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  • "Limpet" started this thread

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1

Monday, August 13th 2007, 3:05pm

EWCM

Is EWCM always an indicator of ovulation? Or can you get EWCM at that sort of time of the month but without ovulating?

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Monday, August 13th 2007, 3:07pm

For me, personally, I only ever get it when I ovulate, never when I don't


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Monday, August 13th 2007, 3:14pm

I only get it when I ovualte aswell hunni xxx


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Monday, August 13th 2007, 3:46pm

Same here

Sometimes i get it when I have bad PMT - ie if i go 6 weeks instead of 5 but normally its when I ovulate


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Monday, August 13th 2007, 3:54pm

I get it when I'm going to ovulate, but I have had a small amount of it a day or 2 before af a couple of times, just to confuse the hell out of me :rolleyes:


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Monday, August 13th 2007, 3:57pm

i get it when i ov too :))



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Monday, August 13th 2007, 11:30pm

Me too!

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Wednesday, August 15th 2007, 10:47am

i get it a few days before Ov for some reason...
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Wednesday, August 15th 2007, 7:38pm

I have it twice in a month, once around day 14-15 and again when I actually ovulate around 20 - 23 days
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This post has been edited 1 times, last edit by "Blondie" (Aug 15th 2007, 7:39pm)


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Thursday, August 16th 2007, 7:10pm

I get it a few days before I OV and then is goes more milky/sticky after - sorry if TMI!

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11

Sunday, August 26th 2007, 5:37pm

Same for me.....

....our bodies start making it to help along the sperms when they enter us - makes the journey up to the uterus more slidey for them!!!!!!!!!....

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12

Wednesday, September 5th 2007, 1:51pm

RE: EWCM

Quoted

Originally posted by Limpet
Is EWCM always an indicator of ovulation? Or can you get EWCM at that sort of time of the month but without ovulating?



Hi Limpet,

I have only just noticed your post about mucus. It took me a little while to realise what EWCM was, as I am still not (despite help from Eeyore) clued in to the FZ codes.

I have grown rather pendantic with the passing years and tend to go in to great detail about aspects of fertility and their meaning. The exact nature of CM change through the cycle is usually lesson one when a couple are unfortunate as to have be confronted by me. This is because it is a very important and useful symptom that women and couples can use in becoming informed about their cycle. However it is also a very misinterpreted symptom. If you can bear with me for a while and not get bored I will outline what I tell such couples. Apologies also if I sound too school-teacherish and seem to be telling what you already know.

During the two-four days prior to ovulation the cervical mucus changes from being cloudy and either dry, runny or yoghurty and therefore pre-ovulatory, to the classical clear, stretchy egg-white discharge which we all recognise. At the same time the cervix changes postion, and the os, the entrance to the cervix, opens wider. These are all the observations that I use to indicate to me and to my patients that ovulation is on its way, and they are a signal to begin insemination, whether naturally(love-making) or artifically (husband or donor sperm). All of these changes are brought about by predominently by a rise in oestrogens. How well these things happen depends upon a number of factors including the number of oestrogen receptor sites on the cervix and whether she is taken clomid or similar oestrogen inhibitor.

At ovulation the sharp rise in LH, which is what you detect with the home predictor type tests kits, causes an ovarian follicle(s) to rupture and release then egg. The crater left on the ovary from thie rupture site becomes the corpus luteum ("yellow body") which then goes on to make progesteron to activate the uterine emdometrium. Progesterone also acts on the cervix reversing the changes of oestrogen i.e. cervix closes and mucus changes to thick and cloudy and minimal quality. If there has been good ovulation with a rapidly rising progesterone then this change happens very abruptly, overnight or 24 hours. If/when I see these cervical changes I know that the woman has ovulated.

If these changes do not happen then there has been no ovulation, the LH surge was not high enough or long enough lasting to trigger follicle rupture, or the ovary has become resistant to LH hormone (eg in the menopause). Or occasionally the progesterone rose only slowly and poorly - a poor luteal phase -which is not good.

If there has been no ovulation, despite the pre-ovulation mucus/cervix changes and the attempted LH surge, the the mucus stays as EWCM for longer than expected, and only slowly disappears as the cycle continues. So seeing EWCM only indicates preparation for ovulation - it is its disappearance that confirms ovulation. For women who regularly miss out on ovulating they will have more EWCM than they should, and lasting longer, as there has been no progesterone rise to chase it away.

In summary seeing EWCM is a good sign which all women should know about, but it has to disappear promptly after 2-4 days to indicate ovulation has occured.

I hope that makes sense. I have had to rush this so let me know if it doesn't


Regards,


Paul

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  • "Limpet" started this thread

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Thursday, September 6th 2007, 12:19pm

RE: EWCM

Thank you so much for this. The last two paragraphs were the new bit for me - about how EWCM disappears with progesterone. Very interesting.

