{"id":4121,"date":"2020-09-16T20:32:00","date_gmt":"2020-09-16T20:32:00","guid":{"rendered":"https:\/\/premom.com\/?p=4121"},"modified":"2025-07-25T18:13:10","modified_gmt":"2025-07-25T12:43:10","slug":"when-to-schedule-a-fertility-consultation-with-nurse-practitioner-steph-kagan","status":"publish","type":"post","link":"https:\/\/premom.in\/te\/when-to-schedule-a-fertility-consultation-with-nurse-practitioner-steph-kagan\/","title":{"rendered":"\u0c2b\u0c46\u0c30\u0c4d\u0c1f\u0c3f\u0c32\u0c3f\u0c1f\u0c40 \u0c15\u0c28\u0c4d\u0c38\u0c32\u0c4d\u0c1f\u0c47\u0c37\u0c28\u0c4d\u200c\u0c28\u0c41 \u0c0e\u0c2a\u0c4d\u0c2a\u0c41\u0c21\u0c41 \u0c37\u0c46\u0c21\u0c4d\u0c2f\u0c42\u0c32\u0c4d \u0c1a\u0c47\u0c2f\u0c3e\u0c32\u0c28\u0c47 \u0c2a\u0c4d\u0c30\u0c36\u0c4d\u0c28\u0c32\u0c15\u0c41 \u0c28\u0c30\u0c4d\u0c38\u0c41 \u0c2a\u0c4d\u0c30\u0c3e\u0c15\u0c4d\u0c1f\u0c40\u0c37\u0c28\u0c30\u0c4d \u0c38\u0c2e\u0c3e\u0c27\u0c3e\u0c28\u0c2e\u0c3f\u0c38\u0c4d\u0c24\u0c3e\u0c30\u0c41"},"content":{"rendered":"
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From an Instagram LIVE interview with Steph Kagan on September 16th, 2020<\/p>\n\n\n\n

We\u2019re really excited to have Steph here today. She is one of our Premom virtual consultants right in app. We\u2019re super excited to have her. And you can get to know her a little bit and see if she\u2019s someone you\u2019d like to work with. Steph, why don\u2019t you start by telling us a little bit about who you are, what\u2019s your background, your experience and all that great stuff? <\/strong><\/p>\n\n\n\n

Sure. I grew up in Florida, and I\u2019m actually currently living in Colorado. So I\u2019ve been a nurse since 2012. I was a labor and delivery nurse for about three years. Went to University of Central Florida. And then I decided I wanted to pursue women\u2019s health further. So I went to Thomas Jefferson University in Philly and got my master\u2019s degree there, specifically in women\u2019s health nursing. And ever since then, I\u2019ve been in the field of reproductive medicine or reproductive endocrinology, which is specific to women\u2019s fertility. So, I have spent the last five years working in a reproductive office doing things like inseminations, IVF cycles, oral cycles, like Clomid, letrozole, things like that. Really managing fertility cycles for patients.<\/p>\n\n\n\n

Fantastic. Wow. <\/strong><\/p>\n\n\n\n

Yeah. So I\u2019ve kind of seen both sides of the women\u2019s health field. I started in labor and delivery. And now I\u2019m back on the other side helping women reach that goal. So it\u2019s pretty cool to have seen the whole spectrum from start to finish.<\/p>\n\n\n\n

Yeah, that really gives a complete picture I\u2019ll bet.\u00a0Why did you choose to work with us at Premom?<\/strong><\/p>\n\n\n\n

Actually, I was really excited about this opportunity. Premom, I think is an essential step to helping women get to that goal of expanding their family, whether it\u2019s their first baby or third baby. A lot of these reproductive offices that I work in are not so accessible to patients. So this really changes the game for people, to allow them to have access to providers like myself, who work specifically in there, you know, some of these offices don\u2019t take insurance, or they don\u2019t take the insurance that the patient may have. So this really gives them that opportunity to get all that quality information from being at home and not using their insurance or anything like that. And it\u2019s much more affordable for patients. And sometimes it\u2019s pretty intimidating to really make that call to an infertility clinic and say, hey, I need help. So this is a little bit more comfortable from your home. You can sit there with your partner, your husband, your wife, and really kind of have that safety net of being home, not being so exposed. They can choose to just chat if they don\u2019t want any type of video, face to face or the video face to face is awesome. I\u2019ve done phone calls, we\u2019ve done secure chat. It\u2019s really been great for patients to ease their way into that field of taking that next step of seeking help for fertility.<\/p>\n\n\n\n

