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Basic fertility check before 12 months ttc
An_191842 posted:
Hi. My husband (32) and I (29) have been ttc conceive #4 for six months now, after an iud removal, and have had no luck. My first 3 pregnancies were within two months of quitting birth control. I have been using OPKs each month and have timed intercourse accordingly. My cycles have been irregular, ranging from 29-35 days. The only way I know when I will start my cycle again is from the positive opk. Two weeks later I start. But the last few cycles I have started spotting at 10dpo. I have hypothyroidism (levels are normal) but otherwise healthy.

I know that it is suggested to wait 12 months ttc before seeking medical advice but my question is, is there any basic testing that can be done earlier to rule out any obvious problems?
teachnstyle responded:
I have a DD that we conceived after 5 mos of natural trying. I gave up breastfeeding at 7 mos since I struggled with it while I worked. We are trying now that she is 10 mos, but my cycles are completely irregular like yours.

I called my doctor and scheduled an appointment. I will be discussing options to regulate my cycle, and they seemed fine with me coming in after only 1-2 mos of trying. So, I would suggest calling your doc to see what can be done first, such as help regulate your cycle.
FrenchBulldogMom responded:
Your doctor might want to see you even though it's only been 6 months. Can't hurt to try!
Susannah D Copland, MD, MS responded:
While most insurance companies will only cover a fertility evaluation after a full year of unprotected intercourse without pregnancy, most should cover the evaluation of possible ovulation dysfunction when menstrual cycles are irregular. You are correct, hypothyroidism can cause irregular periods, so ensuring that your TSH is normal will be helpful. Your OB/Gyn may also order other reproductive hormones and an ultrasound to fully characterize your ovulatory function. Good Luck!
SaraMPH responded:
I also was diagnosed with hypothyroidism at 29 and didn't conceive during the 6 months of trying prior to the dx. My cycles have always been a little off when not on BC, and I was having trouble determining the day I was ovulating that I mentioned at my annual physical. My PCP gave me a referral to a reproductive endocrinologist (at the same exam where she picked up the hypothyroid). That she gave me a referral that quickly and didn't make me wait longer onc eteh hypothyroid evened out was to my benefit, because it was another 3 years of tests and 3 cycles of IVF before I gave birth to my beautiful, healthy son. Dx in August 2006 and referral - birth March 2009.

You may also have beginning endometriosis which can make pregnancy more difficult to achieve and which may need a referral for some "help." It can also be the reason behind some other changes you may be having in menstruation. Good luck!

Thank you Dr. Copland for mentioning that hypothyroidism can cause irregular cycles. I did not know that, and through all my trials, no one ever mentioned it to me.

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For more information, visit the Duke Fertility Center