Optimizing Fertility with Ovulation Detection

May 1, 2007 - Tuesday
12:44 PM to (EST)
Guest Speakers: G. Wright Bates, Jr., M.D.
Atlanta Center for Reproductive Medicine

Categories
Endometriosis • Fertility • IUI • IVF • Ovulation • PCOS • Pregnancy

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Dr._Bates	Good Evening and Greetings from Atlanta.
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Corey_Whelan	Hi everybody! I'm Corey Whelan, your chat moderator and the AFA's Director of Development. Tonight we get to really focus on how to increase your chances of conception through ovulation detection. We have as a very special guest speaker, G. Wright Bates, Jr., MD. Dr. Bates is an infertility specialist who is well known for his interest and expertise in supporting patients to create family.
cgalla	Hello and thank-you
Corey_Whelan	Welcome early birds. Since Dr. Bates is on board, we are ready to begin.
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Melissa_Majewski	Hello
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Corey_Whelan	Hi everybody! Now I know that you didn't log on to be silent. This is an amazing opportunity to get your questions answered by a leader in the field.
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cgalla	Ok - Dr Bates can you please give us an overview of how ovulation detection works?
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Dr._Bates	Thank you for the question cgalla.
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Dr._Bates	In general ovulation is the result of follicle growth, maturation of an egg and release of that egg.
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Dr._Bates	The process requires the rise and fall of the hormones (mainly estrogen and progesterone) that results in a regular menstrual cycle.
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lynne	Hi, I am concerned that I am not reading the OPK's properly. can they show positive several days before ovulation or truly 12-36 hours before it occurs.
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CA_Gort	Hello Dr. Bates,
Dr._Bates	Women who have regular predictable cycles and "PMS" or moliminal symptoms..ie breast tenderness, bloating or moodiness... are ovulating most of the time.
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ACDCJen	Is it possible to have those symptoms and not ovulate at all?
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Melissa_Majewski	good question
Dr._Bates	IN a 28 day cycle, ovulation occures around day 14 but it is the 2nd half of the cycle that is relatively constant at 14 days ..so shorter cycle...ovulation occurs sooner.
CA_Gort	Thank you so much for sharing your expertise with us. I have regular cycles (although they are long, 31-40 days usually) but I have not shown a positive on the over the counter ovulation predictor sticks.
ACDCJen	CA-neither have I, but I have pretty regular cycles. No line ever for me.
Melissa_Majewski	Ditto
ACDCJen	and I get the symptoms mentioned above.
holly11251	I have never had a "regular" 14 day ovualtion. MIne can be anywhere from 10 to 18 days before I ovulate. Is that normal?
Dr._Bates	Lynne...most OPKs measure the urine LH surge that occurs prior to ovulation. The peak of this surge is typically one day before ovulation but is often detected only a few hours before the event. A positive OPK several days in advance may not be accurate
lynne	I added a new symptom this month, bumps on the areola, "montgomery glands" and yet wasn't pg. is this common with menstruation as Ihave never had this happen before?
CA_Gort	Also Dr. Bates, not to overwhelm you with questions - I know it is hard to type fast - I only have one ovary. Would that affect how often or when I should be ovulating?
Miss_Teri	is it normal for there to be no line at all?
ACDCJen	But you don't have to wait until you get a positive opk in order for pregnancy to occur...
Melissa_Majewski	I have had this too- you ladies aer asking all the good questions!
Dr._Bates	False positive or early OPK readings are seen with PCOS and especially following the use of clomid. Finally, high LH or FSH values with early menopause can give early or false results
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ACDCJen	Would you get some sort of line though? Or only if a surge is imminent?
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Dr._Bates	CA-Gort...welcome to our west coast friends?? Cycles that are beyond 35 days or irregular are often not associated with an ovulation or release of the egg
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Melissa_Majewski	Do ovaries alternate ovulating?
ACDCJen	Define irregular other than over 35 days.
ACDCJen	And does that include a late o?
