HCG Preganacy test
LH Ovulation test
Your Guide: Anna Peris, PharmD.
-Stadtlanders' Clinical Fertility Specialist
Assisted Reproductive Technology (ART: GIFT, ZIFT, ICSI, and IVF)
If you've reached this point, you and your partner have probably tried all the
"basic" methods to enhance your chances of becoming pregnant. You've been monitoring your cervical mucus secretions, measuring your basal body
(BBT), and perhaps even testing your urine to predict ovulation.
Despite persistent attempts with these simple strategies, you have yet to
achieve a pregnancy. At this point, your doctor may have suggested one of
several fertility therapies to maximize your chances of getting pregnant. If you
feel confused and overwhelmed with the options available to you, don't worry,
we are here to help! -Anna
Introduction to Fertility Treatments
Fertility treatments don't have to be as complex as they may initially sound.
Millions of couples go through these treatments every year. And although it is frustrating, the most important thing you can do for yourself is to gain as much knowledge as possible regarding each treatment option. You need to feel comfortable with every step of the process and know what to expect from a
medical, emotional, and financial standpoint.
The purpose of this primer is to give you basic information that you need about
fertility treatments in general. Continue to follow the links for each individual
treatment option to learn more in depth material such as indications, side effects,
and success rates. Remember, the more you know, the better you'll feel.
In general, fertility treatments fall into one of three categories:
Artificial Insemination (AI and
Assisted Reproductive Technology (ART: GIFT, ZIFT, ICSI, and IVF)
The purpose of ovulation induction is exactly what the name says - inducing the woman to ovulate. This is done with either a pill or injectable medications.
Ovulation induction is appropriate for certain women, depending on their
diagnosis - it's not right for everyone. It usually works the best for couples where
the woman can't get pregnant because she doesn't ovulate regularly or
consistently. In some cases, a little pill may be all that is needed to do the trick
(for more information on fertility medication, see At The Pharmacy).
The answer is not always so simple however. Some couples may be more
suitable candidates for
artificial insemination or AI. AI means taking a purified specimen of the male partner's sperm and injecting it into the female partner's reproductive tract. In many cases, this may facilitate fertilization if a couple is
unable to get pregnant. AI is certainly more involved than ovulation induction - it requires an outpatient procedure and monitoring the woman's response to
potent fertility medications.
The most complex fertility procedures are grouped under the name ART, which stands for
Assisted Reproductive Technology. There are several different kinds
of ART procedures, including
IVF, GIFT, ZIFT, and
ICSI. The basic concept
behind ART is that involves taking the egg out of the female body in order to
assist the process of fertilization. The simplest ART procedure, IVF has been
around for over 20 years. Although it is still being perfected, modern medicine
has come a long way. In many cases, the ART procedures have helped hopeful couples have many children.
ART, or any of the other fertility treatments should be approached with careful consideration. Although these therapies provide exciting possibilities, it is
important to understand what each one entails. Fertility treatments utilize potent medications and require a significant emotional and financial commitment from
each partner. Learn the most you can about your options, and ask many
questions. It is critical to have all the information you need up front, before you
"I have one child and shortly after his birth i became pregnent again. I had a miscarriage during my third month. since ..."
-Talk About It
Ovulation induction is a very common term that you may encounter in your
journey through fertility treatments. Basically, this term refers to the use of
medications to stimulate your body to produce one or more eggs. Ovulation
induction may be necessary in women who do not ovulate consistently, but want
to have a child. There are many reasons why women do not ovulate regularly - polycystic ovarian syndrome (PCOS), excessive exercise, and
hyperprolactinemia are just a few examples. One important prerequisite for a
woman to participate in ovulation induction is that she must have good quality
eggs remaining in her ovaries. This procedure is of no use to women who have ovarian failure or eggs of poor quality.
