Purpose of Profasi with Clomiphene

Q.We are trying to conceive our third child. I am using Clomid, ovulation predictor kits, and Profasi injections.

Since I'm detecting my surge with OPKs, I should ovulate 12 to 18 hrs later, correct? But since I will be taking a Profasi injection right after seeing the surge, will I ovulate sooner? And will I release all my eggs when I do ovulate?

A.Ovulation usually occurs at least 24 hours after LH surge, sometimes longer. My guess is that the Profasi injection is just to make sure all eggs are released from the follicles, not to make you ovulate sooner.

Varicocele Repair & Endometriosis

Q.My husband had varicocele repair in December 2002. We have been told that no significant change will be noticeable until at least March of this year, maybe even June. I have mild endometriosis with occasional annovulatory cycles but have checked out okay at present. We have both started using fertility blend vitamins hoping that it would help our attempts.

I saw listed on your site that you were familiar with the herbs and maybe could give us some kind of direction as to how long it might take, the surgery in conjunction with the vitamins. Before surgery we were only IVF candidates but our specialist was leery about doing it because I am only 22 years old. If you could maybe give us some guidelines as to what we can possibly expect, I would appreciate it a lot.

A.If your husband has had the varicocele repair and is taking the antioxidant and superantioxidant regimen that I suggest (vitamin C, vitamin E, B12, beta carotene, zinc, selenium, L-arginine, L-carnitine, and pycnogenol) and a cool pack to the scrotum twice per day, his healing time should be reduced.

I am more concerned about your endometriosis and anovulatory cycles. Although you have “checked out okay at present”, I believe that endometriosis often causes implantation and hormonal problems that are often overlooked. Without knowing details of your medical history, I usually recommend women with endometriosis take 125 mg. of pycnogenol (from the extracts of grape seed, pine bark, red wine, and citrus bioflavonoids) along with 1200 mg. of fish oil daily to reduce the inflammatory reaction your body has to the endometriosis, which also prevents implantation. If you start this regimen now, you may both be healthy enough to conceive about the time your husband’s sperm parameters are optimum.

Underweight and Hormonally Imbalanced

Q.I am 19 years old, am skinny, and have steadily absent menses due to hormonal imbalance. I only had [a period] one time at age 16. Can you help me with something to restore my natural balance of hormones, or to balance my hormones?(I wanna get off the birth control pills.)

A.The best remedy for your hormonal imbalance is to ensure that your body fat content is adequate to produce its own hormones. No herbal remedy will work effectively if your body can’t support the corrective measure. When your body fat content is adequate, supplementing herbs which help support the reproductive system like dang gui (angelica) can be helpful, but not in lieu of sufficient body fat. That doesn’t mean you have to gain a lot of weight, just enough until the hormones are produced naturally by your body.

Spotting and Long Cycles

Q.What does it mean if I have two days of brief spotting five days after ovulation? Is this the egg disintegrating? My cycle is usually over 35 days and I'm trying to track my ovulation with a fertility monitor.

A.Spotting after ovulation often does mean an ineffective implantation. If your cycles tend to be longer than 35 days, your ovulation is occurring later than normal, which may mean that the egg produced by the follicle is not healthy enough to become a hearty pregnancy. When a woman consults me for long cycles, I first try to ascertain what imbalance is making her ovulate late. When I treat that imbalance, either with acupuncture, herbs, dietary suggestions, or all, ovulation will usually come earlier, a healthier egg will be the result, and the product will be a pregnancy which remains.

Reason for Darker Menstruation & Not Conceiving

Q.I'm 26 years, trying to get pregnant for last five months. I don't use any contraception, my period is regular, but recently I found the colour of bleeding during my menstrual cycle was darker. Is this a problem? Why am I not getting pregnant inspite of frequent intercourse? Can I have periods during pregnancy?

A.It may be a problem with the uterine lining itself. If the menstrual blood tends to be very dark (brown or black), I usually prescribe herbs and make nutritional recommendations to improve the menstrual flow, and the ability of the uterine lining to accept a fertilized egg. This often includes herbs like dang gui (angelica), taking evening primrose oil or fish oil, applying castor oil (with a heating pad or hot water bottle) to the lower abdomen before ovulation, and including foods like seaweed in the diet. And, although women can have periods during pregnancy, it is uncommon.

Natural Treatment for Hostile Mucus

Q. I have been married for almost 10 years. After many years of unsuccessful attempts to conceive, we have resumed fertility treatment. My post-coiteral tests (PCT) for the past four months have shown that my husband's sperm cannot penetrate my cervical mucus. All sperm has been dead. My doctor prescribed Serophene (clomiphene) for two months now and my PCT last month was the same (no living sperm). This month through vaginal ultrasound when my follicles were "mature" at 18, they have given me my first injection of Profasi.

During my research on Serophene, I have read articles that [the drug] can cause hostile mucus which makes me curious as to WHY I have been prescribed this. Is there something "natural" that I can take to stop the hostile mucus? It has been suggested to me to douche with mineral water before intercourse during ovulation.

A.Serophene absolutely can worsen cervical mucus. Although intrauterine inseminations bypass the cervix, it does not treat the underlying problem. Some general recommendations that I can make to help make the mucus less hostile without knowing your underlying history, is to make sure you are eating very alkaline foods (organic vegetables, very little wheat, very little animal products, avoid alcohol, coffee), as acidic environments are not sperm friendly. Excess vitamin C can also produce more acidic cervical fluid as well. Douching with mineral water and baking soda water helps reduce acidity locally, but won’t necessarily penetrate into the cervical environment. Egg whites (yes, really) also help sperm survive longer in the vaginal canal, as their pH mimics neutral cervical fluid. If your mucus is too thick, which can also impair sperm transit, you may want to take an expectorant like guaifenesin, which thins all secretions, including cervical. All of these methods together may help your body produce more alkaline cervical fluid, and help the sperm survive longer and get through the cervix.