Jodi	I would like to know if there is a particular brand of Ovulation Predictor tests that are recommended? I have used the Answer Brand 20 pack the last two months.
Ann	If the OVC kits are so unpredictable, what's the best way to predict then?
Dr._Bates	On the other had ovulation on day 10 or 18 (HOlly) is normal if your cycle is 24 or 32 days but if it is quite variable..you may want to confirm ovulation with a serum progesterone, ultrasound and see you MD
ACDCJen	That's what I want to know Ann. Good ???
viviane	Hi all, Doc, for someone like me that has PCOS, I understand these OPK don't work properly and are not reliable for someone with PCOS
CA_Gort	Good question Ann - what is the best way to determine if we are ovulating?
Dr._Bates	lynee..good point breast and skin changes are commonly associated with the menstrual cycle
Dr._Bates	The side of ovulation is random and does not alternate.
Melissa_Majewski	Thank you
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Dr._Bates	By irregular, I mean varying by more than a few days each month and cycle lengths that are less than 21 days or more than 35 days. However, less than 24 and more than 32 may not be ovulatory
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Melissa_Majewski	Is the saliva opk good to use?
kfenton	For a 27 day cycle, would you usually start ovulation earlier than 12-14 days?
holly11251	What was the "salt" OPK's I saw referenced by you?
happiness	if your urine is light in color due to fluid intake, do you get false or negative result on the ovulation kit. they never seem to work for me. even if I use the ones that are unsed in the md's office.
viviane	IS OVWatch good for someone with PCOS?
Dr._Bates	Ann and JOdi: The OPKs are limited in that they rely on urine LH which is quite variable in timing and amount. While they are good at saying ovulation occurred, they often are poor at giving much advanced notice...especially with once a day testing
CA_Gort	Does the fact that I haven't been getting a positive on the OPK definitively mean that I am not ovulating or is there a better method of prediction?
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Melissa_Majewski	AH HA Dr bates.
ACDCJen	Is using basal temps and CM a good predictor?
marni	Dr. Bates: how many cycles does it usually take after a failed IVF cycle to return to a "normal" cycle (24-32 days)?
ACDCJen	and if your temps and CM show you had a "shift" but a negative OPK, does that mean you didn't ovulate?
Dr._Bates	Testing the saliva for hormones is nothing new. However, newer test don't rely on LH but look at chloride changes that reflect the menstrual cycle. This can be done in the Saliva but even more convenient is checking it on the skin.
CA_Gort	If I am not ovulating, what are some ways of jumpstarting the ovary to produce? Is there anything else other than chlomid? Are there any non-invasive options?
Dr._Bates	The OVWatch measures the changes while a woman sleeps and unlike urine kits, gives 4 or 5 days notice of the approaching ovulation.
Dr._Bates	ACDC...great name..... temperature charting is easy...but very inaccurate so I and many others encourage patients to not use it
estelle61	I've had a lot of problems with the watch not working.
viviane	is OV Watch good to use if you have PCOS??
cgalla	Dr Bates, when a woman is older, does the amount of advance notice it is possible to get from these kits decrease? Are any products more effective for women over 40?
ACDCJen	Ride On Dr. B. So how do you check the nacl on the skin?
Dr._Bates	However, the temps and the shift as you referred to is a good way in retrospect to tell if you ovulated but again no advance notice or usefulness in the current cycle and HIGHLY inaccurate
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arothman	is ov watch something that they sell in the stores and is good and safe to use?
Dr._Bates	CA...while Clomiphene is the oldest fertility tablet...many people are now using letrozole or femara (off label) to induce ovulation
Corey_Whelan	Folks, I need to let you know that Dr. Bates has an affiliation with OV Watch.
Melissa_Majewski	What is the best saliva kit to use?
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estelle61	I bought it, costs around $200, and in my opinion only worked the first time. I had to send it back and will have to again.
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ACDCJen	can you use letrozole or femara if you are overweight?
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Dr._Bates	Injectable medication will also induce ovulation and by the way if you are already ovulating, there is still a benefit to these medications
ACDCJen	And do either of those meds increase the problems with endometriosis?