Ovulation induction can be as simple as taking a daily pill or more complicated,
like injecting fertility medications and seeing your specialist daily for necessary monitoring. The simplest form of ovulation induction involves taking clomiphene. Clomiphene is a small tablet that must be taken on specified days of the cycle.
It is relatively inexpensive and has very few side effects. If taken correctly, clomiphene can be very effective in inducing ovulation. As many as 50-80% of women who take clomiphene will ovulate, however only about half of these will achieve a pregnancy.
In some cases, a woman may need a little extra help in getting her body to
produce eggs. Remember, not everyone is the same and therefore not every
woman will necessarily respond to clomiphene. More potent medications, known
as the gonadotropins, are available for more intensive ovulation induction. Gonadotropins are injectable medications that are made up of a combination of follicle stimulating hormone (FSH) and luteinizing hormone (LH) or just FSH alone. These hormones can be very helpful in getting a woman to produce and release
her eggs. Because these medications are so potent, you will be required to visit
your specialist's office frequently to get appropriate monitoring and guidance.
This can include bloodwork, ultrasounds, or just verbal counseling in regards to dosing and injection techniques. Close contact with your healthcare team will
ensure that you get the best outcome from the treatment and also help prevent potential side effects from the therapy.
For some women, ovulation induction with medications will not be enough to
achieve pregnancy. Even if the medications work, there may be other reasons
that prevent the couple from becoming pregnant - for example, a low sperm
count. For couples where ovulation induction is unsuccessful in producing a pregnancy, one of many ART procedures may be advised as the next path to parenthood.
For the ART procedures, injectable gonadotropin medications are also used to stimulate the woman's ovaries to produce multiple eggs. However, when medications are used in preparation for an ART procedure, the process is no
longer called ovulation induction, but rather controlled ovarian hyperstimulation
or COH. The only difference between the 2 procedures is that in COH, the woman
is never actually "allowed" to ovulate - rather, her eggs are retrieved from the
ovaries immediately prior to the anticipated time of ovulation (in the case of IVF)
and fertilized outside of the body, in a laboratory. In ovulation induction, however, ovulation is desirable since a natural pregnancy is being attempted. COH
requires extensive monitoring and follow-up since it involves the use of
The success of ovulation induction in achieving a pregnancy is highly variable.
It depends on your diagnosis, age, the medication being used, and numerous
other factors. Therefore, it is important that you speak with your specialist
regarding your anticipated rate of success with a chosen treatment.
สิ่งสำคัญที่สุดคือรังไข่ ยังทำงานอยู่คือยังมี "ไข่" และสามารถสร้างฮอร์โมนเพศได้ สตรีที่สมควรได้รับการกระตุ้นและชักนำให้ไข่ตกได้แก่ 1. สตรีที่มีความผิดปกติของฮอร์โมน เช่น 1.1 มีความผิดปกติที่ระดับส่งการบริเวณสมองส่วน Hypothalamus ซึ่งมักเกี่ยวข้องกับความเครียด น้ำหนักตัวที่มากหรือน้อยเกินไป 1.2 มีความผิดปกติที่ระดับสั่งการ บริเวณต่อมใต้สมอง เช่น มีเนื้องอกของต่อมใต้สมอง2. สตรีที่มีความผิดปกติในเรื่องของการตกไข่ คือ "ไข่" ไม่ตก กระตุ้นไข่และชักนำให้ไข่ตกมี 3 แนวทางด้วยกันแนวทางที่ 1 กระตุ้นที่ระบบสั่งการในสมอง แนวทางที่ 2 กระตุ้นที่รังไข่โดยตรงแนวทางที่ 3 ใช้ทั้งสองแนวทางร่วมกัน
AI and IUI
Suffering from blocked fallopian tubes
I am 27 and my husband and I have been trying to have a baby for 2 years now.
No luck! In that time I have had ma..."
