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@OurEastAndWest: Definitely get a SA for your DH. My OB at the time had me do 6 rounds of Clomid assuming it was an issue for me - changed OB's and she suggested a SA for DH - turns out we had a MFI problem - just wasted 6 months and took clomid for nothing! ugh!

Your OB should be able to help you schedule a SA for DH - good luck!

I would definitely have your DH get a SA before starting any type of treatments. My OB was able to write my DH a referral so he could get one.

Please have your hubby get an SA before you do any treatment! It is seriously the easiest least invasive thing you can do right now, and you'll get results within 3-5 days. You should know the whole picture before taking any meds. Also, if you ovulate on CD 17, you shouldn't be going in for a progesterone test on CD 21, you should probably be going in on CD 23, that is when your progesterone should be at its peak, and CD 21 assumes you ovulate on the 15th.

I agree with all the ladies here and many of us have been there/done that (including more extensive fertility treatments). Keep in mind that OB's are not trained in HOW to get a woman pregnant, only how to deal with their health before and after conception. So, with that in mind, I would definitely do the following before taking clomid:

*have DH get an SA. It's as easy as getting it scheduled, having him do his thing into a cup and a few days to a week later, you have the results.
*Have them do some blood tests on you, including thyroid, FSH and AMH. These should be easy to do and will tell you if you have any hormonal issues or if your egg reserve is on the low end (how old are you?)
*Do an HSG. It will see if your tubes are clear, because if they aren't, then no amount of meds are going to get you pregnant if the egg can't get through.

Once you have done these and feel comfortable starting Clomid, I would seriously insist on at least one ultrasound to monitor the follicle development while on the meds. Many OB's just prescribe Clomid as a fix and don't actually do any monitoring, which can lead to multiples or the adverse. Perhaps you aren't even responding to the Clomid and need something stronger, but without the ultrasound, they wouldn't know that.

Sorry this is long, but I've been where you are and feel like I lost a year of my trying with my OBGYN, so I'm a huge advocate for you guys. This is a good place to be for asking questions!

eta - also, if you are concerned about your luteal phase, I would ask about taking progesterone supplementation to help sustain a pregnancy. It's super easy and prometrium is very reasonable (might even be covered by insurance). It definitely doesn't hurt to take just in case.

@OurEastAndWest: Also, you shouldn't need a referral to see an RE. I just made an appointment after I was fed up and my OB kept saying that nothing was wrong.

On day 21, she was testing your progesterone level, which should be above a certain number to show that you ovulated and can sustain a pregnancy.

You are welcome! Honestly, if you think that you would eventually want to start seeing a fertility specialist, I might start researching it now and see if you can get an appointment made at the 1 year mark. It took me 4 months to get into mine, but every clinic is different.

I would also see what your OB can do for testing as if she orders it, it is more likely to be covered by insurance (i'm not sure what your coverage is). If an RE orders the tests, your insurance might not cover them at all. I'll try to respond more later, but I totally get the inpatient side of things. Plus, women sometimes just have an intuition about these things and it certainly doesn't hurt to get checked.

@Sweetie Pie ha! my DH has totally been on clomid since our original MFI diagnosis so @Oureastandwest she may be right! your DH 100% needs to get a SA. It really makes me insane how much testing and scrutiny is given to women TTC when something like 50% of IF diagnoses are on the male side. And MFI is WAY easier to deal with. There's a stigma around it I guess...men feel "less manly" if there's something wrong with their sperm but that's life! Happy to give you more info if you need it @oureastandwest. I've been on this rodeo for years now.

Just adding in - my OB also thinks ovulation should be days 13-15, like others above. He thinks that the further you go past that timeline, the more degraded the quality of egg and chances of conception. I don't know if I buy that completely with things like days 16-18 but just wanted to say that line of thinking isn't crazy uncommon.