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Thursday, March 6th 2008, 11:18pm

I dont get EWCM at all!! :sadface:


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Friday, March 7th 2008, 1:41am

Hi Sarah,

Firstly - Dont Panic. This will only make things worse all round.

Many women are not aware of their mucus changes. Sometimes this is simply because they have never really thought to look for it or knew what it was. But many others produce much less EWCM such that there may be too little mucus produced for to it to be obvious and easily found.

Women who produce a lot of mucus will be aware of it at the vaginal entrance and on their thighs, or on their pants, and will see it for perhaps two or three days. So much so that they often seek medical help, thinking that they have a vaginal discharge/infection. Other women do not make much mucus but provided that the little that they do make is clear and non-hostile to sperm then this is not a major problem. The beauty of secreting a lot of EWCM is that it acts as a supportive environment in which to store and nurture the sperm that are put in to the vagina at intercourse. The vaginal secretions are hostile to sperm and only those sperm that quickly get into the mucus will survive long enough to swim up the cervix and on towards an egg.

If you don't produce much mucus then you lose out on a useful sign of impending ovulation and of ovulation having subsequently occurred (see my longer posting above). If there is very little mucus then you can also lose out on the benefits of its storage and nurturing properties. If all other factors are good including the sperm picture, then this loss is not too terrible. But where there is a less than ideal sperm picture, ie volume, sperm numbers and activity, then the number of sperm surviving and moving into the cervix can become a problem, as too many may die in the vagina rather than being rescued by the mucus. Where this is the case your fertility as a couple may be reduced (but not to zero!) and it can prolonged your ttc time.

To check whether you really are producing good, clear mucus, either you or your partner needs to touch the cervix to try to retrieve some mucus. Use a clean finger with a small piece of tissue over it to which the mucus will stick better than to finger alone, and then examine the tissue for signs of EWCM. If you are doing this yourself it is easier to reach your cervix when you are squatting down with one foot raised slightly on a couple of books. In this position the vaginal is shorter than when lying down on your back. You may only find one day when you can detect EWCM, which means you have a narrower window to put sperm in than is ideal.

Reasons for reduced cervical mucus include poor hormones, although taking oestrogen tablets does not always seem to improve the situation; fewer glands than usual secreting mucus; damage to these glands from cautery (to treat cervical erosions or polyps), cervical surgery; infection such as thrush, chlamydia etc; short cycles allowing too little time for mucus to develop, taking clomid at too high a dose or for too long; or for no apparent reason.

To deal with the problem - first try to find the mucus and see what the little bit that you do find really looks like. If need be get some help with this by finding someone to sample it using a speculum, who can then test it against your partner's sperm. This can be done very easily and is one of the very first tests that I do with a couple coming to me for help. Also check all the other things that might be contributing to your delays in achieving a pregnancy, especially hormones and sperm. If your mucus really is scanty, but what is there is OK then making love in positions which allow for deep penetration will ensure that he ejaculates as close to the cervix as possible. This is particularly important if his semen volume is on the low side. If need be you could ask someone to perform insemination of the sperm into the cervix, a simple procedure very little different to having a smear test done.

I hope the above all makes sense. Contact me privately if you want to discuss this in more detail.

Kind regards,


Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

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Friday, March 7th 2008, 8:43am

Pre-seed can be used to help sperm with their travels if you do not produce lots of EWCM ! It is the only sperm friendly lubricant devised especially

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Saturday, March 8th 2008, 11:20pm

Hi again,

I have read the marketing information about Pre-seed, and also their blog and the praises thereon. The latter however is strange as virtually all of the postings are by the same person. I couldn't see any documented or referenced evidence of what they were saying about their product. It may very well be true that pre-seed is more sperm friendly than other lubricants, which would be a good thing. KY Jelly I do not like as it is hostile to sperm, so a better lubricant than this is certainly useful. I might try to get a sample of pre-seed to test against some sperm samples - perhaps they will send me some to test.

The problem though remains that pre-seed even if sperm friendly, is NOT cervical mucus. Mucus has a number of properties that make it ideal for sperm to be in and survive in. It contains fructose which is necessary to feed the enzyme mechanism for sperm motility. It has a linear, sub-microscopic structure that directs and guides sperm along the cervix, or into the "crypts" along the cervix where they can be stored for a little while. If you watch sperm swimming into and through mucus you can see the directional nature of these sperm pathways.

Cervical mucus also serves to help in the "capacitation" of the sperm. Sperm as first ejaculated are incapable of penetration into a egg. They have to undergo important biochemical and physiological changes to do with the head portion of the sperm known as the acrosome, plus the tail movement changes from a wave-like motion to a whiplash action. Such changes take place as the sperm progress along the female reproductive tract (or in special culture medium in the laboratory, for IVF purposes). Movement into cervical mucus brings about the first stage of this capacitation process, and this can be monitored by observation of the change in the tail activity. A very useful laboratory test of sperm function.

