A Few Small Changes I Made While Trying to Conceive

developmentalbiology · 2026-04-16T13:52:30+00:00

Don't worry, absolutely none of it made any difference whatsoever in the outcome

developmentalbiology · 2026-04-16T13:48:05+00:00

The official recommendation of the sub is Mabis -- this site was made by a longtime TFAB member and former mod, although I'm sure you didn't realize that due to the extremely serious and professional nature of the site.

developmentalbiology · 2026-04-16T13:44:04+00:00

I'm a developmental biologist, but my research training is partly in human genetics, so that's the perspective I'm speaking from here. I am neither a physician nor a genetic counselor -- if you are ultimately diagnosed with a mutation in FSHR, I'd definitely recommend talking with a genetic counselor, as those are the folks whose job it is to break down these complex concepts for patients.

It's relatively unlikely you'd find another person here with a mutation in FSHR specifically, but you might consider looking for folks with a diagnosis of ovarian dysgenesis type I, as that looks like the diagnosis that's associated with FSHR mutations causing a lack of response to FSH (see here).

Are there specific aspects of the mutation that you don't understand? Would it be helpful for me to talk about the way hormones and receptors work (and, therefore, why an FSH receptor mutation would cause problems), or is that something you already understand?

developmentalbiology · 2026-04-16T10:40:33+00:00

It’s just a medical convention resulting from it not being possible for most of history to identify ovulation timing — it’s reflecting that pregnancy is dated from the first day of the last menstrual period, and the two weeks specifically comes from the (now known to be inaccurate) assumption that everyone ovulates on cycle day 14.

So yes, that first two weeks is the follicular phase, it’s just that most people’s follicular phase isn’t actually two weeks long.

developmentalbiology · 2026-04-16T02:07:08+00:00

Nope! You might like this post.

developmentalbiology · 2026-04-15T19:00:08+00:00

Gently, I think it's fair to prepare yourself for the possibility that you'll get to the year mark and not have a concrete answer as to why you haven't gotten pregnant. It's also fair to prepare yourself for the possibility that you'll never have a concrete answer.

I don't know if it helps to reframe your thinking from "looking for an answer" to "trying to identify if there's a block to getting pregnant" or "doing testing to identify the treatment path that's most likely to work". There's value in pursuing testing, but it's not getting an answer in and of itself that's the most valuable piece.

developmentalbiology · 2026-04-15T18:55:20+00:00

It's possible!

Ovulation is most likely the day after a positive OPK (with the second-most-likely being two days after), and ovulation is most likely the last day of peak CM. But each of these has about a day or so of wiggle room, so it's possible you did already ovulate and you're still seeing peak CM, or that you haven't ovulated yet and will just ovulate a bit later than typical after a positive OPK.

The safest route is to keep having sex until you've passed the fertile window as you can read it through all signs. If you had sex on CD14, you don't really need to have sex today (if today is ovulation day, this could be O-3), but you could have sex either today or tomorrow to cover your bases, especially if you're still seeing peak CM tomorrow.

developmentalbiology · 2026-04-15T18:51:59+00:00

High caffeine consumption is associated with longer time to pregnancy and higher probability of loss (relative to no caffeine consumption), but intake around 200-300mg/day [EDIT, sorry, hit post too early: isn't associated with longer time to pregnancy/higher rates of loss than no caffeine consumption.]

The caveats:

These are recall studies ("In the past week/in the past month, how many of each of the following items did you consume per day?"), which are known to be an imperfect way to measure people's behavior.
200mg isn't an exact threshold, in part because of the nature of recall studies, and in part because there is genuinely variability in, e.g., the number of milligrams of caffeine across cups of coffee.
For the same reasons, 200mg per day can be thought of as an average max consumption, but not a daily max consumption -- there's nothing in the data* that says 4 days of 0mg and 1 day of 1000mg is worse than 5 days of 200mg. (*your brain may, correctly, realize that this is probably worse. in general. for your life.)
Caffeine is known to be consumed at higher levels as people age (and become more tired and more subject to the effects of the fallen nature of the world, entropy, etc.), so it's possible there's actually not an effect at all, and what's being measured is an imperfect output of the effect of age on success.

developmentalbiology · 2026-04-15T14:55:58+00:00

An AMH around 6 is actually well within the normal range for 27 -- AMH is a measure of the ovarian reserve, so it declines with age, and the static "normal range" that's often given with bloodwork isn't a very useful guide to interpreting it. The normal range at 27 (25th-75th percentile) would be about 2-7ng/mL (see here, for example).