Fantastic. What do you specialize in your work?<\/strong><\/p>\n\n\n\n

When I work at or when I work at the IVF clinic, it\u2019s mostly IVF cycles and things like inseminations. We do cycle monitoring. We\u2019re watching very closely, LH surges, patient\u2019s hormones, how they\u2019re changing. And then we specialize and I personally specialize in nutrition for women\u2019s health. So I also have my own small business called Nourish Mama, where I help women who are trying to conceive currently pregnant and postpartum with the nutrition aspect of pregnancy and everything related to it. Because unfortunately, while there\u2019s so much information out there, it kind of pulls you in all these different directions. It\u2019s kind of like which one do I follow, which one do I start. So I don\u2019t believe in anything restrictive any extremes. I don\u2019t think you have to give up carbs forever. I don\u2019t think you have to never eat dairy again. There\u2019s really healthy ways to kind of promote your hormone balance and everything. So a lot of the clients that are using the Premom app and they\u2019re tracking their cycles are really paying attention to hormones, but then we can also start adding in the nutritional component and try and help regulate cycles. I specialize in a lot of unexplained infertility PCOS. A lot of the PCOS patients that I work with have a metabolic or nutritional component. They\u2019re at risk for high blood pressure, metabolic disease, like heart disease, things like that. So when you pair that hormonal irregularities of PCOS with the nutritional component, I really work on matching those two things up to make sure we\u2019re getting the longest strides we can towards reaching the goal.<\/p>\n\n\n\n

Fantastic.\u00a0So who do you enjoy most working with? Do you enjoy working with those who are struggling with PCOS or similar challenges for fertility? <\/strong><\/p>\n\n\n\n

Yeah, I really enjoy PCOS. I had a huge PCOS pop following back when I was working in Pennsylvania of patients who really were able to utilize the nutritional component. But really, the most important thing to me is being adaptable, being willing to implement some changes. I can give you all the advice in the world, I can guide you, I can tell you, hey, these hormones we need to pay attention to or we need to draw this lab. Or make these changes, but if you\u2019re not willing to adapt or change, it makes it much more difficult. So anytime I see a patient \u2014 no matter what culture their from, or what their struggle is \u2014 everybody has their own struggle, whether it\u2019s a weight struggle, PCOS struggle, endometriosis, something like that. As long as you\u2019re flexible and adaptable and willing to try some new things to help push you towards that goal. I\u2019m all game.<\/p>\n\n\n\n

Awesome.<\/strong> And you guys should definitely check out her Instagram. I was poking around there a little bit today. \u201cnourishedmomma.\u201d <\/strong>I thought that I saw you have\u00a0a recipe or two in there, and you have a lot of great pictures there.<\/strong><\/p>\n\n\n\n

Yeah, thanks. I\u2019d like to talk about specifics, nutrients like choline and\u00a0folate versus folic acid, beta carotene, all of those little micronutrients that can really add up and make a difference in pregnancy. Things that when the baby\u2019s eyes are developing in the womb, when we need to be focusing on certain nutrients. And then when you\u2019re trying to conceive certain things that you want to cut out like canola, oil, vegetable oil, all of those things are very, very inflammatory. And when you\u2019re trying to conceive, keeping that inflammation in your body as low as possible is absolutely crucial. They help a lot of moms \u2014 and women who are trying to conceive that aren\u2019t yet moms \u2014 really just reduce inflammation, regulate your cycle. The more regularly you\u2019re ovulating, the easier this all becomes. So Premom is fantastic. Because it really helps you\u00a0 \u2014 the app helps you figure out each month when you\u2019re ovulating through all of the science and the data behind it. So, if you start adding all these things together, we\u2019re really stacking the odds in your favor.<\/p>\n\n\n\n

I wanted to ask you one more question. I don\u2019t know if everybody knows the difference between nurses and nurse practitioners.\u00a0Can you talk a little bit about the different specialists in the app and what you do specifically, like the difference? <\/strong><\/p>\n\n\n\n