Pre-seed, even if non-toxic to sperm, will not be able to carry out these functions. This is in itself probably not too big a problem. The danger is when there is too much of this lubricant sloshing around at the top of the vaginal, adjacent to the cervix. This will act to dilute down the mucus, and especially so when there is less mucus than normal, and will impair sperm access to the true mucus in the os (the entrance to the cervix). This will make thing worse rather than better.

Where there is a good sperm picture and adequate non-hostile EWCM, but vaginal lubrication is required, then using Pre-seed might be useful. And where the sperm picture is less than ideal, it may enhance sperm activity and survival in the upper vaginal. But it cannot replace cervical mucus and may make the situation worse.

If you are using any lubricant it is important that you don't use too much, to avoid diluting down the seminal fluid or the cervical mucus, and where possible it is probably safer not to use anything at all.

Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

This post has been edited 1 times, last edit by "Paul Entwistle" (Mar 8th 2008, 11:23pm)


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Monday, March 10th 2008, 6:04pm

Hello there,
I am reading all this with interest..I ovulate, I get a smiley face anyway, I only get very loose mucus, no stringy stuff, I used to last year but not anymore. I have also investigated said cervix on the day the smiley face appears and it's very low..from what I read it should be high and open. It's very low and wet but not stringy wet , just wet..actually a couple of days pre surge it's very very wet but very loose. Can anyone shed some light on what is going wrong?
Thanks
Jo
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Monday, March 10th 2008, 6:21pm

EWCM

Hi Paul I have used Pre- seed but with no positive effect, I do take evening primrose oil 1000mg / day up to ovulation, and just before ovulation I try and drink more water and have also tryed taking cough medicine! all to improve EWCM, you'll try anything when your desperate. We have a 4 year old daughter conceived naturally and have been trying for nearly 3 years! I am all clear (had keyhole laperoscopy and dye test), but DH had a large varicocele and had a embolization in Nov 07, a coil was inserted via his left spermatic vein. Next week he is going for another SA so we are hoping things are a bit better, he has also been taking vitamins with zinc, selenium and others, eating brazil nuts, I give him tomato soup everyday! for his lunch and has not touched alcohol since before xmas, he is however training for the London Marathon so not sure if this will effect things. Any advice would be welcome.

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Monday, March 10th 2008, 11:38pm

Hi Bobby and JoJoJo,

I will try to answer both sets of your mucus and cervix queries in the same post, if that's ok, then do a separate one to deal with Bobby's more general questions.

The problem of cervical mucus quality and its detection troubles many women. Some lucky women have oodles of "cascading" mucus that flows freely down the vaginal, acting as a natural lubricant and is clearly obvious to both partners. Such women can conceive without ever having penetrative sex as the sperm are able to swim up the vagina from the labia and into the cervix. A virgin birth no less.

Rather more women appear to have very scanty EWCM and are never able to detect this even after repeated and careful searching. This may be a problem in reducing (but not eliminating) their fertility. But even for these women it can be shown to be there when a speculum is used to examine the cervix. At the same time it can be sampled and tested for hostility, plus intra-cervical insemination can be undertaken.

The majority of women however are in the middle situation - seeing mucus in occasional cycles only, or only after being coached into how to find it, or after careful seaching; and not much of it when they do see it. Nevertheless this group of women still appear to conceive without too much trouble. Most women who conceive their children naturally and without too much delay (70% of the population) will have never needed to look for EWCM , will have never even heard of it, and importantly, will have never even noticed it, as it was never very obvious. Yet they conceived easily.

Thus the connection between fertility, conception and cervical mucus (its detection that is rather than its presence and quality) is not as absolute as it might appear. It is only one of the fertility parameters needed for optimum fertility, and it's importance is inversely related to the quality of the sperm picture. Thus a good high sperm count and quality, in a good semen volume will enable adequate numbers of sperm to penetrate into the cervix and into the uterus and tubes, despite the relative lack of EWCM or its poor quality, and even when she has a degree of antisperm antibodies in her mucus. However when the sperm picture is less than this ideal ie in 10-15% of men, then the reduced mucus volume and quality can become a significant factor in the couple's delay in conceiving. Conversely when the sperm picture is not so good, then a good ample mucus environment will maximise the chances of some sperm getting through.

Ideally you should have good enough EWCM in the cervix to allow a window of 2-3 days within which the sperm can penetrate and wait around for the egg to appear. This way you do not need to find the exact day of ovulation but are able simply to make love a couple of times "around" ovulation, and this will do it. Most couples conceive from such random love making, rather from exact timing. It is imposible to quarantee to make love on ovulation day as no test, symptom or kit tells you or predicts accurately the exact day. If you have a very brief mucus window say just one day of best mucus, then getting this day right does become a problem, as does having good mucus in some months only and not others, as can happen.

If you have real concerns about cervical mucus then you need to get someone to look at you over 3-5 days in a typical cycle, see what is there, compare this with your usual test kit findings, and sample the mucus to test against partner's sperm. This is the crossed hostility sperm/mucus test you may have heard of. This was a major part of my research project at Liverpool Women's hospital, and has always been a vital part of my normal testing profile for couples. It tells me and the couple an immense amount about her cycle, her mucus, his sperm quality, and his sperm performance in her mucus.

