Friday, January 22, 2010

Using BBT chart and Ovulation Predictor Kit while on Clomid


Question:

First, thank you for your time. It is awesome that you would offer your advice on line.

I am on Clomid 150mg. I show on my BBT chart that I ovulated on cd 17. My temps stayed above the coverline till 7 DPO and again today on 8 DPO it is still low. All of the research I find says that implantation dip is only a single day, but that my temp should drop of between 10-16 days to start menstruation.
Here is the link to the website where I get my BBT chart. http://www.fertilityfriend.com

Thank you for your time.

Answer:

Thank you for your question, I try to give as good advice that I can considering the limiting factors, which of course include not being able to talk to you at length and in person.

I would not analyze the temperature chart so closely. It is not that accurate. Many factors can influence the temperature. It is only useful to see if there is a rise in the mid-cycle, which is an indirect measurement of the LH surge, indicating ovulation is going to occur. If you are going to continue using the chart, use it only for that indication i.e. timing of intercourse, and nothing else.

Another option, which I think is more accurate but more expensive is the ovulation predictor kit or OPK. However, with this kit you also cannot evaluate the luteal phase. The only way to evaluate the luteal phase is to do an endometrial biopsy. You will need to begin infertility testing for that.

Follow-Up Question:

One more question. My cycles are very irregular I take progestrone to start before the clomid. When do you recommend taking the home pregnancy test?

Thank you for your time.

Follow-Up Answer:

You are going through a lot of effort that is not very efficient.

The way that I do Clomid cycles is I follow my patients using the Ultrasound starting from day # 10 of the Clomid cycle. This allows me to see if the patient is responding to the dose that I prescribed, count how many potential ovulatory follicles there are so that there are not too many, and to time when intercourse should occur. I also use HCG to trigger the ovulation. With this method, the cycle is done more efficiently. I then do a pregnancy test two weeks later. It is programmed. There is no guessing. If your doctor is not doing it this way, then you are probably not seeing the right person or specialist. This is the correct way.

If you don't have a choice, then you have to go by the calendar method which is based on your period. Cycle day # 1 is the day your period starts. Begin intercourse on cycle day # 13-17, once per day, only one ejaculation per day. Do a pregnancy test on cycle day # 28 and repeat on cycle day # 30. If it is positive, then have a blood pregnancy test done on those days.

I hope this helps. Good Luck!

Sincerely,

Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

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