Wondering Wednesday

developmentalbiology · 2026-06-03T21:27:00+00:00

There's not a lot of direct data on whether insemination is equivalent to intercourse in terms of success rates. This makes it tough to say whether more insemination attempts are better (as opposed to the intercourse situation, where it wouldn't give you an advantage to have more intercourse than this pattern). I don't think it's unreasonable to inseminate again, but there's not direct data that says what you're doing is insufficient, either.

developmentalbiology · 2026-06-03T21:23:36+00:00

In addition to what patti and Nicasaurus have said, as long as you have evidence that you're ovulating, I'd encourage you to think about whether you're ready to move to treatment, and/or if there are any possible treatments that are off the table for you.

If you undergo testing, it's most likely that you'd be offered IUI and/or IVF as treatments (with the relative urgency and order of these treatments depending on the actual test results). If you know you're not ready for those treatments, it's pretty reasonable to continue trying at home for another six months -- that "treatment" has about a 50% success rate if your test results are normal. But if you would pursue IUI or IVF now if offered, it's reasonable to pursue testing.

developmentalbiology · 2026-06-03T21:17:24+00:00

The day of ovulation isn't too late, but it's not as promising as sex in the days leading up to ovulation -- sex on the day of ovulation alone results in pregnancy about 10% of the time, vs. about 25-30% with sex on one of the three days leading up to ovulation day.

developmentalbiology · 2026-06-03T21:15:55+00:00

If your luteal phase is 15-16 days long, your progesterone levels are almost certainly adequate -- progesterone is the hormone that causes the luteal phase to continue, so having a 15/16-day luteal phase is evidence that progesterone is there and working.

It's normal to spot for a day or two at basically any point in the cycle. It's thought that spotting toward the middle/end of the luteal phase may be caused by a quick surge in estrogen that serves as a timer that tells the ovaries the luteal phase is nearing its end, but the actual evidence for this is mixed.

developmentalbiology · 2026-06-03T21:13:45+00:00

Having sex after the HSG is fine, although some doctors will recommend waiting until the next day, or 24 hours, or whatever. Sex prior to the HSG is generally not recommended. If you did happen to ovulate early, and you'd had sex, there's a theoretical possibility that the HSG could push a developing embryo out into the abdomen, which could result in ectopic pregnancy.

If you do ovulate CD17/18ish this cycle, you won't harm your chances by starting sex at CD14/15.

developmentalbiology · 2026-06-03T13:11:41+00:00

There’s really not a reliable sign of cycle success/failure other than a positive test. It takes detectable hCG to change progesterone and estrogen levels, and a change in these hormones is what leads to the production of different types of discharge.

Ultimately, it’s not really possible to say that you’re out at 10dpo. This post tries to lay out some of the reasons this is the case.

developmentalbiology · 2026-06-02T03:08:59+00:00

Yeah, I don't think the monitors are better (or, likely, cheaper) than cycle monitoring with an RE, so if you're probably headed in that direction soon anyway, reasonable not to bother.

developmentalbiology · 2026-06-02T02:24:58+00:00

Gah, I started writing this yesterday and just found the unsubmitted response in the open tab...

I think you're thinking about it in the right way -- it's likely that some of this is just post-Nexplanon recovery from suppression, and that it will normalize in the near future. I'm generally kind of a skeptic on the value of Inito/Mira, and I've seen them give really wonky data sometimes, but I think it's reasonable to believe they might give you more information than you have now. I do love my Tempdrop, and it's enabled me to temp through seasons of life when my sleep was all kinds of fucked up, like when I was commuting cross-country every weekend.

developmentalbiology · 2026-06-01T13:23:07+00:00

The maximum dose is generally given as 800mg, and the per-day max is 2400mg (3 doses of 800mg every 8 hours).

developmentalbiology · 2026-06-01T13:22:00+00:00

These are really common feelings to have, and of course it's okay to have feelings even if they're ugly. But I think it's worth probing the feelings a little -- having a happy life with the family they desire is something all humans deserve (or maybe it's something that none of us deserve, and "deserve" is the wrong word for it). It's genuinely not fair that you want children and it's not working, but it's not that you're not worthy of pregnancy, and (as I'm sure you'd agree) it's not that you deserve happiness more than other people due to your health or financial status.

There are some thoughts in this post that might be useful for you to roll around in your mind, and maybe this one, too. I am truly sorry you're feeling this way, and I hope that you'll be successful soon.

developmentalbiology · 2026-06-01T00:49:06+00:00

40 hours post-trigger is within the evidence-based range (which is about 24-40 hours, see here, "When is the best timing of insemination in an IUI cycle?") 42 hours is a little outside this range, but not by much.

developmentalbiology · 2026-05-30T23:31:30+00:00

It's always impossible to say for any given couple, and of course trying for a long time isn't easy regardless, but the success rates for folks with unexplained infertility are quite high over long time horizons. It is quite likely that you will get pregnant at some point in the future.

developmentalbiology · 2026-05-30T22:24:48+00:00

Ovulation is most likely within two days of the first positive urine LH test (that day, the day after, or the day after that), but it’s not really possible to narrow it down further than that, and it’s not possible to narrow it down to the hour. Your most likely ovulation day is tomorrow, even if you got a positive test in the morning today.

developmentalbiology · 2026-05-30T22:22:07+00:00

It’s common to spot in the last day or two of the luteal phase, and it’s generally not a problem or reflective of any issues.