This is already a long post so I will try to bring it to a halt. The cervix changes position and hardness, and the cervix entrance (the os) opens and closes as JoJoJo has noticed, these can be detected and are useful but it is the mucus that needs to be examined. Using cough mixture such as Benylin which has a mucus digestive action has been reported in the past, but it mainly seems to benefit women who seem to produce a lot of very thick, usually cloudy and tenacious cervical mucus (hence the "Benylin babies"),rather than where there is a lack of mucus.

I hope the above makes sense and answers your questions. I am happy for you to PM me to discuss further the above, or for you to telephone me on my mobile 07905 683 218. I will do another post for Bobby about the rest of her queries later or tomorrow.

Kind regards to all,


Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

This post has been edited 1 times, last edit by "Paul Entwistle" (Mar 10th 2008, 11:46pm)


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Sunday, March 23rd 2008, 7:53pm

Hi Paul,

I have just read your really great information. I just have a question for you. Hubby and I have a four year old son conceived naturally in 6 months, we've now been trying for number 2 for 3 years, done 2 IUI's and nothing. I always have stretchy clear mucus every month, husband has a fab sperm count and mobilty so are at a loss! Is there any other tests we can have done to find out anything else that may be wrong? Sometimes the mucus doesn't dry up and it keeps coming but not the stretchy stuff right up to the end of the cycle does this suggest that I don't actually release the egg? I always get the surge and can even feel the symptoms of ovualting at the same time day 14 every month?

Any Ideas??
DS: 8
TTC: 7 years
3 IUI 3 IVF all BFN

Miracle natural pregnancy 2 months into adoption
Baby girl due 10th Sept. 2012

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Monday, March 24th 2008, 10:29pm

RE: EWCM

Hi Bobby,

I promised you a reply to your post a little while ago - so here goes. Secondary infertility is as common as primary infertility, and can be just as distressing and even more frustating.

How long did it take for you to conceive your daughter? Even if this happened quickly, this may have been good luck rather than good fertility; and you could have still been poorly fertile as a couple even then, and could therefore still be so. The tests that we can do on male and female only approximately reflect fertility and do not give you a measure of HOW fertile you are as a couple. They are more correctly tests for infertility, ie is there an identifiable problem. How soon after your daughter's birth did you start to try for a baby again, did you breast feed, and did your cycle become regular quickly. You may not have got into a good ovulatory cycle and adequately frequent love-making for 10-12 months post delivery, hence your three years ttc may represent only two years, which is not a very long time if things with you or DH were not perfect, and according to your current age, which of course is 7 years older than when you last conceived. Complicated isn't it???

You and he seem to be doing some good things to help, but excessive training might be a problem if he is getting very hot and sweaty and then taking too many and too hot baths or showers. This overheating might be undoing the benefits of his varicocele surgery (sorry DH). And lay off the tomatoe soup, he will start turning yellow and start to look jaundiced - seriously.

Let me know about his sperm picture, and keep an eye on your progesterone level, if this goes down, your chances will also.

Regards,


Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

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Monday, March 24th 2008, 10:55pm

Hi Louis,

Firstly see my above post for Bobby, about secondary infertility, and how there can be a delay in achieving a second pregnancy even when you have already done it once.

Things seem to be all OK with you both, but as always you need to keep a check on your serum progesterone. Even if this was good when first tested, it may be 12-18 months since it was last checked, and it can go down, especially when you become stressed. Having ovulatory symptoms regularly on day 14, and seeing an LH rise with your kit are both encouraging but these do not prove that the LH rise went sufficiently high enough to provoke ovulation. Or that the resulting post-ovulation progesterone peak is regularly high enough for good implantation (30 nmol/L plus).

Seeing a prolongation of your cervical mucus in some cycles hints at a slower than ideal rise in progesterone in these cycles, possible to a reduced peak. But the change in nature from classic clear, stringy mucus is reassuring. However I am always much happier to see the cervix close and the mucus disappear promptly within one/two days, and find that this is related to a rapid rise in progesterone and a good peak. But women can differ in various ways, (as I have often found to my cost) and you may still have a consistently good progesterone.

Two IUI's without success does not prove that this is not the answer, so persevering with this might still prove useful. But check your progesterone, as you will have more natural cycles to try in than treatment ones, and this needs to be good. A poor luteal phase is the most common reason for reduced female fertility I have found.

And look out for very early pregnancy loss, an odd cycle or odd period, Bobby also. This proves fertility is still here and that you on the edge of having your next baby.

I will continue to think about this but keep in touch in the meantime.

Regards,

Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

This post has been edited 1 times, last edit by "Paul Entwistle" (Mar 24th 2008, 10:57pm)


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Wednesday, April 2nd 2008, 8:47pm

hi Paul, its brilliant havin someone on here with so much information!!

