A woman once blamed her doctor for getting her pregnant. It seems he forgot to tell her that the antibiotics he had prescribed for her might render the birth control pill ineffective. When doctors mess up, they mess up bad, and a doctor who isn’t paying attention can make mistakes that effect patients’ fertility and conception.
Probably one of the bigger mistakes that doctors make revolves around the fact that women’s menstrual cycles are individual. The 28-day cycle is an average, and any doctor who assumes that patients are on a 28-day calendar will make mistakes in testing that relies on accurate timing. Your doctor should schedule a test of the quality of cervical mucus within 24 hours after the surge of luteinizing hormone. Called a “post-coital exam, this test checks on how well sperm can swim through the cervical mucus. Another test whose accuracy depends on exquisite timing is the serum progesterone test. This blood test has to be made precisely seven days after ovulation to check whether your progesterone levels are correct. Progesterone prepares the uterus for implantation of the fertilized egg.
Your doctor should be aware that your cycle may very well differ from the 28-day average, and may ask you to keep a cycle journal or to use fertility testing kits to determine accurate testing dates.
(One reason that first pregnancies have historically been “late” is that the doctor’s delivery prediction was usually based on asking the date of the last period without asking how long the cycle was. This resulted in miscalculation of the delivery date, and since many women have 30 days cycles, when doctors used calendars for pregnancy information, they were often too early in their predictions.)
Semen analysis should be performed to make sure that the man’s sperm cells are numerous and viable. Measles can result in male sterility, and a high fever can reduce sperm count. Doctors will probably also take a sexual history to rule out the chances of infertility caused by STDs.
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