-Talk About It
As a couple dealing with infertility, you may be faced with various options in your journey to become loving parents. Artificial insemination or AI is just one of those options that may be considered prior to attempting more involved treatments,
such as IVF. AI is typically recommended for the treatment of infertility due to:
mild to moderate male factor infertility
cervical mucus insufficiency
hostile cervical mucus
various structural abnormalities in the woman
Many couples are presented with the AI option after a trial of clomiphene is unsuccessful.
AI is a relatively simple procedure that involves injecting a sample of specially treated sperm from the male partner into the female partner's reproductive tract.
For most couples, AI is performed with the husband's sperm. However, when the husband's ejaculate contains few or no live sperm, the couple may consider undergoing more advanced procedures including IVF, ICSI, or donor sperm insemination.
It's important to note that AI is a general term - there are actually several different types of AI, and they are named for the location of sperm insemination into the female. The types of AI are intracervical (in the cervical canal), intrauterine (in the uterine cavity), intrafollicular (in the ovarian follicle) or intratubal (in the fallopian
tubes). Therefore, AI merely describes a procedure where a qualified
reproductive specialist injects sperm into the female reproductive tract. The
different types of AI are recommended based on your diagnosis and probability
of success with each method.
Of the four different types of AI, intrauterine insemination (IUI) is the most
commonly used form. It is very useful if the cause of infertility is insufficient or
hostile cervical mucus or low sperm count or motility. The reason for this is IUI
allows sperm to bypass the cervix without encountering "unfriendly" cervical
mucus which could "inactivate" the sperm. The reason that IUI is helpful for low
sperm count or motility is based upon the knowledge that only about 1% of the
total numbers of sperm deposited into the vagina at ejaculation will find their way
into the upper female genital tract. IUI places the healthiest sperm into the female genital tract to increase the likelihood that one of those sperm will fertilize an egg.
IUI is a relatively quick procedure that takes place in the clinic office. It is
performed by passing a sterile catheter containing the sperm through the cervix
and into the uterine cavity. The sperm are then injected directly into the uterus. Usually the insemination itself causes little if any discomfort. Following the insemination procedure, you will likely be asked to remain lying down with your
hips elevated for about 45 minutes.
Although IUI is relatively uncomplicated, and less invasive than IVF, one disadvantage associated with IUI is that it does not allow the doctor to evaluate whether or not fertilization is capable of taking place. With IVF/ET, fertilization
can be confirmed since it takes place outside of the body, in a lab. With IUI,
however, fertilization still takes place within the body, much like a natural cycle. Although IUI is more natural, it is unknown whether or not the sperm actually
fertilizes the egg to make an embryo (unless the woman gets pregnant after
the first IUI cycle). Therefore, if you repeatedly are unsuccessful in achieving pregnancy following IUI, consider discussing the IVF option with your healthcare team.
The pregnancy rates for IUI treatment cycles average about 15-20% per cycle
when IUI is performed for the correct indications. If all other conditions affecting
fertility are thought to be normal or adequately treated, then a reasonable length
of treatment with IUI is about three to six treatment cycles. If you and your partner
are unable to achieve pregnancy by the end of this course of treatment, then
speak with your doctors about other options available to you. Perhaps a reassessment of your diagnosis should be made since some other factor may
be present which has been unrecognized and inadequately treated.
ART stands for Assisted Reproductive Technology. ART procedures include
IVF, GIFT, ZIFT, and ICSI. ART procedures generally involve taking the egg out
of the female body in order to assist the process of fertilization. The simplest
In Vitro fertilization -IVF
has been around for over 20 years and is perhaps the most commonly
recognized ART of all procedures. I have developed a seperate section on IVF and will focus our discussion here on GIFT, ZIFT, and ICSI. -Anna
Depending on your diagnosis, your doctor may discuss the option of performing zygote intrafallopian transfer (ZIFT) instead of conventional IVF. ZIFT may be recommended if the
husband has severe male factor infertility or if there has
been difficulty confirming fertilization with past
procedures. ZIFT has the advantages of allowing fertilization to be confirmed and it has demonstrated
higher success rates than IVF when used for the appropriate indications.