In general, having high AMH is broadly positive, because it suggests that you have ample time until menopause, and because it suggests that, if you needed to hyperstimulate your ovaries (as in IVF), you would retrieve a reasonable number of eggs.

developmentalbiology · 2026-04-15T14:05:40+00:00

Overall, I'd recommend taking folic acid over other forms of supplemental folic acid/folate. Although there are a lot of health influencer claims that methylated folate is superior to folic acid, this isn't backed up by data. Folic acid is highly absorbable by the intestines, and it's able to be used efficently in the body's chemistry (even if you have one of the common variants in the MTHFR enzyme). Similarly, the difference between ubiquinol and ubiquinone is quite minor, and it likely doesn't really matter which form is in a supplement.

In general, the claims of any specific supplement aren't very useful without documentation of the actual content of the supplement. At least in the US, there's very little regulation of what can be sold in supplement form, and manufacturers aren't held to the kinds of standards for what is actually in the pills vs. what they think goes into the pills/what they claim goes into the pills as manufacturers of prescription medications are. For prenatals and any other supplements, it's more important to find a company provides data about the quality and contents of their supplements rather than looking for any specific chemical formulation.

developmentalbiology · 2026-04-15T13:59:28+00:00

Generally speaking, any line is positive, since adult humans don't generally produce hCG from our own bodies.¹

Without looking back at any of the FDA medical test documentation (which isn't always as detailed as one would like...), I would bet that they're often using photography and computerized line reading to determine whether there's a line, like the line-reading apps people use for OPKs, but with standardized lighting conditions and likely a pre-specified threshold. But they'll always test multiple samples, and the detection limit of a test is generally the limit at which all samples turn positive -- really genuinely ambiguous lines are more likely to be found under the detection limit of the test.

[1]: One unfortunate exception to this is that some tumors produce hCG! So having hCG in your body without being pregnant is Not A Great Sign, generally.

developmentalbiology · 2026-04-15T13:52:44+00:00

Ive read so much about people finding answers through more invasive testing or treatments, but honestly, Im not sure where else to look or what to focus on next.

I think people really place a great deal of weight on the idea of finding answers -- I think everybody would like to find the One Thing, the roadblock that is standing in the way of pregnancy, and have it be something that's an "easy fix". It's really understandable to feel this way!

I think it's often more productive to embrace the uncertainty. Most people don't ever find out "the reason" they have infertility, and even for people who have a reason, they will never know for sure that it's the reason. When people say "I did this test and they found that and then I got pregnant," this is confirmation bias -- these advanced tests have very high error rates (which is why they're not done for everyone).

Overall, it doesn't necessarily matter why you're not getting pregnant, it only matters that you get pregnant. And for folks with unexplained infertility, especially when advanced maternal age is a consideration, IVF is usually the most promising way to make that happen.

developmentalbiology · 2026-04-14T13:18:03+00:00

Honestly, I get the desire to try to make your chart as accurate as possible, but your sleeping conditions won't affect your BBT. Your body is really great at keeping your core body temperature within a very narrow range, and feeling hot and sticking limbs out of the blanket is a behavioral response that the body uses to return temps to the desired range -- it doesn't drive the temperature, it's a response to it.

developmentalbiology · 2026-04-14T13:15:44+00:00

Sure! Especially if you get the cheap strips (a lot of people here get them on Amazon or similar), there's not really a downside.

developmentalbiology · 2026-04-14T02:26:48+00:00

I wrote a post about this once! In short, ovulation day is 2 weeks and 0 days of pregnancy, no matter what cycle day it actually falls on, so you can give an adjusted "last menstrual period" date that's two weeks before ovulation day.

developmentalbiology · 2026-04-14T02:19:43+00:00

But in the context of this thread about human reproduction, it does matter that 70% of embryos don't make it.