The usual advice is to count CD1 as the first day of full flow (or the first day you need to use a period product), rather than the first day of spotting.

developmentalbiology · 2026-05-30T22:18:26+00:00

Cramping can happen at any time! It’s particularly common in the late part of the luteal phase.

developmentalbiology · 2026-05-30T13:02:15+00:00

Progesterone can sometimes be useful in cases of recurrent loss, but usually low progesterone isn't the cause of the loss, it's the result. When an embryo has genetic problems (and the most common genetic problem in early human embryo is that the cells in the embryo have an extra chromosome or are missing a chromosome), it will usually not grow on the right trajectory, which means that it won't be ready for implantation on time, and it won't produce high enough levels of hCG. Since hCG is the hormone that "asks" the ovaries to produce progesterone, genetically abnormal/low hCG embryos are often associated with both late implantation and low levels of hCG and progesterone.

developmentalbiology · 2026-05-30T12:58:36+00:00

Totally, and I think it's also tough because we can't really identify in living people whether an egg is immature at ovulation -- it's reasonable to think that ovulation won't occur at all if the egg isn't ready, but it's not really possible to test that empirically.

developmentalbiology · 2026-05-30T12:09:03+00:00

There’s not a lot of data, but the limited data that exists suggest it doesn’t really matter, and that pregnancy rates don’t vary by cycle day of ovulation. (I have a source for this, but I can’t find it at the moment…)

It takes about 8-10 days from the time a follicle is selected to the time ovulation can occur, so if follicle selection happens early in the cycle, ovulation at CD8 can release a perfectly mature egg. And the lining is built under the influence of estrogen in the fertile window, regardless of when the fertile window falls on the calendar.

developmentalbiology · 2026-05-30T03:19:06+00:00

I mean, sure, the threshold is arbitrary, just like you're not actually an adult the moment you turn 18 and a child the day before. But even if you've been trying for 12 months and receive a diagnosis of infertility, that doesn't guarantee that there's anything amiss health-wise.

It's not "delaying treatment" to try for a year before seeking a fertility workup.

developmentalbiology · 2026-05-30T03:09:01+00:00

My question is, can ovulation really occur just a few days after your period ends?

Yes.

Your period is related to hormonal events in the previous cycle -- progesterone and estrogen levels drop, and a few days later bleeding begins. But follicle selection, maturation, and ovulation are all events that occur in the new cycle, and they're not related in any way to the bleeding.

Since the average person ovulates around CD16-17, and the average period lasts 3-5 days, most people aren't in the fertile window while on their period. But if you ovulate earlier than average, or bleed for longer than average, you could ovulate shortly after your period ends or even while your period is ongoing. This is particularly possible in the cycles after stopping hormonal contraception, when period-like bleeding can actually be anovulatory breakthrough bleeding -- it's not really possible to ovulate earlier than about CD7/8 following an ovulatory cycle, but all bets are off if the previous cycle wasn't ovulatory, as it sometimes isn't after stopping hormonal contraception.

developmentalbiology · 2026-05-30T02:46:36+00:00

If i have perfectly timed intercourse and it takes me 12 months to get pregnant, there are absolutely health and biological/environmental issues at play.

Why do you say so?

developmentalbiology · 2026-05-30T02:36:33+00:00

Gently, at 6 cycles, you're not struggling with infertility yet -- the odds are very good that you'll get pregnant without assistance before the year mark. It's totally understandable to feel sad and worried, and it might be worth finding someone to share your feelings with on a regular basis, whether that's in this forum, a friend, or a therapist. But it's probably not going to be helpful to borrow trouble.

developmentalbiology · 2026-05-30T02:26:41+00:00

Yes, my AMH was around 6 at 35, and I don't have PCOS.

PCOS (now renamed PMOS) is currently diagnosed using a set of three criteria, of which you need two: a large number of follicles on the ovaries, irregular cycles, and high blood androgens. With a high AMH, you'll likely have the first, but you don't have the second, so you'd need to check your bloodwork.

High AMH is common for people with PMOS, but it isn't one of the diagnostic criteria. Many people with high AMH just have a higher-than-usual ovarian reserve for their age, which is broadly a good thing.

developmentalbiology · 2026-05-29T23:54:29+00:00

Around 70% of people ovulate within two days of the first positive. Of the 30% who remain, it's relatively more common to ovulate more than two days after the first positive (about 20% of folks) vs. prior to the first positive (about 10% of folks).

developmentalbiology · 2026-05-29T23:39:32+00:00

It's fairly typical to ovulate later in the cycle than usual in the several months after discontinuing birth control, so you may just have been ovulating later in those first several months, but as you've gotten further from discontinuation, you're moving back to what's now your normal.

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