I dont seem to produce any EWCM at all. i do produce mucus but its creamy, not at all slippery or stretchy, and then it turns thicker and more of a paste.

i've tried: preseed, flexseed oil, evening primrose, robitussin cough medicine and drinking grapefruit juice!! Still no EWCM!!!!

Just went to our first consultation in Feb and when i mentioned lack of EWCM the consultant didnt seem bothered about it!
Xx


Me: 31 DH: 32
TTC 14 months
Results due 4 Jun
Shock BFP 26 May!
9 week scan 25th June - All good, and little beans heartbeat going ten to the dozen!
12 week scan done!
21 Week scan - a little girl!!

Baby Robyn Louise Matthews born 9 days early on the 18th January 2009 at 0048.
Absolutely Perfect Xx

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Wednesday, April 2nd 2008, 10:57pm

Hi Sarah,

I agree that many fertility units/doctors dismiss worries about cervical mucus. This can sometimes be because they do not know what do about this and prefer to concentrate on the high-powered stuff like hormones and ultrasound results. It is also sometimes the case that they do not want your opinions and self-observations, there can be a degree of patronising you "don't worry your little head about these things, we are in charge of you now". But it is also the case, as I have said earlier, that women frequently conceive without any obvious or any appropriate mucus, so its relevance and importance varies with other factors as does many fertility parameters.

However there must be a reason why females have changes in mucus. It is true that these changes are a good indicator of what is happening or trying to happen hormonally in the female, as any farmer who breeds cattle by AI will have learned. But it seems to me only commonsense that the sperm need an hospitable environment within which to be deposited, and stored, and swim through. If this mucus is scanty or has not become EWCM then sperm survival and/or penetration will be reduced. Good sperm will battle through quite cloudy, cellular mucus, but sperm in lower numbers or of lesser quality will have a problem.

But what to do when things do not seem right? Firstly get someone to have a look, sample, and test against the sperm, your best mucus in a typical cycle. Have a swab taken to make sure there is no hidden infection making the mucus remain cloudy and cellular. Check levels of progesterone, and prolactin and oestrogen. Try oestrogen treatment whether natural or prescribed. If nothing comes to light and hormones are good, it may be that the glands that secrete EWCM are deficient or absent, as can happen after interventions such cautery treatment for an erosion or polyp or cervical cancer. If the picture can't be improved and this seems to be a major or the only factor, then you may have to consider intra-cervical or intra-uterine insemination to up the odds of a sperm getting to an egg.

Finally, you can have good, non-hostile, cervical mucus from a suitable donor put into the cervix to partly replace the absent or less ideal mucus on each ocasion of insemination with partner's sperm, but you need to have a suitable donor.

Think about all of the above and talk to me again.


Paul

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This post has been edited 1 times, last edit by "Paul Entwistle" (Apr 3rd 2008, 6:52pm)


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Thursday, April 3rd 2008, 11:04am

Thanks Paul. I have my 2nd consultation with the gaeno in June so should i ask them to do the test on my mucus?
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Thursday, April 3rd 2008, 6:57pm

Hi Sarah,

Yes it is worth trying to get the unit to invesigate this aspect of your fertility - and then possibly provide treatment if they feel this is needed and can be done.

Good luck,


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Friday, April 4th 2008, 3:36pm

Thanks for your help!
Xx


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Friday, April 4th 2008, 10:24pm

may I ask a related question please Paul?

I chart my cycle and have documented 4 days of EWCM prior to ovulation.

We have tried to conceive this month and have had ovulation confirmed by higher basal body temperatures.

I'm now 8dpo and have had a significant drop in temperature yesterday, only for it to rise again today and lots of EWCM again. I had 5 days of dry CM immediately after ovulation, so this has been a change for me.

What could be causing the dip and return of EWCM?

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Friday, April 4th 2008, 11:40pm

Quoted

What could be causing the dip and return of EWCM?


Hi Spookycat,

It sounds as if you tried to ovulate at that first attempt but this did not happen and that you tried a second time, and hopefully succeeded, and hopefully made love again to cover for this.

It is not uncommon for all of the preparations for ovulation to take place and the LH surge to begin (perhaps confirmed by ovulation kit test), but no ovulation to occur. The LH rise is very sensitive to being interrupted by illness, long haul flights, stress (even the stress of having to make love on demand!), and if it does not reach a higher enough peak then the ovarian follicle is not ruptured and there is no true ovulation. The subsequent period may come on time or be early or late.

If things return to normal quick enough then there may be a second LH surge a few days later, which if it goes high enough will trigger ovulation. This starts the luteal (post-ovulation phase) later than usual, and if no pregnancy occurs, the period arrives the same number of days late as was this second ovulation.

The fact that your EWCM disappeared and you had your BBT rise as usual suggests that some progesterone may have been secreted by the unruptured follicle(this can happen), but not enough to prevent that second surge and the restarting of the luteal phase. This illustrates the fallacy of assuming that seeing mucus come/go and an LH surge proves ovulation. It is important from time to time to check that ovulation is occuring, with ultrasound scanning and/or progesterone assay. Also to continue to make love beyond the day of supposed, presumed ovulation.