Sure. I\u2019ve been both a nurse and now I\u2019m a nurse practitioner. The difference is really the scope of practice. So as a nurse practitioner, I can really treat you as my patient when I\u2019m working in the office, I can prescribe you medications, I can come up with a treatment plan, I work very closely with physicians to really implement the plan. As opposed to when I was a nurse, it was a little bit more the physician gave me the plan or the nurse practitioner gave me the plan. And I helped outline those steps for the patient. As a nurse practitioner, we\u2019ve been educated to take in data, come up with different diagnoses. If you give me the data, I can say okay, it could be A, it could be B, it could be C, and then you work together with a patient and create that diagnosis to really help problem solve. Instead of \u2014 as a nurse \u2014 you\u2019re following steps, you\u2019re doing step one, step two, step three. to help the patient. As a nurse practitioner, you\u2019re saying, hey, we need to think about what could step one be? What could step two be? As a nurse practitioner, I can really help create and understand what\u2019s going on, rather than just kind of say, hey, do these steps in this order. It\u2019s more figuring out what those steps really are.<\/p>\n\n\n\n

As a nurse practitioner, it\u2019s nice because we\u2019re kind of a middleman. A lot of offices will call us \u201cmid level,\u201d which some PAS and NPS don\u2019t like, but it is what it is. We really are kind of that middleman between physicians and nurses. With a physician, sometimes they don\u2019t truly have time to sit down and go over the fine details. But as a nurse practitioner, we have usually more time. Our schedules are a little bit more flexible. Being an NP I specialized in women\u2019s health specifically, so I spent my whole entire nursing education on women\u2019s health specifically. As a physician, you get to do a whole bunch of different things and really be broaden, but then sometimes they know a little bit of everything, and then sometimes it\u2019s great to work with it a women\u2019s health NP who really that\u2019s their niche. <\/p>\n\n\n\n

That was a great description.<\/strong><\/p>\n\n\n\n

Yeah, I would love it if some of the clients that are using the app are following here on Instagram could send over some questions and stuff.\u00a0 We could talk about nutrition and pregnancy, etc. I have a question:<\/p>\n\n\n\n

When do you recommend to see a specialist?<\/strong> And when can you expect during a consult<\/strong><\/p>\n\n\n\n

Typically, in the infertility world of insurance diagnosis, anybody under 35 has to try for a year in order to be billable or your insurance covers any type of infertility treatment. If you\u2019re over 35, it\u2019s six months. That being said, if you do have any other underlying conditions like PCOS or endometriosis, those timelines don\u2019t really apply.<\/p>\n\n\n\n

There\u2019s two different things I want to clarify for that person who asked it. Seeing an OB\/GYN versus seeing a reproductive endocrinologist are two very, very different things. Seeing an OBGYN, they can technically prescribe you Clomid, they can give you that medication and say, hey, this might help you regulate your ovulation.<\/p>\n\n\n\n