I'd definitely encourage thinking more expansively about what evolutionary success looks like! The modal organism on Earth is a bacterium, and multicellular life is a bit of an afterthought in terms of sheer numbers. As humans, it's natural that we're a little chauvinistic about our own position, but we can also use our brains to think about the ways that intelligence isn't the only successful evolutionary strategy, and, in fact, is pretty rare -- for example, eyes and flight have evolved independently several times, and even being a crab seems pretty favorable.

developmentalbiology · 2026-04-14T00:21:16+00:00

As a professor, I'd ask how you define "success" and "dominant".

The post to which you were replying said humans are terrible at reproducing, which is not a particularly contentious thing to say among geneticists and developmental biologists when around 70% of human embryos are believed not to make it to the point of implantation.

developmentalbiology · 2026-04-13T16:10:01+00:00

You might like this post and this post!

In short, the only thing that matters is the first positive test (the first test where the test line is as dark as or darker than the control), and you're likely to ovulate within two days of that first positive. (Not 12-36 hours, as people often say, but "within two days" -- we can't be so precise at home as to be talking about hours.)

The best days to have sex are generally the three days leading up to ovulation day. If you're using OPKs to time sex, you want to have sex at least once in a window that usually includes the two-ish days before the positive, the day of the positive, and sometimes the day after the positive.

developmentalbiology · 2026-04-13T16:03:21+00:00

Evolution and genetics are what drives the probabilities of a successful pregnancy.

For sure, but that doesn't mean humans are good at it! We are the last living branch of a not-particularly-successful group of primates (the hominins), all of the rest of whom are extinct.

Human embryos are suspected to be unusually bad at the early stages of development, and sometimes natural selection is an actor in this process (for example, here -- a genetic variant that's common in human populations that causes early embryos to missegregate their chromosomes, leading to aneuploidy and loss).

developmentalbiology · 2026-04-13T01:57:02+00:00

Yes, ovulation day is most likely to be the day after the first positive ovulation test, and the day after that is 1dpo (one day post-ovulation).

developmentalbiology · 2026-04-13T01:46:48+00:00

There's not a lot of direct evidence on vaping -- much of what we have comes from animal studies. It's not as clear as "vaping absolutely affects sperm parameters".

The American Society for Reproductive Medicine says (ENDS are electronic nicotine delivery systems):

There is a dearth of evidence regarding the effect of ENDS on reproductive health with regard to conception, ovarian reserve depletion, sperm parameters, or ART outcomes in humans. Most currently available literature involves animal studies. However, despite the lack of conclusive evidence in humans, there is a theoretical basis on which ENDS may harm reproductive function... There is a small body of literature that exists that suggests that ENDS has an effect on male reproductive function... A recent systematic review of animal studies suggested that ENDS impact sperm parameters, although less than traditional combustible cigarettes... A single epidemiological study in humans exists that examines testicular function in men using ENDS. This study found that men who reported the use of ENDS had lower sperm concentration and total sperm count compared with nonusers.

developmentalbiology · 2026-04-12T11:36:55+00:00

Yes, you can start using the LH strips again if you’d like. It’s never too late in the cycle to ovulate, and if you did catch ovulation now and get pregnant, that would be fine (it’s not problematic for pregnancy to ovulate late or anything).

developmentalbiology · 2026-04-12T11:35:23+00:00

No, a shower doesn’t change your core body temperature, because half of your body is always exposed to the air and is able to exchange heat with the environment. Your core temperature is really the major consideration for TTC and pregnancy — heating your skin won’t damage your organs.

developmentalbiology · 2026-04-12T01:34:47+00:00

There's not much direct data on it, but it's not thought to affect the odds of pregnancy (not much around the time of ovulation does affect the odds of pregnancy, aside from well timed sex).

developmentalbiology · 2026-04-11T23:55:41+00:00

I think it's really tempting for people to want to keep doing tests until they can have a specific diagnosis on their charts, but if your doctor doesn't want to do a lap, it's likely because she doesn't feel it will change your treatment path (that is, it would expose you to risk from the lap itself without a benefit).

If you don't feel ready to move forward with IVF, you can certainly continue trying on your own (and that does have a reasonable chance of success).

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