MAY indicate something is wrong, but not necessarily. And like PPs said, most insurance won't cover what little IF treatment they will without 12 months TTC anyways. Don't borrow trouble unless you really, truly think you have an IF issue and have evidence besides lack of being KTFU to back it up.

    I went in for my annual in August after 5 months TTC and brought up TTC and we talked about my concerning  menstrual history (I was only on BC for 1.5 yrs and have my entire AF history since menarche- so ~10 yrs) as well as not ovulating. We decided to run some hormonal bloodwork and it came back that I have PCOS. I didn't expect bloodwork at that appointment either, but I'm glad she suggested it. It was ONLY after I had a Dx that I was able to get to go to an RE. I still didn't get to see an RE until mid October.

    I also want to add that going through IF is not fun. I had to quit my job for my own sanity because the IF itself and medication is having a huge mental/emotional impact on me. You don't want to have to take super-duper hormone pills that can have unpleasant side effects or administer super-duper hormone shots into your abdomen that can give you cramps way worse than AF. I would take getting KU on/before 12 months "naturally" instead of IF treatment any day. Wait the 12 months.
     
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  • I've been looking at the stats. There is some conflicting data, but it seems like 75-80% of couples get pregnant in 6 months, 85-92% are pregnant after 12 months. While some couples do go on to conceive "naturally" After 12 months, 1-3 additional years of trying brings it up to 93-95%.
  • par_mach_kaipar_mach_kai member
    edited January 2016
    This may be unpopular, but I actually disagree with some of the posters here. I always try to look at the science (I work in the medical field) when trying to figure these types of things out. There isn't a ton out there, but I did find a pretty good prospective study on a sample size of 346 women who were using fertility awareness methods to figure out their fertile window; controls were put into place for things like age, education, socioeconomic status, etc.

    In the group, by the first cycle 38% of women were pregnant, by the 3rd cycle 68%, 81% at 6 cycles, and 92% at 12 cycles (for the truly fertile couples that actually conceived, the numbers were: 42, 75, 88 and 98% respectively)  The authors conclude that every other woman after 6 cycles is either sub-fertile or infertile. They cautiously recommend a work-up after 6 cycles is warranted, although if you end up with something like unexplained (i.e. a "good prognosis"), probably better to go the full 12 cycles before pursuing something more invasive because you have a decent shot at conceiving naturally. Whereas if you're found to have poor prognosis you've "bought" yourself 6 months of time on your side.

    Here's a copy of the article:

    https://humrep.oxfordjournals.org/content/18/9/1959.full

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