Infertility: The Role of Basal Body Temperature Monitoring

Infertility, basal body temperature?

Hello, doctor! I have a long-standing habit of tracking my basal body temperature because I really want to get pregnant, but I've been waiting for nearly ten years without success.
I underwent laparoscopic surgery last October due to blocked fallopian tubes.
After the surgery, the left tube was somewhat functional, but the right tube could not be opened! After the surgery, I tried to conceive naturally for six months, but still no luck...
On April 23 of this year, I got my period, and on April 25, I started taking "Gonal-F" at a dosage of 150.
On May 3, during my follow-up, I had two follicles on the right and one on the left.
That evening and the next morning, I increased the dosage of "Gonal-F" to 225.
However, when I returned on May 6 for another ultrasound, the original follicles were gone, and there was only one on the right side 😑😑.
The doctor called it off and advised me to consider in vitro fertilization (IVF)…… 😵 My basal body temperature has also been unusual! Since my temperature dropped on April 23, my period came early on May 14, and as of today, June 8, I have not had a high temperature phase! I don't know what the problem is.
What tests should I undergo during my next appointment?

Huey, 30~39 year old female. Ask Date: 2015/06/08

Dr. Lin Wenbin reply Obstetrics and Gynecology

Based on your condition, it is advisable to follow the physician's recommendation and consider in vitro fertilization (IVF).
Although your description is detailed, it is important to consult with the physician who suggested IVF for further discussion.

Reply Date: 2015/06/08

More Info

Understanding infertility can be a complex journey, especially when it involves monitoring basal body temperature (BBT) and navigating medical interventions like laparoscopic surgery and fertility medications. Your experience highlights several critical aspects of fertility, hormonal balance, and the role of BBT in understanding ovulation and overall reproductive health.

Firstly, it's important to recognize that BBT monitoring is a valuable tool for tracking ovulation. Typically, after ovulation, there is a rise in BBT due to increased progesterone levels, which can help confirm that ovulation has occurred. However, in your case, the fluctuations in your BBT and the absence of a sustained high-temperature phase may indicate underlying hormonal imbalances or issues with ovulation itself.

Given your history of tubal blockage and the subsequent laparoscopic surgery, it’s crucial to consider how these factors may affect your fertility. The fact that only one of your fallopian tubes was successfully opened could significantly impact your chances of natural conception, as the egg must travel through the fallopian tube to meet sperm for fertilization. If the right tube remains blocked, it may limit your chances of conception, especially if ovulation occurs on that side.

The use of fertility medications, such as Gonadotropins (like the ones you mentioned), is intended to stimulate the ovaries to produce multiple follicles. However, the fact that your follicles did not develop as expected could suggest several possibilities: inadequate response to the medication, potential issues with ovarian reserve, or other hormonal factors that may need to be addressed. It’s not uncommon for fertility treatments to require adjustments in dosage or type of medication based on individual responses.

In terms of your BBT, the drop in temperature followed by an early onset of menstruation could indicate that ovulation did not occur or that there was a luteal phase defect, where the body does not produce enough progesterone to maintain a pregnancy. This could be a significant factor to discuss with your healthcare provider.

As for your next steps, it would be advisable to schedule a follow-up appointment with your fertility specialist. During this visit, you may want to discuss the following:
1. Comprehensive Hormonal Testing: This can help assess levels of key hormones such as estrogen, progesterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Understanding your hormonal profile can provide insights into your ovulatory function.

2. Ultrasound Monitoring: Regular ultrasounds can help track follicle development and assess the health of your ovaries and uterus. This can also help determine if there are any structural issues that may be affecting your fertility.

3. Consideration of IVF: Given your history and the challenges you've faced with natural conception, discussing in vitro fertilization (IVF) may be a prudent option. IVF can bypass some of the anatomical barriers posed by blocked fallopian tubes and can be tailored to your specific needs.

4. Lifestyle Factors: Discuss any lifestyle factors that may be impacting your fertility, such as stress, diet, and exercise. These can play a significant role in hormonal balance and overall reproductive health.

5. Emotional Support: The emotional toll of infertility can be significant. Consider seeking support from counseling or support groups for individuals facing similar challenges.

In conclusion, while BBT monitoring is a useful tool for tracking ovulation, it is essential to consider the broader context of your reproductive health. Engaging in open discussions with your healthcare provider about your concerns and treatment options will be crucial as you navigate this journey toward conception. Remember, fertility is a multifaceted issue, and addressing it often requires a comprehensive approach tailored to your unique situation.

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