ZIFT nothing more than a variation of traditional IVF. With ZIFT, the fertilized egg that is transferred back into the woman is allowed to divide only to the 2-cell
stage, instead of the 4 or 8 cell stage as with conventional IVF.This fertilized egg at the 2-cell stage is
called a "zygote".
Like IVF, ZIFT involves ovarian stimulation, monitoring, and egg retrieval,
followed by sperm processing and fertilization in the laboratory. Another slight difference between IVF and ZIFT (besides the stage of the transferred embryo)
is the location where the embryos are placed in the woman's body. With IVF, the embryos are placed directly in the uterus. With ZIFT, however, the zygotes are placed directly into the fallopian tube. Therefore, a criterion for performing ZIFT
is that the female partner has at least one open and functioning fallopian tube.
One disadvantage with ZIFT is that the transfer of the zygote must be performed through a laparoscope. This involves a surgical incision, whereas with IVF, the fertilized eggs are transferred through the vagina without the need for any
incisions. Although laparoscopy is a minor surgical procedure, it still adds to the complexity, risk, and cost of the entire process.
Gamete intrafallopian transfer (GIFT) was developing in 1984 as a variation of in vitro fertilization (IVF). Your doctor may recommend GIFT if your diagnosis is
unexplained infertility infertility due to
immunological factors endometriosis selected cases of male infertility tubal infertility
A requirement for the procedure is that the female partner having at least one
open (patent) fallopian tube. GIFT is sometimes selected based on a couple's religious beliefs that prohibit conception outside the body.
GIFT is not much different than IVF. The main difference is that with GIFT,
fertilization occurs naturally within the female partner's body instead of in the laboratory as with
IVF. GIFT involves ovarian stimulation, and egg retrieval like IVF, but with GIFT, sperm and eggs are placed directly into the woman's fallopian tubes to foster fertilization. The following steps outline what you can expect when undergoing GIFT:
Step 1: Ovarian Stimulation and Monitoring
This step is exactly the same as in IVF. In order to maximize the chances of success, the physician will prescribe fertility medications (such us Humegon? or Fertinex?) to stimulate the woman to produce more than one follicle and egg.
HCG (Profasi? or Novarel?) is then typically given to stimulate the release of the eggs from the follicles and time the egg retrieval step.
Step 2: Egg Retrieval and Sperm Processing
This step also mirrors the process in IVF. The eggs are removed from the
woman and examined under a microscope to evaluate maturity before they are combined with sperm. The male semen sample has been collected, evaluated, and sperm processing performed prior to the next step.
Step 3: Gamete Transfer
Once the physician has determined the eggs are ready for transfer, the selected sperm and eggs are placed together in a catheter. These sperm and eggs are called gametes. In IVF, these gametes would be united in the laboratory by an experienced embryologist, however this does NOT happen with GIFT. With GIFT,
the gametes are injected into the fallopian tube using a special catheter
(laparoscope). Within the fallopian tube, fertilization will hopefully occur
naturally. Unlike IVF in which actual fertilization is observed and confirmed in the laboratory, GIFT does not allow visual confirmation of fertilization. If fertilization occurs, the developing embryos remain in the fallopian tube and then move to the uterus for the natural implantation process.
For selected cases of infertility, GIFT may have a higher success rate than IVF. This may be due to the fact that GIFT more closely mimics natural conception as compared to IVF. Specifically, the egg is fertilized in the fallopian tube rather than
in the laboratory. In some cases, however, GIFT may not offer additional advantages to IVF, but may in fact add to the cost of therapy. Therefore, discuss with your specialist if you are a good candidate for this procedure.
Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm injection, or ICSI, was developed to treat couples who previously had a very poor probability of achieving fertilization due to the male partner's extremely low numbers of viable sperm.This treatment, when combined with in vitro fertilization, allows these couples a more favorable probability of achieving conception. ICSI has replaced the two previously developed micromanipulation techniques of partial zona dissection, or PZD, and subzonal insertion, or SUZI, because of the overall higher fertilization rates achieved with ICSI. ICSI has revolutionized treatment for severe male factor infertility because
the procedure requires only one healthy sperm to potentially achieve fertilization.
A variety of sperm problems can account for male infertility. Sperm can be completely absent in the ejaculate, a condition known as azoospermia. Men with low concentrations of sperm in the ejaculate have a condition known as oligospermia. Poor motility, or a condition called asthenospermia, occurs when
the sperm do not have the forward swimming motion sufficient to make the
journey from the ejaculation site in the female's vagina, though the reproductive tract, to unite with the egg in the fallopian tube. Men whose sperm have an increased percentage of abnormal shapes and forms have a diagnosis of teratospermia. Other sperm problems that prevent fertilization are abnormalities
in the series of steps required for fertilization, such as the sperm's ability to bind and penetrate the cytoplasm of the egg.
Male factor infertility may be caused by blockages, varicoceles, or abnormalities of the ejaculatory ducts causing low or no sperm in the ejaculate. Men who have had a severe injury to their male reproductive organs, some neurological disorders, or surgery (including vasectomy), may have an absence of sperm in
the ejaculate. Men who have had radiation and chemotherapy treatments for cancer, may have low or no sperm present in the ejaculate. Men who have provided semen samples prior to undergoing cancer treatments and major surgeries of their reproductive organs are candidates for ICSI due to the limited number of sperm available to achieve conception with ART procedures.
ICSI may be a recommended treatment option for all of these infertile men.
Steps One: Ovulation Stimulation and Monitoring
The same process used in the other ART procedures to induce ovulation is
used with ICSI.
Step Two: Sperm Extraction
Semen samples can be obtained through masturbation. If any viable sperm can be obtained from this type of semen sample, procedures to extract sperm will not be used. The sperm sample will be evaluated and processed to select only the healthy, viable sperm for the fertilization procedure.
When there is an absence of sperm in the ejaculate, surgical extraction procedures are performed.
One procedure called microsurgical epididymal sperm aspiration, or MESA, is used when sperm are unable to move through the genital tract due to uncorrectable blockage, congenital absence of the vas deferens or seminal vesicles. Aspiration is accomplished with MESA, usually performed as an outpatient procedure, when sperm are extracted directly from the epididymis. Epididymal sperm are typically not fully motile, which means they cannot swim through the female tract to reach the egg for fertilization. These sperm do contain the right genetic material, nucleus and chromosomes, to produce normal babies. These sperm can be used with IVF or ZIFT, assisted reproductive technology procedures that place the sperm in direct contact with the egg.
Sperm can also be aspirated from the testicles in a surgical procedure called testicular sperm aspiration, or TESA. These sperm are also typically not motile and mature, but do contain the normal genetic material to produce normal babies..
Step Three: Egg Retrieval
This step is the same as in the other ART procedures.
Step Four: Micromanipulation and Fertilization with ICSI
Specially trained embryologists and andrologists use micromani-
pulation techniques with the aid of microscopic instruments to enhance the chances for fertilization. In the laboratory, extra steps are taken with the eggs to remove the cumulus cells that support the surrounding oocyte, or egg. This
allows they embryologist and/or physician to visualize the oocyte's maturity
and suitability to undergo the ICSI procedure.
The semen sample is prepared, yielding as many viable sperm as possible.
The goal is to locate as many viable, healthy sperm as the number of selected eggs. While transfer of multiple successfully fertilized eggs increases the probability of success, ICSI has been proven successful with only one viable sperm and one viable egg that are able to fertilize.
Once an embryo is fertilized, it is transferred back into the woman by injection into the uterus, as with IVF.