This stop/start situation is not usually happening every month so it is not so important in ttc naturally. But I get annoyed when clinics providing treatment such as IUI or DI make great efforts to monitor the approach of ovulation, with scans and oestradiol assays, then treat; but then do not follow-up the treatment with a scan or progesterone assay after treatment to check that ovulation did in fact occur. This can be a waste of your limited number of treatment cycles, for which you may also be paying.

If I am right your period, if you are not pregnant, should arrive later than usual, so don't get too excited if your period doesn't come on time. I may be wrong of course, as odd cycles can happen for no definable reason, but either way you just have to ignore this cycle and carry on as usual. Let me know what happens.

Paul

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Saturday, April 5th 2008, 3:26pm

Thanks very much for that Paul, much appreciated.

We'll wait and see what happens. It's all we can do!

Thank you for getting back to me :D

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Monday, May 12th 2008, 11:57am

RE: EWCM

Hi Paul,

I noticed your helpful detailed responses to other people and was hoping you could answer my question.

I have been on the pill for 13 years and we have been trying to conceive for 2 months. A couple of days after I first went off the pill I had a withrawral bleed, then two weeks later a period that lasted around 9 days. It is now day 17 of this cycle and I have had a lot of EWCM the last 4 or so days.

I have two concerns. The first is that my temperature has not risen at all, if anything it has gone down to the lowest I've had.

Second, there was a little spotting on the last two days with the EWCM and I feel like I've got very weak cramps (not like the cramps I get with my period at all, more like sore muscles from sit-ups). I've felt mild nausea (more like a queasy-ness) for the last 3 or 4 days too.

I am wondering if my period does come in the next couple of days, which the signs seem to be pointing to, does this mean I didn't ovulate and there is no chance of conceiving?

Thank you for reading this (I know, its a bit long and detailed, but I didn't want to give you half the story).
Hope you can help!

Flo

This post has been edited 1 times, last edit by "flo222" (May 12th 2008, 11:59am)


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Monday, May 12th 2008, 12:33pm

RE: EWCM

Hello Flo,

When you come off the pill having been on it for some time your fertility may return quickly and powerfully, or it may take a little while for your cycle to restart and fertility to be restored. Having EWCM suggests that your body is trying to ovulate, and many women have pain (called the mittelschmerz) with ovulation as well as spotting. These three things are all good and reassuring signs of ovulation trying to happen.

If this leads to ovulation then your proper period. (if you are not already pregnant), should follow around 12-14 days later. If ovulation did not happen, which is quite common at this stage of pill withdrawal, then your period may come sooner or later than this. But don't panic - it is early days and there is certainly no reason at this point to think that your cycle will be a problem, and that your fertility will not soon become normal and possibly high.

Let me know how this cycle goes - and good luck.

Paul
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Monday, May 12th 2008, 12:46pm

RE: EWCM

Hi Paul

Thank you so much for your reply- and so quickly too!

I didn't realise that I could be having these symptoms around ovulation, and that it might actually indicate ovulation rather than a period.

I will post again in a few days when I know. The outcome could be useful for other people experiencing something similar.

all the best,
Flo

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Saturday, May 31st 2008, 11:20pm

~Help from paul~ewcm question

OK..we've only been trying for a couple months..I'll give a little background info...

I have cycles 35 days in length....

My last period started may 11th....I did an O calculater and it predicted I would ovulate between may 29th and june 3rd...

I didn't have EWCM last month so didn't expect it this month...

We BD on the 26th....then saw EWCM on the 29th(only one day) (would have BD, but hubby was sick) so we didn't BD again til the 30th...

So..only having EWCM for one day...and BDing 3 days before and the day after it...what are chances of conceiving? Is O after the EWCM? Thanks

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Sunday, June 1st 2008, 5:48am

RE: ~Help from paul~ewcm question

Hello and good morning,

I'm not usually awake this time of the morning, so I might as well make myself useful.

Regular (give or take a day) 35 day cycles are equally as fertile as 28 day ones - the problem is that you will have only around 10 cycles per year rather than 13 in which ttc, plus you are always having to wait an extra week to try again which is tedious.

In general the luteal phase (ovulation to next period) is around 14 days but it can vary from 12 to 16 days. Very rarely is it regularly longer than 16 days, and much less than 12 days is too short for implantation. So with your length cycle and assuming that you have already shown that you ovulate well, with a good (>30 nmol/L) progesterone - you should be aiming to be putting sperm in about every two days from day 19 to day 23 of your cycle - which is 30th May to 3rd June in this cycle.

If you do this you will always have sperm around when an egg appears - as with a 35 day cycle you should always be ovulating between these days. Intercourse twice or three times in this five days is therefore all you need to do and is what you should be aiming for, irrespective of any kit or ovulation predictor. If you are ovulating outside of this range then you need to have your cycle investigated.

