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Expert Q&A

	By Lawrence B. Werlin Fertility Specialist

I ovulated Saturday, April 19, and have been temping for eight months. I saw a fertility specialist on April 16. He saw the perfect "egg sac" and said, "Go home and have lots of sex, you're ovulating!" We were very excited.

Yesterday, April 26, I started bleeding, and not just a little pink or brown. My periods are heavy, and here 24 hours later, it looks like a normal period. I am so disappointed. We made love six times in five days and all around the time I ovulated. I don't understand how we could not be pregnant.

I know about implantation bleeding and am hoping that that's the case here. Since I started on day 52 of my cycle, could the flow be heavy because my period would have been so late that there is lots of blood to come out?

I'm sorry that you were unsuccessful. The process of achieving a pregnancy is actually quite difficult. Firstly, you must ovulate. We are good at being able to document ovulation by utilizing tools such as ultrasound, ovulation prediction kits, temperature charts, among others.

Secondly, your egg must get picked up by your fallopian tube. How do we know this occurs? Unfortunately, we don't. You might ask where would my egg go if it didn't get picked up by my tube? The answer is that it may just be re-absorbed by your body.

Thirdly, the sperm must meet the egg in the tube where fertilization occurs. How do we know this takes place? Unfortunately, we don't. In fact even when we do insemination, where we place millions of sperm in the right place, if there were no egg in the tube, we would be unsuccessful.

Finally, even if all of these events occur, how do we know that the resultant embryo will implant? Unfortunately, we don't. In-vitro fertilization (IVF) answers three out of the four questions, in that it places the sperm and eggs together, sees fertilization and places the embryo back into the right spot. However, the ultimate question of implantation still remains unknown.

I would recommend that you follow up with your fertility specialist to make a new plan. Good luck

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