Dr._Bates	Cgalla...great point...age is a key.... 40 is not old.....I am much older!!!!!!!!!! However, it does become more difficult to get pregnant and time is off the essence.... advance notice can only help...but seeking medical care sooner especially if well timed intercourse is not working is very important
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Dr._Bates	Teh OVWatch is an FDA cleared device and quite safe. It is available on the internet....ovwatch.com or other outlets...drugstore.com
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lynne	I have been tested as has my husband and all systems are go. So, it's been 8 months and nothing. What is the issue? the OPK's aren't working? Or, what else can be done? Iwas on clomid for one month to do the clomid challenge and it still didnt' work!?!
estelle61	I hope this is not an ad for the OV Watch. It doesn't work very well, or the manufacturer needs to fix it.
Dr._Bates	letrozole can be used regardless of weight but a higher dose may be needed....5 or 7.5. HOwever, if you are not cycling regularly weight loss is crucial for your efforts
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ACDCJen	Well, I am cycling very regularly, post bcp's. I just don't want something that will make my endo worse.
arothman	How would you test on the skin and with what? Is it just as accurate as the other tests?
Dr._Bates	estelle...thanks for the input...and I use it for my patient but am not advertising letrozole, clomid, OPKS or ovwatch... all have their place and limitations
Dr._Bates	arothman.... thanks for bringing up endometriosis.... many women suffer from cyclic pelvic pain and may have endo
CA_Gort	On the weight loss issue - does being overweight affect ovulation/fertility? Also, are there other dietary issues we should be considering?
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Dr._Bates	Endo lowers the fertility but can be overcome with medical therapy and surgery is only absolutely required for pain issue
Melissa_Majewski	being overweight does affect fertility
Dr._Bates	in theory letrozole will not increase endo pain because it does not raise the estrogen level but no good studies have been done on the low dose for 5 days
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Jodi	Well, I check my cervical position, cervical fluid, cervical feel, temp daily, use OPKs and microscope. You say you think temps are unreliable, however my temps always show a rise corresponding to the other signs. I realize there are a lot of variables with temping, but why do you discourage it?
Dr._Bates	Weight can be a big issue but many women with excess pounds are also fertile so it is not in everyone...however, that being said...there is some scientific evidence to support avoiding refined sugars along with exercise to regulate cycles and overcome PCOS
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ACDCJen	I'd agree with that. I lost 40 pounds and my cycles became more regular.
Melissa_Majewski	I agree. I gained 75 lbs and my cycles are now irregular
Corey_Whelan	As a woman with pcos, I can strongly attest to the connection between going low carb, insulin resistance and ovulation. Being overweight isn't the issue as much as being a carb consumer is. Of course, if you lower your carb count your weight automatically goes down.
Dr._Bates	arothmanregarding accuracy...many test will tell if ovulation occurs but the advance notice of the Chloride testing is the key. In fact, next week at the annual meeting of Am College of OB/GYN, researchers from Emory are presenting data that the Choride skin testing is as sensitive as urine testing even in very difficult patients with PCOS
Melissa_Majewski	May I ask again, is there a saliva kit that you would reccomend Dr. Bates?
CA_Gort	Dr. Bates, your intro on the AFA website said that dectecting the chloride changes in a woman would predict the pre-ovulation time making fertilization more likely. How do we do this?
ACDCJen	Carbs are the key huh? That's good to know.
Corey_Whelan	Feel free to email me off line and I can go into detail with you. Also keep your eyes open for our chats on pco
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Corey_Whelan	welcome smiley. feel free to post your questions for Dr. Bates.
Dr._Bates	If the temperatures work for you (JODI) it is a cheap and easy way to follow your cycles. However, the studies say that it may be as low as 25% predictive...ie 1 in 4 is it accurate in advance and many women find the morning ritual stressful...also if you move around, have coffee, go to the bathroom, etc.... that day's ready may be invalid
Jodi	Sorry, not to overwhelm you, but I would like to know what your opinon is on ovulation pain? I only have one fallopian tube (the left one) and would love to know if that was a predictor to which side I was ovulating on.