Definitive statistics have not yet been published by the Registry of Assisted Reproductive Technology. Preliminary success rates reported by various practices that offer ICSI range from
15% to 35% deliveries per egg retrieval.
The American Society of Reproductive Medicine Fact Sheet on ICSI published
in December of 1996 states expected egg fertilization rates of 50% and cleavage rates of 80% or more, but only 15% to 20% of egg retrievals produce a delivery in well selected couples. This Fact Sheet also states that perinatal outcomes
studies in Europe suggest that although multiple pregnancies are common in
ICSI, there is to date no evidence of increased incidence of birth defects with this procedure.
Your Guide: Anna Peris, PharmD. -Stadtlanders'
Basal Body Temperature Chart (BBT)
Charting your BBTs is really pretty easy. Basically, what you are doing is
taking your temperature first thing each day and plotting the temperature
on a chart. What you are looking for is to see a shift of at least .4
degrees Fahrenheit after ovulation making your chart biphasic (showing low
temperatures before ovulation in the follicular phase, and higher ones
after ovulation in the luteal phase).
- Take your temperature first
thing in the morning before you get out of bed or even speak -- leave
your thermometer at your bedside within easy reach so you dont have
to move much to get it. If you use a glass thermometer, make sure you
shake it down before going to bed.
- Try to take the temperature at
as close to the same time each day as possible -- set an alarm if you
need to. Staying within a half hour either side of your average time
is a good idea because your temp can vary with the time (i.e., if you
usually take your temperature at 6 a.m., it is OK to take your BBT
between 5:30-6:30, but the closer to 6 the better). The normal
variation is by up to .2 degrees per hour -- lower if you take your
temperature early, higher if you take it late.
- It is best to take your BBT
after a minimum of 5 hours sleep, and at least 3 in a row is
- You can take your temperature
orally, vaginally, or rectally -- just stay with the same method for
the entire cycle.
- You should try to place the
thermometer the same way each day (same location of your mouth, same
depth vaginally and rectally).
- Plot your temperature on your
chart each day, but refrain from reading too much into it until the
cycle is done.
- Some women, not all, have a
temperature drop when they ovulate. If you see this drop, it is a good
idea to have sex in case you are ovulating.
- What you are looking for is a
temperature shift of at least .4 degrees over a 48-hour period to
indicate ovulation. This shift should be above the highest
temperatures in the previous six days, allowing one temperature to be
thrown out as inaccurate (fluke, illness). Perhaps the best way to
explain this is to show an example.
In the image above, the seven BBTs before ovulation are 97.2, 97.3,
97.8, 97.4, 97.2, 97.3, 97.0 then it jumps to 97.7 and then 98.
Ovulation most likely occurred on the day with the 97.0 and you can
comfortably draw a coverline at 97.6. You just ignore the 97.8 on day
- After you see a temperature
shift for at least three days, or at the end of your cycle, you can
draw a coverline between your follicular phase and luteal phase
temperatures. With luck, it is easy to see a clear shift and draw your
line between the highest follicular phase BBT and the lowest luteal
phase BBT as in the sample above. The main reason for drawing this
line is just to clearly delineate that your chart is biphasic.
- Look at the chart at the end of
the month to analyze what happened.
- Chart for a few months and look
- If your temperature stays up for
18 days or more after ovulation, you should test for pregnancy.
One thing to note is that women
with ovulatory cycles but with irregular cycle lengths, the greatest
variation from cycle to cycle should be in the follicular phase. The
luteal phase should be relatively constant (within 1-2 days). So if one
has a cycle that ranges from 28-34 days, and a luteal phase of 14 days,
ovulation would occur somewhere between days 14-20 -- not the middle of a
cycle, not day 14 . . . This is the biggest mistake women with long cycles
make when trying to conceive.
