Actively Trying

Q: How do I figure out when I'm ovulating?

A: 1. From basal body temperatures to ovulation kits, figuring out when you actually can get pregnant can feel mind-boggling.

The doctor says:
"There are multiple ways to figure out when you're ovulating. You can use a basal body temperature chart, you can use a urine ovulation kit, you can count back two weeks from the first day of your next period, or a fertility doctor can use blood tests and ultrasound exams to better time ovulation."
--Fertility expert Dr. Daniel Stein, MD, is medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City

Getting It Right:

• Basal body temperature - Chart your temperature over the course of a few months. You can download a chart online. Take your temperature every day at the same time before you get out of bed. You can read the results yourself or take it to your OBGYN, who can read it more accurately.
• Ovulation kits - Ovulation predictor kits can give you a good sense of when you're ovulating because the kits test for a surge of the hormone that causes you to release an egg. Midday is the considered the best time to take the predictor test. Peak fertility is one to three days after the surge, so plan to have sex during that time!
• Doing the math - Typically you ovulate two weeks before the first day of your next period. So, if you expect your next period will start on April 1, you will probably ovulate around March 14.
• A fertility specialist - A fertility specialist can use blood tests and ultrasounds to give you a clear sense of when you're ovulating.

Mom•Logic Moms say:
"When I was trying to get pregnant, I made sure to 'try' a few days before ovulation because I know that sperm can live up to a week in there. For me, that worked like a charm - both times," says Stefanie, Mom of two.

Q: How do I take my temperature to figure out fertility?

A: Figuring out your basal body temperature is a tricky process. Make sure you get it right.

The doctor says:
Take your temperature from the first day of your period every day for a few months. If you are ovulating there'll be a point in your cycle when your temperature will rise. It may go up by as little as ½ a degree and it will stay up for seven to 10 days and then it'll start to fall again.
--Fertility specialist Dr. Daniel Stein, MD, is medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City

Getting It Right:

• Download a Basal Body Temperature chart from the Internet
• Take your temperature at the same time every day before you get out of bed in the morning. Keep the thermometer by your bed so you don't have to move to get it.
• Do as little as possible before you take your temperature. Some say to take it before you even speak!
• Plot your daily temperature on the chart
• Do it daily for a few months
• Internet sites will help you interpret the results
• For a more accurate reading, take your chart to your doctor and have her interpret it for you.

Mom•Logic Moms say:
"When I was trying to conceive, I never knew if I was taking my temperature properly or not," says Elizabeth, mom of one. "It was all so confusing! But after a few months, I got the hang of it."

Q: Can a woman get pregnant the day after her period?

A: For moms trying to get pregnant, it would be nice if every day were a possible pregnancy day. But that's not necessarily the case.

The doctor says:
"No. If that happened, then it wasn't your period."
--Fertility expert Dr. Daniel Stein, MD, is medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City

Calculating When You're Ovulating
Figuring out when you're ovulating is an exercise in predicting the future. Typically ovulation happens approximately two weeks before your next expected period. For example, if you expect that the first day of your next period will be April 1, then you'll probably be ovulating around March 14. The portion of your cycle that follows ovulation is much more stable, usually two weeks.

Mom•Logic Moms say:
"I always heard you couldn't get pregnant the day before your period," says Sally, mom of two, "but that didn't stop me from trying!"

Q: Can I have a cocktail when I'm trying to get pregnant?

A: It goes without saying that you should steer clear of the booze when you're pregnant, but what about before you're pregnant?

The doctors say:
"If you're tying to get pregnant you certainly shouldn't be drinking heavily anyway. If you want a glass of wine on the weekend, sure, go ahead and have one. You certainly should avoid heavy drinking, but if you drink in moderation, you shouldn't be worried."
-- Dr. Hilda Hutcherson, OBGYN, is a professor of Obstetrics and Gynecology at Columbia University in New York

"If you want to be certain that not a lick of alcohol passes to your baby, avoid drinking any alcohol after you ovulate," says fertility expert Dr. Daniel Stein. "But there's no reason at all to cut out the booze before you ovulate."

