OPK blinking v peak and when to TTC

aprl416 · August 2014

TTC for 18 months, I'm 34, normal cycle, normal labs, normal OV, BDs samples came back good. OB says its 'unexplainable infertility.' Last 2 months was on Clomid @50 then 100, responded well increased progesterone based on Day 21 test. I am wondering if I am TTC to early? should I wait until the OPK peaks and TTC for the next 3 days straight? I've been TTC every other day when OPK blinks thru 1st day OPK peaks. Is this wrong?

BunnyBerry · August 2014

Hi there, I'm so glad you came here!

Sorry for your struggle with TTC.

If you're working with an OB and not an RE (reproductive endocrinologist), it's very hard to know if you are truly unexplained. There are many more tests that need to be done before you start treatment with Clomid, the first of which is an HSG to test that your uterus and tubes are clear (if you haven't had it yet).

An RE is trained to find subtle interrelated issues with hormones and "hardware" and help to treat them. An OB is trained to help pregnant women have healthy pregnancies.

Just the fact that you took at CD21 progesterone test is a red flag. Progesterone should be tested at 7 days past ovulation, whenever it is, based on proof of ovulation (temps and/or ultrasounds), not just a OPK which says your body is gearing up to ovulate but no guarantee when it actually happens. ETA: And not just based on an assumed 28 day cycle and CD14 ovulation.

The best results come from regular intercourse throughout each month and if your DH (dear husband - I guess that's what you meant when you said Baby Dance

) has a healthy SA (sperm analyslis), then either every day or every other day will give the same results. When an OPK peaks, you will likely O either that day or the next day. Keep having sex regularly until you're sure from temps or ultrasound that you ovulated.

Is your OB monitoring you with an ultrasound early in the cycle (CD2 or 3) to make sure you don't have cysts left from Clomid the month before? If not, you could easily end up in the hospital with a ruptured cyst that can even permanently harm your ovary's functioning, or end up with cysts that produce estrogen and act as birth control while you're trying to ovulate.

Is your OB monitoring you with ultrasounds around CD10 and every few days thereafter until ovulation? If not, you could easily end up with a large number of follicles and turn into the next octomom, or at least have dangerous higher order multiples. Or, you could have a thin uterine lining (which Clomid is notorious for causing) and then a fertilized egg could not even implant anyway - and if this goes on for a couple cycles, it can take months to let your lining build back up while you wait.

Basically, your OB seems to have put you on what I like to call the "OB Regimen of Shut My Eyes and Hope for the Best," also known as put women who have diagnosed infertility (12+ months TTC, or 6+ months with advanced maternal age) through a few months of (often unmonitored) Clomid and timed intercourse without knowing for sure what the problem is and just pat themselves on the back when a percentage of those women get pregnant.

Realistically, the right person for the job once you've tried this long is an RE. There are many options other than 50mg Clomid and TI with OPKs that could possibly be much better tailored to your situation. If you are having unmonitored Clomid, I hope you demand monitoring, and an HSG at least before medicating yourself any more.

Good luck and stay healthy!

shirleymaeby · August 2014

@BunnyBerry FTW!!

SarahP1986 · August 2014

I agree with BunnyBerry. I have also just been seeing my OBGYN and taking Clomid. My doctor does do monitoring (ultrasound CD 2 and CD 12, blood work done a few times to check my hormone levels) but I know that some don't. My second month on Clomid I had 3 follicles left, all between 17 and 22 mm. That could have really caused problems if I wasn't being monitored. My cycles are a little too long but other than that I have normal cycles, normal hormone levels, husband has normal SA. Like you my doctor says unexplained infertility. We are planning to take a break after this month (our 3rd cycle on Clomid) and then go to a RE after the break. I would really consider going to an RE if I were you. And like BunnyBerry said, insist on monitoring. It would be awful to have the medicine hurt your chances instead of helping them! I have done the OPK test for months and months and finally got sick of it. My DH and I just have sex every other day from around CD 10 to CD 24 or so. Maybe not the best method but it insures if I do ovulate that we don't miss it!

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