\u0c05\u0c2f\u0c3f\u0c24\u0c47, \u0c2e\u0c40\u0c30\u0c41 \u0c28\u0c3e \u0c32\u0c3e\u0c02\u0c1f\u0c3f \u0c35\u0c02\u0c27\u0c4d\u0c2f\u0c24\u0c4d\u0c35\u0c3e\u0c28\u0c3f\u0c15\u0c3f \u0c2a\u0c28\u0c3f\u0c1a\u0c47\u0c38\u0c47 \u0c2a\u0c41\u0c28\u0c30\u0c41\u0c24\u0c4d\u0c2a\u0c24\u0c4d\u0c24\u0c3f \u0c0e\u0c02\u0c21\u0c4b\u0c15\u0c4d\u0c30\u0c3f\u0c28\u0c3e\u0c32\u0c1c\u0c3f\u0c38\u0c4d\u0c1f\u0c4d \u0c32\u0c47\u0c26\u0c3e \u0c28\u0c30\u0c4d\u0c38\u0c4d \u0c2a\u0c4d\u0c30\u0c3e\u0c15\u0c4d\u0c1f\u0c40\u0c37\u0c28\u0c30\u0c4d \u0c35\u0c26\u0c4d\u0c26\u0c15\u0c41 \u0c35\u0c46\u0c33\u0c4d\u0c33\u0c3f\u0c28\u0c2a\u0c4d\u0c2a\u0c41\u0c21\u0c41, \u0c2e\u0c47\u0c2e\u0c41 \u0c2e\u0c40\u0c15\u0c41 \u0c06 \u0c2e\u0c02\u0c26\u0c41\u0c28\u0c41 \u0c07\u0c1a\u0c4d\u0c1a\u0c47 \u0c35\u0c3f\u0c27\u0c3e\u0c28\u0c02 \u0c2e\u0c30\u0c3f\u0c2f\u0c41 \u0c26\u0c3e\u0c28\u0c3f\u0c24\u0c4b \u0c2a\u0c3e\u0c1f\u0c41 \u0c1c\u0c30\u0c3f\u0c17\u0c47 \u0c2a\u0c30\u0c4d\u0c2f\u0c35\u0c47\u0c15\u0c4d\u0c37\u0c23 \u0c1a\u0c3e\u0c32\u0c3e \u0c2d\u0c3f\u0c28\u0c4d\u0c28\u0c02\u0c17\u0c3e \u0c09\u0c02\u0c1f\u0c3e\u0c2f\u0c3f. \u0c2e\u0c47\u0c2e\u0c41 \u0c2e\u0c40\u0c15\u0c41 \u0c2e\u0c02\u0c26\u0c41\u0c32\u0c41 \u0c07\u0c38\u0c4d\u0c24\u0c3e\u0c2e\u0c41, \u0c15\u0c3e\u0c28\u0c40 \u0c2e\u0c40 \u0c1a\u0c15\u0c4d\u0c30\u0c02\u0c32\u0c4b \u0c30\u0c46\u0c02\u0c21\u0c41 \u0c32\u0c47\u0c26\u0c3e \u0c2e\u0c42\u0c21\u0c35 \u0c30\u0c4b\u0c1c\u0c41\u0c28 \u0c2e\u0c47\u0c2e\u0c41 \u0c39\u0c3e\u0c30\u0c4d\u0c2e\u0c4b\u0c28\u0c4d\u0c32\u0c28\u0c41 \u0c17\u0c40\u0c38\u0c4d\u0c24\u0c3e\u0c2e\u0c41, \u0c2e\u0c47\u0c2e\u0c41 \u0c05\u0c02\u0c21\u0c4b\u0c24\u0c4d\u0c38\u0c30\u0c4d\u0c17\u0c2e\u0c41\u0c28\u0c41 \u0c17\u0c41\u0c30\u0c4d\u0c24\u0c3f\u0c02\u0c1a\u0c47 \u0c35\u0c30\u0c15\u0c41 10, 12, 15 \u0c30\u0c4b\u0c1c\u0c41\u0c32\u0c32\u0c4b \u0c35\u0c3e\u0c1f\u0c3f\u0c28\u0c3f \u0c2e\u0c33\u0c4d\u0c33\u0c40 \u0c17\u0c40\u0c38\u0c4d\u0c24\u0c3e\u0c2e\u0c41.<\/p>\n\n\n\n

The difference in seeing your OBGYN is that they kind of hand you the medication and say, \u201cOkay, good luck; I hope this works.\u201d But with a reproductive endocrinologist and people who specialize in fertility, it\u2019s: \u201cHere\u2019s this medication. Now we\u2019re going to see back five more times this month, and we\u2019re going to tell you within 36 hours of when you\u2019re ovulating.\u201d<\/p>\n\n\n\n

That\u2019s what\u2019s nice about the Premom app too, is with that LH it tells you \u201cHey, you\u2019re ovulating now,\u201d not just \u201cHey, with Clomid you might be ovulating in the next five days.\u201d Over 35: six months. Under 35 \u2014 one year trying or just even actively, you don\u2019t have to be trying trying, but you can say: \u201cHey, it\u2019s been a year, I\u2019ve\u00a0been off birth control. We haven\u2019t been trying, but we haven\u2019t been not trying.\u201d That\u2019s when you should go see a specialist. If you have PCOS or endometriosis, you should start that process sooner.<\/p>\n\n\n\n

Somebody else asked a question about successful tips for IUI.<\/strong> If you\u2019re doing an IUI in a reproductive endocrinologist\u2019s office, you want to make sure that going into that cycle, your weight is optimal, you\u2019re exercising, you\u2019re doing all of those little things that can really add up and stack the odds in your favor. I always recommend patients to be taking a high quality fish oil.\u00a0But there\u2019s a few different options for fish oils, things like that, really, you want to go into your IUI feeling as good as possible. And I do want to touch on weight, because weight is the one thing that you kind of do have control over. Sometimes, we don\u2019t get to pick the stack of cards that were dealt when it comes to fertility, but a 5% reduction in weight more towards your optimal weight \u2014 or even 5% gaining weight if you\u2019re severely underweight \u2014 can really really boost fertility chances. So for the person who asked about IUI, I obviously don\u2019t know you personally or what your weight is like, but just kind of make sure that\u2019s in line. <\/p>\n\n\n\n

There\u2019s another question here. If the<\/strong> blood test shows you aren\u2019t ovulating, is that a fairly easy thing to fix?<\/strong><\/p>\n\n\n\n