It is unclear how long sperm last in the female reproductive tract, but good sperm going into good, non-hostile mucus, should last 2 to 2.5 days, and once you have ovulated the egg is viable and reachable for another 10-15 hours. Ovulation kits are a useful guide, but not, I believe, accurate enough to make love to. The time scale from the detection of the LH surge. to ovulation actually happening, can be anything from two and a half days to just a few hours. You can pick up the LH surge on the morning testing and ovulation could then be happening that same afternoon or two morning later. It is always better to have the sperm in waiting for the egg then to wait for the egg to appear, then try to rush some sperm in.

EWCM should always precede ovulation as it is the production of progesterone that makes the mucus change back to cloudy. If there is no ovulation then there is no abrupt change from EWCM to cloudy mucus. Where there is only one day of EWCM, then ovulation should be happening as this is disappearing at the end of this day. Where there are several days of mucus then it is at the end of these days that ovulation is happening, ie as it is starting to change, so this is the signal that you have ovulated.

In summary, in this cycle the first sperm that went in could have just lasted until ovulation, and the second lot seemed to have gone in just after ovulation - so the timing is not bad at all. However you would be wise to do it again, as it is still quite early in your cycle, then keep your fingers crossed and let us know the result. And if not a pregnancy - then keep trying, and you should get there.

Regards,

Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

This post has been edited 1 times, last edit by "Paul Entwistle" (Jun 1st 2008, 5:48am)


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Sunday, June 1st 2008, 1:13pm

RE: ~Help from paul~ewcm question

THANK YOU! :)

You reply was very quick and very helpful~ Still gives me some hope for this cycle....I wasn't sure if O happened after EWCM...especially with me only having one day of it.....you answered that for me....thanks again

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Saturday, June 14th 2008, 7:24pm

RE: ~Help from paul~ewcm question

Hi Paul.

Thank you so much for giving such kind and helpful advice . Youre a Saint.

I was on BCP for about 7 years and went off them in July '07. Since then my cycles have been very irregular (btwn 37 - 51 days long). Over the last 4 cycles they APPEAR to be getting shorter (45-45-37-35). Is that a good sign? Is it normal for cycles to take this long to regulate?

My husband and I have done tests, his sperm is "better than optimal", and all my tests (blood, hormone, sono-u/s) were all normal. OPKs always shows surges and other ovulation signs are there (except for the lack of EWCM- or any CM for that matter) , so I can't help but wonder why we aren't pregnant yet. Could it really be the lack of CM that's causing our infertility? Would you suggest taking Evening Primrose Oil?

Thank you in advance!!!

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Sunday, June 15th 2008, 10:16pm

RE: ~Help from paul~ewcm question

Hi,

After coming of oral contraceptives some women very quickly resume a normal and ovulatory cycle and are immediately fertile, often very much so. Most take 3-4 months to establish a normal cycle, and some, probably around 7% may take rather longer. Your irregular cycle for so long is not therefore too uncommon, although in some of those longer cycles you may not have ovulated, despite seeing an LH surge. However the indications are that you are now ovulating, even if a little irregularly, and that the cycle length seems to be stabilising and normalising. This process should continue, but even if you stabilise on 35 days or so and have a good (> 35 nmol/L) serum progesterone, then this should be adequate for you to conceive.

As to why you have not conceived before now - you can only have had about 7-8 cycles since July 07, some of which were probably not ovulatory. Depending upon your age, this is not a long time (in scientific/medical terms, not emotional terms that is) to be trying and not succeeding in establishing an ongoing pregnancy. So don't lose heart just yet. But do keep an eye on your progesterone - and get a figure for this - don't let them fob you off with "it's ok or it's normal".

Regarding mucus - many women seem to get very little EWCM or mucus at all, at least as evidenced by self-examination. I have heard no reasonable explanation for this, other than where cervical cautery has had been done which destroys the mucus-secreting glands. However this is not too terrible as it is certainly the case that most fertile women, who have conceived their families quickly and normally, were never aware of seeing mucus. Many women only seem to have any EWCM on one day in the cycle only, and if it is admixed with normal vaginal secretions or with seminal fluid, then it may be very difficult to spot.

With a women who has never conceived the cervical opening (the os) can be very small and I often can only demonstrate the developement of EWCM after regular specular examination, and the amount so observed may have been insignificant for it to be evident on self-examination. Whilst having oodles of clear mucus cascading down the vagina can be a factor in improving fertility, by providing a protective environment for sperm (like a non-stick frying pan) - this is not a common finding, and minimal mucus is more the usual finding, even in proven fertile women.

If your hormones are only just now starting to settle then this may also account for your apparent lack of mucus, and this might improve over the next few cycles. If you are still worried, then get someone to look at you a couple of times in a couple of cycles, and see what is really happening on-site. In the meantime please don't panic, you seem to be on your way. Look out for early implantation failure, any positive pregnancy test, even for a couple of days, proves you are getting to the embryo stage - and this is good news.