Mom•Logic Moms say:
"Most people have had a few cocktails when they conceive anyway, right? I drank plenty in the weeks before I knew I was pregnant and my doctor told me not to worry about it so I figure if you can drink while you are pregnant, you can certainly drink while trying to get that way!" says Andrea, Mom of one.

Other Moms say:

• Even though my doctor said I could drink while trying, I was too paranoid to do so.
• Booze probably helped get me pregnant in the first place!

Testing

Q: I think I might be pregnant. Can I take a pregnancy test BEFORE my period?

A: When you're trying, it's hard not to get trigger-happy with all those tests that promise early detection.

The doctor says:
"Don't take the pregnancy test until you've missed your period by one day. It just doesn't make sense. There are some tests that will pick up pregnancy before you miss your period, but you just set yourself up for a lot of disappointment if you test before you miss your period. So I tell my patients to wait.
--Dr. Hilda Hutcherson, OBGYN, is a professor of Obstetrics and Gynecology at Columbia University in New York

Mom•Logic Moms say:
"Go for it! These days the tests are super sensitive. I tested a week before my period was due and could see a faint line. Of course, buy a ton of tests because no matter what the response, you will feel compelled to take it over and over again," says Tina, Mom of two.

Other Moms say:

• I once bought 3 pregnancy tests on the same day!
• I couldn't help myself--I spent over $100 on pregnancy tests in one month. (They sure aren't cheap!)
• I'd heard they weren't 100 percent reliable, so I tried to stay away from early-detection tests to avoid disappointment.

Q: What are the early signs of pregnancy?

A: Some moms swear they just knew when they were pregnant. What's their secret?

The doctor says:
"Each woman has her own way of knowing, but it varies so much. Every woman is so different. Some have no signs at all, some get breast tenderness or enlargement, some women say they feel tired. Others get headaches. Most women don't feel anything until they're eight weeks pregnant, though."
--Dr. Hilda Hutcherson, OBGYN, is a professor of Obstetrics and Gynecology at Columbia University in New York

Tips to Surviving the Dreaded Symptom: Morning Sickness
Morning sickness usually sets in after about eight weeks. Here are some tips for surviving this early pregnancy symptom:

• Eat frequent, small meals rather than big meals
• Suck on peppermint candy
• Lemonade without any sugar helps
• Chew on crackers in the morning
• Avoid mixing dry food with liquid food
• Try anti-nausea wrist bands that hit pressure points in your wrist

Mom•Logic Moms say:
"I think tingly boobs are a dead give-away. That's how I knew I was knocked up. The boobs hurt horribly sooner than they did when I was just PMSing. Plus, some people, like myself, just have a feeling..." says Kelly, Mom of one. Other Moms say:

• I was so tired.
• The only thing that made me think otherwise was the 'plus' sign on the pregnancy test!

Fertility Challenges

Q: I've been trying to get pregnant for a while, but no luck yet. Am I "infertile"?

A: When getting pregnant turns out to be more difficult than you thought, all sorts of thoughts run through your head. The truth may be less scary than you think.

The doctor says:
"It definitely doesn't mean that you won't be able to get pregnant. In many cases it can be quite simple to greatly improve fertility rates. The problem may be a very minimal issue or it could be a very significant issue. There's no reason to panic, it's just a reason for an evaluation."
--Fertility expert Dr. Daniel Stein, is medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City

What Does Infertility Mean?
Infertility is defined as a woman who is under 35 and has failed to conceive after having sex around the time of ovulation every month for 12 months. For a woman who is over 35, we recommend a fertility specialist evaluate her after she tries for six months.

Some Causes of Infertility

• Bad Timing: It may simply be a problem of bad timing. If you're not having sex frequently enough at the right time of the month, you may have trouble getting pregnant. All you may need is a doctor to help you pinpoint the best time to try.
• Irregular Ovulation: You may ovulate irregularly because of age or hormonal imbalances.
• Low Sperm Count: Your partner may have low sperm count.
• An Anatomical Problem: You may have a more serious fertility problem like damaged or blocked fallopian tubes. In this case, you may not be able to get pregnant without in vitro fertilization.

Mom•Logic Moms say: "Infertility means that you would give anything for a baby, and are willing to spend thousands and thousands of dollars for a slim chance of getting pregnant," says Jamie, who's still trying. "Or at least that's what it means to me."

