Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Trying to conceive for a year

13 June, 2017

Question:

I am married for a year now and have been actively trying to get pregnant since the beginning. I got pregnant after eight months, but it ended in an early miscarriage.

I have yet to have a positive result on an ovulation test. I am suspicious that I keep missing ovulation, though I always start testing the day before mikva for a week. I thought I am not ovulating normally but the miscarriage must mean I ovulated. I have more or less regular cycles, though they are on the shorter side (27–28 days), which causes further trouble in me missing ovulation. I have a heter to try to get a clean hefsek on day 4, but this rarely works (maybe only once or twice).

I was wondering what halachic and medical advice you could give me in being able to conceive and be able to go to the mikva earlier. I have gone to the doctor but he said to wait another 2–3 months and I could really use some advice prior to that.


Answer:

Mazal tov on your recent marriage!

We are sorry to hear of your frustration, and about your miscarriage.

It is normal to take up to a year to conceive, and standard medical practice for women under 35 is to begin a fertility evaluation only after a year of trying. So your doctor's suggestion of waiting another few months makes sense. As you noted, the fact that you conceived shows that you did ovulate at least one cycle after mikveh. In addition, after a miscarriage it can take a few months for your body to sort itself out.

Halachically, you should make sure you are getting to mikveh as soon as possible. The hefsek taharah and bedikot need not be completely clear. Stains that are yellow or light brown (the color of coffee with milk) with no reddish hue are acceptable. Other questionable stains can be brought to a halachic authority for evaluation.

From a medical standpoint, you should continue testing ovulation. Start taking the ovulation tests a number of days before mikveh.  If after another two cycles you are not ovulating at all, you should return to your physician for further evaluation. If the tests show that you are consistently ovulating before mikveh (as variations of up to a week in cycle length are normal), then you should present this information to your doctor to discuss medical treatments to delay ovulation.

Unless you are over age 35, it is by far preferable to give yourself some more time to see if anything happens naturally (especially given the fact that you did conceive during the past 6 months) rather than starting testing or taking medication.  As frustrating as it seems, try to be patient, and try to relax. Stress and anxiety can interfere with fertility.

Please feel free to get back to us with any further questions.

We wish you much hatzlacha!


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