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

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Treating halachic infertility

20 July, 2014

Question:

We are trying to conceive for almost a year. For the past 9 months, while tracking ovulation using ovulation kits, it came out that I ovulated before going to the mikveh. I bleed for a long time. I tried taking vitamin C to get clean faster. I tried using clomid, vitamin B, and the estrogen pill to ovulate later. The clomid and the vitamin B did not delay my ovulation and I had really bad side effects from the estrogen pill (premarin). I am at a loss as to what to do. I really want to have more children, and I am not sure how to proceed.

Thank you so much for your help.


Answer:

The first step is to try to get to mikveh sooner. Once the bleeding is no longer bright red, you can attempt to perform a hefsek taharah. Any stained bedikot should be brought to a rabbi for evaluation, since there are many acceptable shades of brown. The rabbi should be aware that you are currently ovulating before mikveh

We assume you tried Clomid for three cycles without success. If not, speak to your reproductive endocrinologist (RE) or fertility specialist about giving Clomid another chance. Additionally, there are estrogen options other than Premarin that may have better success and fewer side effects.

If the above do not work, another option you can discuss with your RE is artificial insemination or intrauterine insemination, which can be done during the clean days if necessary.

You can also explore treatment options with a complementary medicine practitioner. There may be herbal remedies or acupressure/acupuncture treatments that can help shorten the bleeding, and/or delay ovulation. Make sure to discuss any herbal remedies with your RE, as there can be interactions between herbal and pharmaceutical medications.

While we hope these suggestions prove helpful, there may be additional factors (such as age, or medical history relating to previous pregnancies) that may indicate decreased fertility. If this is the case, you should discuss further treatment options with your RE or fertility specialist.

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

We wish you much hatzlacha!


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