QuestionDr. Ramirez,
We have been trying to get pregnant with our 3rd child for about 4 months. I have been on clomid for three months. My OB put me on it because I had to be on it with my last pregnancy, due to low progesterone. I only took it one month and got pregnant. This time, I have not had any lab work, etc.. to see if I actually needed the clomid. They just put me on it. The first two months I had regular cycles each 29 days. The next month my cycle was 32 days and I did not ovulate. This month..today is my 35th cycle day and I'm just now getting a positive OPK. I'm a little confused by this and have thought maybe I was pregnant. Due to the CM I did an OPK and it was positive. IF in fact I am now ovulating is there a problem with ovulating this late in my cycle? Is there any conflict between OPK's and clomid as far as getting false positive results? I'm getting frustrated because my first pregnancy just happened, the second one with one round of clomid and now this. I'm just unsure of what to make of the ovulating on day 35. Does clomid normally regulate your cycles? Is this normal?
AnswerDear Tara,
If your OPK was positive for pregnancy, then you should have your OB/GYN doctor do a blood pregnancy test to confirm. If it confirms to be positive, then congratulations.
Many general OB/GYNs and Family practice docs put patients on Clomid immediately without a real indication. This is because they do not know what else to do. With Clomid, patients should be monitored by ultrasound to evaluate the response and time intercourse. It should not be used as just a pill taken at the beginning of the cycle and then nothing else. I also use Progesterone supplementation on my Clomid patients.
Clomid will not cause a false pregnancy test. In terms of the length of your cycle, the cycle length is not as important as long as the timing is all correct. That can only be evaluated by ultrasound monitoring in the Clomid cycle. Sometimes, patients will have a slow "follicular phase" where the follicle is being created then ovulate. In general, however, menses will occur 14 days after ovulation if pregnancy does not occur (luteal phase). If the cycle is 39 days, then the progesterone should be checked at the mid-luteal phase or around cycle day # 25.
Don't get too frustrated with getting pregnant. In humans, it is not an easy process, despite the fact that you got pregnant easily before. This also depends on your age. A woman's fertility decreases with increasing age. In her peak fertile years (16-29), a woman has an 18% chance of pregnancy per year. 85% will take 12 months to get pregnant. So, I would recommend that you continue to try but don't obsess over it. That stress by itself could prevent you from getting pregnant. However, if you are over 35 years old, then things are different. We recommend that women see an infertility specialist (not General OB/GYN) if no pregnancy occurs after 6 months of trying.
I hope that this answered your questions.
Sincerely,
Edward J. Ramirez, M.D.
Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF
www.montereybayivf.com