Good luck.

Paul
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Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

This post has been edited 2 times, last edit by "Paul Entwistle" (Jun 15th 2008, 10:24pm)


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Sunday, June 15th 2008, 10:22pm

Hi again,

Just to say to anyone listening - I am going to try to get to National Infertility Day, in London, on Saturday 19th July.

If anyone wants to meet up or talk about a problem - or just for a coffee, then let me know in advance and I will be happy to talk and listen, either as a scientist or as a counsellor.

Please pass this information on to anyone else with whom you are in touch, who might be planning to go to this meeting.

Paul
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Monday, June 16th 2008, 12:27am

I greatly appreciate you taking the time to help, Paul.
Thank you so much!!

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Monday, June 16th 2008, 5:47am

There is a little bit more about NID in this thread here :D

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Monday, July 14th 2008, 7:51pm

Hi

I'm going to be there too ... looks like it is going to be an interesting day :)
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Monday, July 14th 2008, 10:11pm

Hi,

NID is usually a good and useful day. If you wanted to meet up for a brief chat then contact me and I'll give you some phone numbers to find me.

Amongst the many aspects of my infertility work, I have worked with COTS.

Regards


Paul
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Natural family planning teacher.

This post has been edited 1 times, last edit by "Paul Entwistle" (Jul 14th 2008, 10:13pm)


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Friday, July 25th 2008, 9:33pm

Sorry didnt get back to see your post - was a really good day :)
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Thursday, July 31st 2008, 8:14pm

I've been reading this thread with interest, as I've noticed EWCM in the past but have only been charting for a month or so.

I'm totally confused though... I'm currently on day 35 of my cycle, and have had no sign of EWCM until yesterday and today. Could I be about to ovulate this late? (My cycles tend to be irregular and are usually around 35 days).

Any advice appreciated


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Thursday, July 31st 2008, 8:54pm

are you taking your temps?

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Thursday, July 31st 2008, 10:19pm

Hi, from me,

You certainly wouldn't be ovulating on day 35 in a 35'ish day cycle. Maybe this cycle is going to be longer, you may be ovulating now and, unusually for you, you will go on to have a 49 day cycle. So just in case, make sure you make love now, and try and make it a nine month long cycle!

If your period starts in the next day or so then this is just a random odd cycle, which does happen, and you may not have ovulated at all this cycle (which does happen). Stringy mucus can occasionally appear out of the blue and at the wrong time. Sometimes as the cervix contracts, either a little while after ovulation or just before a period is about to start, a small amount of mucus, which did not come out at the correct time, is squeezed out and you spot it. So try not to worry too much about this, continue your cycle monitoring through the next cycle and see what happens. But the golden rule always is to make love throughout the whole cycle, every 2 or 3 days, rather than trying to find "THE DAY". This way, irrespective of when you ovulate, and whether or not you spot it, you always have sperm around waiting for an egg to appear.

If you have a fairly regular (give or take 2/3 day) 35 day cycle then you are just as fertile as somebody with a 28 or 30 day one, it's just you only get 10 tries per year rather than 12 or 13 which reduces the odds slightly. But if your cycle is irregular around 35 days, sometimes up to 40 days then this needs looking at and stabilising, because it is not so fertile a situation.

Keep in touch, and good luck,


Paul
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Friday, August 1st 2008, 9:30am

Thanks for the advice... my cycles can be anything from 22 to 49 days (and sometimes I skip a few months), so definitely irregular.

I haven't actually started TTC yet as my partner and I are saving up to start IUI at the end of the year (we're a lesbian couple). We've had our initial consultation at a clinic and they're going to put me on clomid to regulate my cycles.

But I''ve started charting my temps and CM just so I get used to it and know what's going on with my body - although so far I'm none the wiser!

What can cause such long and irregular cycles? I was anorexic in my teens/ early 20s and my periods stopped for several years, could this have something to do with it? When they atarted again 3.5 years ago they were regularish, but in the last year or so they've been all over the place.

Thanks, sorry if this is slightly off the topic of EWCM.


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50

Sunday, August 10th 2008, 5:45pm

Hi Paul,

I was wondering if you can help me. Some months I get ewcm, quite alot and sometimes a little. I use the clearblue fertilty monitor and still no luck after 12 months of trying. I have seen my gyn, to be honest
I personally dont think they done enough tests but have no referred me for IVF but I will have to pay as my husband has a son from a previous relationship that he has fulltime. They did an SA which came back great, I had a dye and lap which came back with no issues. Ovulate on 14 days each month and have a 28 day bang on cycle. They did blood tests to confirm ovulation but nothing else. Should they not be checking if I have in-hostile mucus, the quality of my eggs etc before they make this judgement for IVF or will that happen at my IVF appointment?

I just feel that something should have happened now after a year considering also that all my family conceived more or less the first time.

Many thanks for any comments.

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