Melissa_Majewski	I found temps almost impossible to keep due to all those facotrs
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kylie	Dr. Bates, thanks for your time. I am frustrated. I use opk's and temp. I see that I am ovulating and I am having sex when I get the positive on the stick (or the night of) but I am still not pregnant. Hubby is fine. What is going on. why is "preovulation" time important?
ACDCJen	And is O pain supposed to be so bad that you can't function? Can that be O pain or is that endo pain? Midcycle it occurs.
Jodi	Thanks, Dr. Bates.
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Dr._Bates	The only salivary chloride testing I am aware of for fertility is OVUCUE. However, it also requires vaginal mucous testing for complete accuracy. A few of my patient did not like the vaginal sampling but again the science of chloride or ions surges relative to hormones is impressive
smiley	thank you....my question is: when precisely does one ovulate once it regiters on the ovulation predictor kit?? should you have sex on that day or better to wait until the next day??
Melissa_Majewski	Thank you for that information.
Dr._Bates	Jodi...mitteschmerz or midcycle pain is a great way to predict ovulaiton and unlike endo as the name suggest occurs mid cycle around the time of ovulation. I have not seen any studies to gauge it accuracy in predicting the side of ovulation but I NEVER argue with a woman who knows her own cycle and body well
Melissa_Majewski	LOL
Dr._Bates	Kylie....sorry you are dealing with the delay and frustration in conceiving.... many woman have unexplained fertility....EVERYthing is normal but are not conceiving .... if you have tried for 6 months to a year, I would see a fertility doc
Jodi	Melissa - I am very strict with my temp taking (same time every morning as soon as I wake up before doing anything - even moving). If there is some type of variable, I note it or disregard the temp. Also, I use it only as a confirmation that ovulation has occured. I think it can be used as confirmation at least, but only if you are disciplined enough to follow those guidelines.
viviane	I heard ovulation occurs sporatically to people with pcos, My question is does it skip several months like 3 at a time or every other????
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leanne	does anyone heard about ovwatch fertility detection?
Dr._Bates	Never wait for sex...in that the sperm can live in the reproductive tract for 5 - 6 days but the egg will not wait and may only be viable or receptive for fertilization for a few hours or less than a day
ACDCJen	The sperm can wait for up to 6 days? I've always heard it was 4?
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Melissa_Majewski	Jodi- you are more disciplined than I. ::biggrin
Dr._Bates	woman with PCOS do not ovulate regularly or often in many cases and often struggles with excess weight and hormone imbalances (hair growth and acne)
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Dr._Bates	ACDC...4 days is probably underestimating the sperm life but we should not miss the point that most pregnancies occur after intercourse that occurs 2 -3 days BEFORE ovulation...the day of ovulation MAY be too LATE
ava	Could I be timing it worng? I see that CA_gort is talking about preovulation time...maybe I am timing it worng? I need ot have sex before the positive on the stick?
viviane	does high androgen levels impeed ovulation?
smiley	just for the record, can excessive alcohol consumption damage a man's sperm? i am wondering if this is the reason we are not having any success...
ACDCJen	I've heard you should have sex every other day after your menstrual cycle ends. Is that enough? Too much?
Melissa_Majewski	Dr bates, I have always wanted to know if increased libido at the same time every month is indicative of ovulation or impending ovulation?