Other Moms say:

• It seemed like every doctor's definition of infertility was different. Some would say I was definitely infertile, while others told me to keep trying. It was frustrating.
• The definition of infertility? Me.

Q: IVF: How much does it cost? Success rate? Covered by insurance?

A: Struggling with fertility takes more than an emotional toll on a couple; it can take a financial toll, too.

The doctor says:
"The answer to all of your questions is: it varies widely. Costs vary from center to center across the country. Success rates vary because every woman's situation is different. And some insurance policies cover the procedure while others do not. Some centers take insurance and others don't."
--Fertility specialist Dr. Daniel Stein, is medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City

Breaking It Down:

• Cost: Expect to pay anywhere between $7,000 and $13,000 for one IVF cycle. Why such a range? The cost varies depending upon where you are and which center you choose. A boutique center in the well-heeled Upper East Side of Manhattan may cost much more than a center in Tucson, Arizona, but the quality of service might be comparable. Remember, a more expensive center does not necessarily provide a better service.
• Success Rate: Success rates are notoriously inaccurate and are often manipulated. A patient should not use success rates as a measure of a center's quality. Even the American Society of Reproductive Medicine and the Society for Assisted Reproductive Technology strongly caution patients to not use success rates as a means to compare centers. The success of IVF depends mostly on the age of the woman and the reason for infertility.
• The Skinny on Insurance: Several insurance companies cover IVF, but not all centers accept insurance. Whether a center accepts or doesn't accept insurance doesn't say anything about the quality of the center.

Mom•Logic Moms say: "IVF cost me my life savings, but it was worth it because I got a beautiful, healthy baby at the end," says Karen, mom of one. "When all was said and done, we spent $48,000."

Other Moms say:

• How much are infertility treatments? Too much!
• It depresses me too much to think how much it costs, quite frankly. But I'll pay any amount of money to get pregnant--to me, that is priceless.

Q: What's the "turkey baster" method?

A: So it turns out chicken's not the only thing you can cook with those things.

The doctor says:
"The "turkey baster" method is a colloquial term used to describe self-insemination. It refers to a woman who uses donor sperm or her partner's sperm and injects it into her vagina with a needle-less syringe. It is not terribly effective and it is not a recommend form of insemination."
--Fertility specialist Dr. Daniel Stein, is medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City

A More Reliable Way:
There is a therapy called intra-uterine insemination in which semen is prepared in a special manner to allow it to be injected through the cervix into the uterine cavity. That's what doctors would do in cases where the only problem is an absence of sperm.

Mom•Logic Moms say: "I always found the 'turkey baster' phrase to be so offensive," says Andi, Mom of one. "We're making a baby, not a turkey!"

Other Moms say:

• We tried IUI three times before getting pregnant.
• IUI was so much cheaper than IVF--it cost $600 per treatment. Thankfully, it worked for us, because it was all we could afford.

Q: I've had two miscarriages in the past. What are my odds that I'll have one again?

A: Losing a pregnancy can be heartbreaking. Losing two, devastating. Should you prepare to lose again?
The doctor says:
"It depends on the cause of the miscarriages and it depends on the age of the woman. Having a single miscarriage is very common and does not indicate that there's a significant problem in any way. Once a woman has had two miscarriages, it is time that an evaluation be performed by a specialist. Being evaluated doesn't mean you have a problem; it just means you're being evaluated."
--Fertility specialist Dr. Daniel Stein, is medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City

Your Odds:

• One Miscarriage: The chance of any pregnancy miscarrying ranges from 15 percent to 30 percent.
• Two Miscarriages: In general, a woman who's had two miscarriages and has never had a live birth has at most a 50 percent chance that her next pregnancy will miscarry. However, every woman is different and a woman with a specific fertility problem could have a much greater chance that she'll miscarry again. But take heed, two miscarriages doesn't necessarily mean that you have any fertility problem whatsoever.

Mom•Logic Moms say: "I had three miscarriages in between my first and second child," says Traci, mom of two. "Don't give up!"

Other moms say:

• I've had three miscarriages after my first son. I want another kid but I don't know if I can take the disappointment anymore.
• I had a miscarriage after my first child, then consulted a fertility specialist. I ended up getting IVF, and now have a healthy daughter.