Yes. So I\u2019m not sure what blood test you had, but probably a progesterone level. If that progesterone level showed that it\u2019s low, less than three that indicates the ovulation did not happen. In that kind of situation, what we would do is prescribe a medication called Provera. Provera is a progesterone withdrawal supplement. What happens is your body thinks you have progesterone, the progesterone goes away, your body says \u201cOh! No more progesterone,\u201d and your cycle starts. Then we would give you something like letrozole or Clomid to help stimulate your body to make a mature follicle.<\/p>\n\n\n\n

So to kind of touch on just the physiology of your cycle: the first half is estrogen- dependent, and the second half is progesterone-dependent. So estrogen is when your ovaries are working, working, working, growing that follicle,\u00a0 estrogen\u2019s rising. And then you have your LH surge \u2014 which is what Premom prides itself on is really monitoring that LH surge \u2014 the LH surge spikes, and then within 36 hours after that you typically have ovulation. After ovulation, your estrogen kind of plateaus and then stays steady, but your progesterone spikes up. So for the person who\u2019s asking me about the blood test showing that you aren\u2019t ovulating, I\u2019d have to talk more to them specifically. You can feel free to message me on nourishedmama, and I can answer some basic questions for you. But if you want to set up a consult in the app, I can really go into detail with you. But, we can fix it with modern science. Also, there could be some things that we could do to just see if your hormones are \u2014 or inflammation is \u2014 a little bit out of balance, to help you get ovulating.<\/p>\n\n\n\n

I have a four centimeter cyst on my right ovary. My doctor says it\u2019s nothing to worry about. Would an IUI be successful with the cyst?<\/strong><\/p>\n\n\n\n

So it depends on the type of cyst. But yes, there are two types of cysts. There are functional cysts and simple cysts. Simple cysts are not producing hormones. They\u2019re kind of a bug. Sometimes they can cause you some pain or some discomfort, but they\u2019re not pumping out hormones that would impact your cycle. However, if your doctor draws your estrogen level on day three of your cycle, and it\u2019s through the roof, which it shouldn\u2019t be, then that cyst is making hormones, and it\u2019s called a functional cyst. That could interfere. However, if your doctor I\u2019m sure is monitoring your blood work and your hormones as well, you can certainly be successful with an IUI and an ovarian cyst at the same time.<\/p>\n\n\n\n

Next question: my husband and I are trying to start a family. I haven\u2019t been to a doctor in five years, but I\u2019m 30, periods are regular, and I\u2019m very healthy. Should I go to the doctor to get checked out?<\/strong><\/p>\n\n\n\n

Yes. So I do think you should go to the doctor and get checked out just because you wouldn\u2019t want to be four months pregnant, and then find out \u201cHey, I haven\u2019t done a pap smear in five years. And now I have this stage 2 something that needs to be taken care of.\u201d But then it\u2019s too high a risk to do it while pregnant. Most likely, you should hopefully be very successful in your pregnancy and getting pregnant quickly, I hope for you. But it\u2019s always a good idea to go into it and say \u201cHey, what\u2019s my hemoglobin a1C, what\u2019s my cholesterol look like?\u201d Because pregnancy \u2014 although you feel young and healthy and great \u2014 can really change things, and you don\u2019t want to end up with preeclampsia, or high blood pressure or anything that can make your pregnancy high risk. Because we want to remember, the goal is one healthy baby, healthy pregnancy, healthy mom, healthy baby. Just touch base with your doctor. It doesn\u2019t have to be anything invasive. But just some simple blood test to make sure that you\u2019re safe to be pregnant is the best thing that you can do for yourself.<\/p>\n\n\n\n

I also have never peaked over .8. Is that low? Am I ovulating?<\/strong> It looks like\u00a0this person here is\u00a0asking a question about her LH tests. The data that Premom uses and the science behind it, the numbers are quantified by how dark your test line is to your control line. That may be different for everybody. Some may come up at 1.31 and some may come up at 0.8. I don\u2019t want you guys to stress the numbers. If you\u2019re showing a change in you\u2019re getting negatives, negatives, negatives, but still getting positives and then back to negatives, it\u2019s still showing that LH peak that we\u2019re looking for. If you want to talk more about whether you are ovulating, set up a consult. I\u2019d be happy to talk with you more about it, but you could definitely still be ovulating with that .8.  <\/p>\n\n\n\n