Dr._Bates	hello viviane.... yes hormone imbalance or high androgens are a problem...EVEN with regular cycles ...excess hair in the middle of your body, acne, etc..... lowers the chance that you are ovulating dramatically
restongirl	I'm arriving late, pls tell me if you've covered this...do you put much stock in OTC Ov. predictor kits? If so, which do you recommend? IS morning urine okay?
cgalla	M_M good question - I have wondered the same thing
Dr._Bates	Smiley...excess alcohol yes... and tobacco use of ANY kind lower fertility for BOTH
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restongirl	2 beers a night = excess alcohol?
smiley	what about when you use ICSI/IVF, will the sperm still be a problem due to excessive alcohol use?
viviane	I got pregnant last August with the help of clomid after 4 years of trying, it happened on my second cycle of chlomid, I gave birth to a stillborn this past february at 7 months. I am about to start chlomid this week again and the HCG shot, what are my chances of conceiving on the first try???
arothman	what is considered excess alchol
Dr._Bates	Sex during the menstrual cycle probably does not contribute to fertility regardless of the frequency.... abstaining more than 7 - 10 days is bad for sperm quality but as long as it occurs BEFORE ovulation the frequency is not crucial.... don't stress about daily....every other day...etc etc..... BEFORE is the key....and life is busy
leanne	Dr. Bates have you heard about OV WATCH FERETILITY PREDICTOR?
ACDCJen	Viviane--I'm sorry for your loss.
Dr._Bates	2 beers okay.... margarita or COSMO is better
ACDCJen	HAHAHAHA.
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viviane	thanks ACDCJen for the support
Lisa	Dr. Bates - We have done IUI and IVF. We were having no luck . . . making good embryos but they were not sticking. Ultimately, my RE determined premature ovarian failure was occuring and we decided to stop trying through IVF and go back to the old fashion fun way. My question is with premature ovarian failure, can I skip releasing an egg one month even if my cycle appears normal (27-28 days)?
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Dr._Bates	leanne as I mentioned earlier the OVWATCH is a great and accurate way to predict ovulation well in advance of the event so a couple has time to work intercourse or "TRYING" into the hectic pace of life
hopeandpray	is the ov watch the best method?
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Dr._Bates	Measure of chloride ions may also not be subject to high LH levels and definite avoids having to PEE ON A STICK
Julie	what about using the ov-watch with metformin and clomid. Does the drugs do anything to the prediction
ACDCJen	what are the other methods of measure Chloride ions?
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Dr._Bates	However, the most accurate means to follow ovulation is to see me and get tons of bloodwork and ultrasounds but driving to ATlanta is time consuming and expensive
Melissa_Majewski	Good questions AC/DC Jen! ::tongue
Dr._Bates	Sorry to hear about your long ordeal Lisa!!
ACDCJen	Word.
Melissa_Majewski	LOL Dr. Bates! ::biggrin
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Lisa	thanks . . . i've found a sense of humor and an occassional margartia is key to survival
ACDCJen	Many margaritas!
Lisa	lol!
leanne	Hi Julie, i took metformin and used ov watch and it works for me after using the ov watch twice
hopeandpray	is the ov watch the best, 2nd to tons of ultrasounds and bloodwork?
Melissa_Majewski	I agree ladies! After a miscarriage and years if trying.. It gets tough!
Dr._Bates	Premarure ovarian failure can occur at any age and makes IUI or IVF difficult at best. Even with regular cycles the quality of the egg is lowered so pregnancy is difficult BUT not impossible...it is just that treatments don't seem to increase the low rate so arenot worth the effort in many cases (EXCEPT donor egg)
Julie	tahnks leanne
Dr._Bates	ACDC..mentioned above that these ions can be tested in the saliva and vaginal secretions
leanne	your welcome and i'm happy to share it with you and yes im 30 weeks pregnant now
viviane	does high prolactin levels contribute to anovulation?
Julie	congrads
ACDCJen	What do you use to test the secretions?
hopeandpray	I ovulate regularly, have normal FSH and have produced many follicles when stimulated however, I am 47. Is it futile to try naturally or with medicated IUIs?
Melissa_Majewski	CONGRATS LEANNE
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ACDCJen	Congratulations Leanne.
leanne	thanks
cgalla	I have been told that donor eggs are the best option for "older" women, by a mile - do you agree?
restongirl	is it possible to ovulate on different cycle days each cycle?
Lisa	yay, leanne!
ACDCJen	Does Metformin help make ovulation "stronger"?