Basal Body Temperature Questions
Q: What will my BBTchart tell
A: The goal is to find out if you
are ovulating and help you time intercourse. If you see a definite
biphasic chart, thats a good sign. You can also tell whether your
luteal phase is long enough if your temperatures are up for at least 12
days after ovulation.
Q: How long should my
temperature stay up after ovulation?
Ideally, 14 days. Some doctors say
anything over 10 days is acceptable, but it really makes sense to test for
luteal phase defect if one typically shows 12 days or less of high
temperatures. You can test for luteal phase defect with a serum
progesterone level and/or an endometrial biopsy. Many doctors will want to
see two cycles of low progesterone or out of phase biopsies before making
a definite luteal phase defect diagnosis.
Q: My temperature dropped for a
day in the luteal phase, does that mean this cycle is a bust?
A: Not unless it stays down. Some
people have a short drop that may go well below the coverline that is a
secondary estrogen surge (which may be accompanied by mucus).
Q: How long should I chart
before seeing a doctor if I suspect infertility?
A: Good question! If your cycles
are irregular, you shouldnt waste time on BBTs alone -- see a doctor
and find out what may be causing the irregularity. If you do have
normal-length cycles and decide to start charting, you only need to wait
about 3 months to establish a problem and seek help. For example, if you
have a 28-day cycle, but ovulate on day 18, and that happens 2-3 months in
a row, you should see your doctor. Otherwise it depends on your age and
urgency. Its not a bad idea for everyone to get preconception advice
and bloodwork -- test for immunities to rubella, chicken box, fifth
disease, also test for anemia and thyroid function at a minimum.
Q: What are average BBTs?
A: The average range of BBTs is
between 97.0-97.7 before ovulation and 97.7-99.0 after ovulation. Ideally,
a womans temperature will not bounce around more than .5 degrees in the
follicular phase and will stay above the coverline during the luteal
Q: My BBTs are lower/higher than
average, what does this mean?
A: Either case warrants checking
your thyroid. Low BBTs are often a sign of hypothyroid which can cause
some fertility and pregnancy problems. Excessively high temperatures may
Q: I did and ovulation predictor
kit, how long after the positive should my BBT rise?
A: You should ovulate 12-48 hours
after the positive ovulation predictor test, and your BBTs should go up
within 48 hours of ovulating. It can take up to 4-5 days to see the rise,
but ideally you see it within 3.
Q: My chart looks more like the
Rocky Mountains than anything else, what does that mean?
A: Most likely a) you are not
taking your BBTs consistently or sleep erratically, b) you are taking your
BBTs orally and you sleep with your mouth open, or c) you are not
ovulating. If being more consistent, or switching to taking your BBTs
vaginally or rectally, doesnt help, you should go to the doctor to have
your hormone levels checked out and see what may be causing your
Q: How late in a cycle can one
A: It is possible to ovulate very
late in a cycle -- there is not any day limit -- so a long cycle doesnt
mean there is no hope. Long cycles do, however, reduce opportunities to
get pregnant and warrant looking into. It is also a good idea to have at
least one cycle every 3 months, brought on by medication if needed, so
that the uterine lining does not become too thick.
Q: Can I tell I am pregnant from
a BBT chart?
A: You are most likely pregnant if
your BBTs stay up for 18 or more days after ovulation. It is also common
to see a triphasic chart, a second shift sometime during the luteal phase,
when pregnancy is achieved.
Q: Do I really need BBT
thermometer, or will a fever thermometer do?
A: A BBT thermometer is more
reliable and more accurate. In glass thermometers, fever ones are only
accurate to .2 degrees Fahrenheit. You really need it to be accurate to .1
degrees. The main plus of the digital BBT over a fever BBT thermometer is
speed. The BBT digital is more accurate for some people, and it only takes
30-60 seconds, which can matter if you are waiting to go to the bathroom
first thing in the morning. The digital ones are harder to break and
remember the temperature for you if you dont want to chart it