Fertility Challenges: Ovulation and Pregnancy Concerns

Can I get pregnant?

I have been married for three years, and there has been no progress in my pregnancy journey.
After visiting the hospital for examinations, it turns out my husband has no issues, but I have chocolate cysts on both ovaries (the right side had surgery for a cyst before but has recurred).
The left fallopian tube is blocked, while the right one is open.
Additionally, I have adenomyosis in my uterus.
These factors make it very difficult for me to conceive naturally.
Since I am already 36 years old, the doctors have advised me to proceed with in vitro fertilization (IVF).
However, due to financial considerations, I am currently unable to pursue IVF, so I have started tracking my basal body temperature and using ovulation test strips.
Here are my temperature readings:
- November 17: 36.79 (menstruation, evening)
- November 18: 36.26
- November 19: 36.69
- November 20: 36.85
- November 21: 36.88
- November 22: 36.69 (menstruation ended)
- November 23: 36.59 (intercourse)
- November 24: 36.58
- November 25: 36.68
- November 26: 36.62
- November 27: 36.58
- November 28: 36.58 (intercourse at 2 PM)
- November 29: 36.45 (T=C)
- November 30: 35.88 (intercourse around 2:45 PM) (T- December 1: 36.69
I would like to ask if I should have intercourse today.
I'm unsure if I have already ovulated.
After measuring my temperature at 6:00 AM and recording it in the app, it immediately suggested having intercourse within the next 12 hours, recommending a time of 11:00 AM.
However, I cannot do it at that time and am worried about missing the opportunity.
If I wait until the afternoon to have intercourse, will I miss my chance? I would like to know if the low temperature indicates the ovulation period, or if the day when the temperature rises is the actual ovulation day.

vivi, 30~39 year old female. Ask Date: 2016/12/01

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, ovulation occurs around the time of low temperatures.
Engaging in intercourse before and after ovulation does not have a specific time point.
Wishing you good health.

Reply Date: 2016/12/01

More Info

Understanding fertility challenges can be a complex and emotional journey, especially when dealing with conditions like chocolate cysts (endometriomas), blocked fallopian tubes, and uterine fibroids. Given your situation, it’s important to address both the medical and emotional aspects of your fertility journey.

First, let's clarify some key points regarding ovulation and the timing of intercourse. The basal body temperature (BBT) method you are using is a common way to track ovulation. Typically, a woman's BBT is lower during the follicular phase (before ovulation) and rises after ovulation due to increased progesterone levels. The day of the temperature shift (when your temperature rises) is generally considered to be the day of ovulation or the day after. In your case, the significant temperature increase after a period of lower temperatures suggests that ovulation likely occurred around that time.

Regarding your question about whether you should continue to have intercourse, it’s important to note that sperm can survive in the female reproductive tract for up to five days. Therefore, if you had intercourse on the days leading up to and including the day of ovulation, you may still have a chance of conception even if you miss the exact ovulation window. However, if you are concerned about timing, it is generally recommended to have intercourse on the day of ovulation and the days leading up to it.

Now, concerning your specific conditions: chocolate cysts can affect fertility by disrupting normal ovarian function and potentially causing pain. Blocked fallopian tubes, particularly if one is open, can also complicate natural conception, as the egg needs to travel through the tube to meet the sperm. Uterine fibroids can impact implantation and the overall environment of the uterus, making it more challenging for a fertilized egg to implant successfully.

Given that you are 36 years old and have been trying to conceive for three years, it’s understandable that your healthcare providers have recommended in vitro fertilization (IVF) as a more effective option. However, financial constraints can be a significant barrier. It’s important to discuss all available options with your healthcare provider, including potential financial assistance programs, payment plans, or even exploring less invasive treatments that may help improve your chances of natural conception.

In terms of emotional support, it can be incredibly beneficial to connect with others who are experiencing similar challenges. Support groups, whether in-person or online, can provide a sense of community and understanding. Additionally, consider speaking with a mental health professional who specializes in fertility issues. They can help you navigate the emotional ups and downs that often accompany fertility challenges.

In summary, while tracking your ovulation through BBT is a helpful tool, it’s essential to consider your overall reproductive health and the impact of your specific conditions on your fertility. Continue to monitor your cycle, and don’t hesitate to reach out to your healthcare provider for guidance on the best next steps, whether that involves further testing, exploring treatment options, or discussing IVF when financially feasible. Remember, you are not alone in this journey, and there are resources available to support you both medically and emotionally.

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