Melissa_Majewski	LEANNE- Where are you from is it in the water? We'll all be right over to have a glass!
Julie	restongirl - I have that is why I bought the watch to help me figure it out
ACDCJen	Use it for the ice in the margaritas!
Dr._Bates	hopeandpray.....futility is difficult to define and all of these treatments should be used in the context of what is right for each women...each couple on many levels ...however, most experts would recommend donor embryos with IVF as a woman passes her mid40s
Melissa_Majewski	Absolutely Jen!
leanne	Good luck julie
Dr._Bates	IN some case donor eggs cycles exceed 60 or 70% pregnancy rate per months versus oftern less than 5% for women who need this advanced treatment
Dr._Bates	ACDC...you are rocking with questions
ACDCJen	Sorry. I've been relying on the basal stuff and CM for so long. I'm ready for something new.
hopeandpray	Is the ov watch the best method to detect the fertile window or is the chloride ions method the best?
Julie	thanks leanne
Dr._Bates	and yes, metformin increase the number of ovulatory cycles and thus you are more likely to detect ovulation and get pregnant but recent research indicates it is best with diet, weight loss and used with other meds like clomid or letrozole
ACDCJen	Do you ever recommend other "pills" like herbs and such or are those a waste of time?
cgalla	thank-you for those useful stats Dr Bates. I gotta say - it beats simply being told you are OLD, or have OLD EGGS, by a mile! ::biggrin
ACDCJen	I took Met and I do not have PCOS, but my dr. thought it would help with stronger O. Guess I'll get another RX.
Jodi	Dr. Bates - I have three children, had a tubal ligation ( got pregnant twice within 4 months last year with my "tubes tied"), I lost my right tube due to an ectopic pregnancy, then, had a reversal on the remaining left tube. I was told that everything was absolutely perfect and that my tube practically fell back together. What do you think the chances are with one tube, and do you think it would take a long enough amount of time to invest in the OV Watch?
restongirl	so metoformin increases the number of cycles...are the cycles shorter? thought that was a bad thing?
Dr._Bates	HopenPray... in my experience my patients love the ease of wearing it at night and the straightforward results....FERTILE day 1, 2, .....etcand I even use it to time IUI but I don not have the same level of experience or positive feedback with the saliva/vaginal testing
Melissa_Majewski	Dr. Bates- I am overweight and in the process of loosing weight. How much weight will I need to loose to see a difference in my cycles?
ACDCJen	I think it's the luteal phase that matters most. Not how short the cycle is, I think...
CA_Gort	What exactly is the luteal phase?
ACDCJen	Melissa-you can do it!!
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Corey_Whelan	folks, we have five minutes left to our chat.
Julie	restongirl - I have been on met for 2 months so far my cycles went back to 29 - 31 days
ACDCJen	CA-the number of days after you O until your period starts. In layman's terms.
ACDCJen	I think.
viviane	sometimes even 10 pounds lost makes a big difference Melissa
Dr._Bates	tubal reversal of one tube often works but age, status of the tube, prior fertility all play a role..... however, I would hedge my bets and correctly time my "EFFORTS" and seek care if not pregnant in 6 months
CA_Gort	Thanks Jen - thanks Corey - and thanks Dr. Bates. this has been really helpful. What would having a long luteal phase mean?
Melissa_Majewski	Thanks Jen! and thanks Viv!
Ann	Dr. Bates- Can you summarize what the best indicators are in general terms?
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Dr._Bates	Melissa....even a small amount of weight loss helps...only a few pounds begins to improve your hormonal status.....
ACDCJen	CA-I think you should have at least 11 days, otherwise it's luteal phase defect. It all goes along with the 2 week wait...
Melissa_Majewski	Thank you Dr Bates! Going to go for my walk tonight too then! ::biggrin
Dr._Bates	so I echo vivi..... a little helps ...look longterm.... run from sugars and sweet.... and run in general ...more exercise..
arothman	what is the best way to use the stick test and the best way to read it?
