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The Plan



Short Version:



"Try" every other night starting Day 8

Buy 10 ovulation predictor kit sticks

Begin ovulation testing on Day 10

When test is positive, "try" that night, plus two additional nights in a row

Skip one night, then do one last "try"

Take a home pregnancy test 15 days after your ovulation test was positive, if your period has not begun

If your ovulation test never goes positive, continue "trying" every other night until Day 35, then do a pregnancy test if your period has not begun.

Statistics coming in from women who write me show that about 40% of post-miscarriage women will get pregnant on the first try if they are faithful to the plan, about double the number of the normal population who are not on the plan. This assumes, of course, that you waited for a normal cycle to begin after your loss, and did not begin trying before having a period after a miscarriage. Many women do not ovulate in that first cycle.



Detailed Version:



On day 8 of your cycle, counting from the first day you bled, begin "trying" every other night. Begin taking Ovulation Predictor Kits (or continue with your Ovulation computer) on Day 10. Buy two five-packs so as not to scrimp on taking them and stop too early. To make sure your OPK is working well, take your test in the afternoon or after work and do not drink any liquids or go to the bathroom for at least four hours prior to testing. (Morning is not a good time for OPKs, which look for the LH surge, which usually happens during the day.) Read your OPK instructions carefully, as usually a faint line does not indicate a positive, you need a line that is darker than the test line. LH is produced throughout your cycle and will only predict ovulation when it has a big surge.



When your OPK turns positive, begin trying every night for three consecutive nights, skip the fourth night, and then once more. Then stop! The waiting begins.



Take a home pregnancy test 15 or 16 days after your OPK was positive if your period has not begun. Do not buy internet pregnancy tests or tests that claim to work before your period is expected. They are not well manufactured and are not reliable. They will only cause you more anxiety than you already feel in wanting to know. Please resist the urge to do a blood test at your doctor's office just to find out sooner unless you have a medical reason to know early. Fertilized eggs that do not grow are actually a terrible but normal occurrence as much as 75% of the time, and seeing a very low put positive blood test in the first 14 days can place you on a terrible emotional roller coaster. By the time a home pregnancy test is positive, your baby has safely implanted and your odds of miscarriage are down to a normal 10%.



Should your OPK never become positive, keep the every other day trying going until day 35. I recommend at that point taking a home pregnancy test, but even if it is negative, you might want to take a quantitative hCG blood test at your doctor's office. Remember that not every women will ovulate every month. I personally did not ovulate for two months following my first miscarriage.



As you are trying, make sure to "release" the sperm in your partner at least once during the gap between ovulation and new cycle Day 8 so that no more than 10 days elapse without new sperm production. Sperm is also a cause of genetic damage, not just eggs, so keep it fresh! If you are not successful the first month, it is not because your sperm did not get to your egg. 75% of eggs are lost within the first 14 days due to normal genetic damage or failure to fertilize. Just keep trying!



Here are a few facts that may surprise you:



Many books tell you that sperm can last for 5 days and the egg for 24 hours. While this is technically true on the very long end (and something to follow if you trying to NOT get pregnant), most sperm will only last about two hours if you do not have fertile-quality cervical mucus for it to swim in. The sperm will struggle to swim up to your uterus, use all its reserves, and not make it. The egg typically lives only about 12 hours, so it cannot wait for long. You can now see how important that cervical mucus is! You will never get pregnant with sperm living two hours and an egg only twelve. This information is really just to make you feel better if you've been trying a long time and all your infertility testing came back normal. If the Deanna-plan does not work and you are faithful to it for three months, take a dose of plain Robitussin cough syrup (or any cough medicine that says "expectorant" and NOT "antihistamine") each day (preferably a few hours prior to "trying") starting around Day 10 until the day after your ovulation predictor goes off. It should help make all the mucus in your body runnier, including that produced by your cervix. (Oh the gruesome details required in baby-making!) The sperm in the runnier mucus will live about two days, and will be up there and ready for the 12-hour life of the egg. A NOTE ABOUT CLOMID: Clomid causes cervical mucus to dry up in 25% of the women who take it. If you notice your mucus is not plentiful as it was before taking this drug, take the Robitussin and call your doctor to make sure your really need the Clomid. If you are ovulating on your own and do not have a documented luteal phase defect, you most likely do not need it.

"Trying" too often can actually do more harm than good. Do not try every night! You will get exhausted and sore, and your mucus--both for fertility and for lubrication--will dry up, and you will stop trying too early in the month or miss an important day. Every other day is absolutely sufficient, with three nights in a row during peak time sealing the deal.

Don't worry about stress! Regular old worries about getting pregnant, and if you will ever have children, are perfectly normal and do NOT affect your fertility. Ignore those people who tell you just to relax and stop thinking about it. This is not their problem! The only thing that could actually affect you is serious stress, like moving to a new house, losing your job, family deaths, and other things that make you physically ill or depressed. This can delay your ovulation, or make you not ovulate in a cycle, since you will produce an excess amount of the stress byproduct called prolactin. It will not affect you for long, and the next month you should come back and be normal again.

An early period is not an indication of an early miscarriage, even if you know you timed your trying perfectly. Usually it means that the egg was not fertilizable, and so progesterone was not adequately produced. This shortens your cycle. Sometimes eggs simply don't develop properly during the ovulation process. It is usually a one-month problem. If you are regularly seeing that fewer than 10 days are passing between ovulation and your period, however, it's time to be tested for a luteal phase defect. You can read more about that under hormone causes of miscarriage.

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