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Melissa_Majewski	Yes, THANK YOU for the encouragement. I am definitely doing all those things. (except running.) I'll just walk for now. ::laugh
Dr._Bates	THE majority of woman will have around 14 days from ovulation to the next menses...that time is called the luteal phase in reference to the corpus luteum that makes progesterone
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ACDCJen	Yeah, that's what I meant.
Dr._Bates	Regarding detection of ovulation: regular cycle, mucous, midcycle pain, temperature are important
Dr._Bates	temperature is good looking back
Jodi	Cool! So, I should be pregnant really soon! ::wink
cgalla	Thank-you Dr Bates!
cosmiclobster	ohhh I missed todays session!! Is there a transcript that I can read after the fact? Thanks!
Melissa_Majewski	WOW Jen! What do you do for a living? (MD on the side?)
Melissa_Majewski	::biggrin
Corey_Whelan	Dr. Bates, thank you so much for your time tonight. You gave us so much information! CosmicL, the transcript will be up in a few days.
restongirl	regular cycle...to the day or does within 4 days = regular?
ACDCJen	Melissa-sadly no...Been doing this too long I think!!
Ann	If mucous is presnet several days does that mean ovulation has occurred??
Dr._Bates	urine kits are helpful to confirm ovulation but you may miss the true OPPORTUNITY or fertile window
ACDCJen	Thanks Dr. Bates!
Lisa	Thank you, Dr. Bates
Julie	thanks dr bates
Corey_Whelan	And thanks to all of you for being here too! Our Chat is officially over. good night all and BEST OF LUCK!!!!!!
ACDCJen	You should make house calls!
Jodi	I think luteal phase defect could also be a from an inadequate follicular phase or inadequate ovulation rather
Melissa_Majewski	Good Luck JOdi!
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cosmiclobster	excellent! Where can I find it?
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ACDCJen	I know some woman who take progesterone after O to help with the luteul phase.
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Dr._Bates	so using the choride surge and getting 4 or 5 days notice is very exciting new technology and that is how I first discovered the watch... as I prepared a talk for the Am College of OB/GYN on new methods of ovulatin detection
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arothman	why do you miss the window with the urine kits?
viviane	people with PCOS always have cervical mucus most of the month right Dr. Bates?
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Dr._Bates	luteal phase defect is controversial at best but progesterone supplementation has few downsides or sideeffects so many fertility docs give it
ACDCJen	Does the amount of EWCM dictate how strong your O is?
Melissa_Majewski	THANK YOU Dr. Bates. And good luck to ALL of you. Good vibed coming at ya from CHicago!
ACDCJen	Hey! I'm in IL too!
ACDCJen	Good luck Melissa!
Melissa_Majewski	Woops- I mean VIBES! I wish every one of you the best.
CA_Gort	Thank you again Dr. Bates - and good luck at the Am College - it is exciting to recognize the importance of that time ahead of the ovulation. Good luck to EVERYONE - wishing you all success and fertility!
viviane	THANKS for all the Advice, coming from NEW YORK
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Dr._Bates	I will end the session ...thanks questions and participation...you have been a great group and definitely...GOOD luck to you all in your struggles with this issue
Melissa_Majewski	Really! I
ACDCJen	Viviane-I grew up near Buffalo.
Dr._Bates	GO SABRES....good night.
ACDCJen	hehehee.
viviane	cool Jen, its nice there been there once
cosmiclobster	OK, now I see the link - I will check back in a few days - Thanks!!
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ACDCJen	Good luck ladies!
Julie	I just bought my watch using this link http://www.ovwatch.com/pregnantin3months.asp
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viviane	Julie does it really work?
restongirl	do you just wear it? Seems to easy?
restongirl	too easy...
Julie	I am using it for my first cycle. My BF got pregnnat using it after 2 years of trying and 2 ivf failed cycles
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ava	IF anyone wants to get in touch with Dr. Bates, you can ask him a question at www.mybabychat.com ask the doctor forum.
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Optimizing Fertility with Ovulation Detection

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