Each month LH surges are different in everybody, That LH surge may be 30. Anything over 30 is a true surge when you\u2019re looking at blood levels. Premom app, luckily because it\u2019s so noninvasive, is not looking at your blood levels. It\u2019s looking at just that control line versus your test line. I don\u2019t want you guys to stress the numbers. .8, 1.0 1.1 \u2014 no big deal. As long as we\u2019re ovulating, having regular cycles, we can still be successful.<\/p>\n\n\n\n

I had a chemical pregnancy \u2014 am I more likely to miscarry again?<\/strong> <\/p>\n\n\n\n

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\u0c2e\u0c40 \u0c15\u0c3e\u0c30\u0c4d\u0c2f\u0c4b\u0c1f\u0c48\u0c2a\u0c4d\u200c\u0c28\u0c41 \u0c17\u0c40\u0c2f\u0c21\u0c02, \u0c05\u0c02\u0c1f\u0c47 \u0c2e\u0c40 \u0c15\u0c4d\u0c30\u0c4b\u0c2e\u0c4b\u0c1c\u0c4b\u0c2e\u0c4d\u200c\u0c32\u0c41 \u0c2e\u0c30\u0c3f\u0c2f\u0c41 \u0c2e\u0c40 \u0c2d\u0c3e\u0c17\u0c38\u0c4d\u0c35\u0c3e\u0c2e\u0c3f \u0c15\u0c4d\u0c30\u0c4b\u0c2e\u0c4b\u0c1c\u0c4b\u0c2e\u0c4d\u200c\u0c32\u0c41 \u0c2e\u0c30\u0c3f\u0c2f\u0c41 \u0c15\u0c4a\u0c28\u0c4d\u0c28\u0c3f \u0c1c\u0c28\u0c4d\u0c2f\u0c41 \u0c2a\u0c30\u0c40\u0c15\u0c4d\u0c37\u0c32\u0c28\u0c41 \u0c17\u0c40\u0c2f\u0c21\u0c02.<\/p>\n\n\n\n

We also track with basal body temperature.<\/strong><\/p>\n\n\n\n

\u0c05\u0c35\u0c41\u0c28\u0c41, \u0c2c\u0c47\u0c38\u0c32\u0c4d \u0c2c\u0c3e\u0c21\u0c40 \u0c1f\u0c46\u0c02\u0c2a\u0c30\u0c47\u0c1a\u0c30\u0c4d \u0c2a\u0c4d\u0c30\u0c40\u0c2e\u0c4b\u0c2e\u0c4d \u0c2f\u0c3e\u0c2a\u0c4d\u200c\u0c32\u0c4b \u0c12\u0c15 \u0c2a\u0c46\u0c26\u0c4d\u0c26 \u0c2d\u0c3e\u0c17\u0c02. BBT \u0c1a\u0c3e\u0c32\u0c3e \u0c2c\u0c3e\u0c17\u0c41\u0c02\u0c26\u0c3f, \u0c0e\u0c02\u0c26\u0c41\u0c15\u0c02\u0c1f\u0c47 \u0c2e\u0c40\u0c30\u0c41 \u0c2e\u0c40 \u0c36\u0c30\u0c40\u0c30\u0c02\u0c24\u0c4b \u0c1a\u0c3e\u0c32\u0c3e \u0c38\u0c28\u0c4d\u0c28\u0c3f\u0c39\u0c3f\u0c24\u0c02\u0c17\u0c3e \u0c09\u0c02\u0c1f\u0c3e\u0c30\u0c41. \u0c2e\u0c30\u0c3f\u0c2f\u0c41 \u0c28\u0c3e\u0c15\u0c41 \u0c2a\u0c4d\u0c30\u0c40\u0c2e\u0c4b\u0c2e\u0c4d\u200c\u0c32\u0c4b \u0c28\u0c1a\u0c4d\u0c1a\u0c3f\u0c28 \u0c35\u0c3f\u0c37\u0c2f\u0c02 \u0c0f\u0c2e\u0c3f\u0c1f\u0c02\u0c1f\u0c47, \u0c07\u0c26\u0c3f \u0c2e\u0c3f\u0c2e\u0c4d\u0c2e\u0c32\u0c4d\u0c28\u0c3f "\u0c39\u0c47, \u0c2e\u0c47\u0c2e\u0c41 \u0c07\u0c02\u0c1f\u0c4d\u0c32\u0c4b \u0c2a\u0c4d\u0c30\u0c2f\u0c24\u0c4d\u0c28\u0c3f\u0c38\u0c4d\u0c24\u0c41\u0c28\u0c4d\u0c28\u0c3e\u0c2e\u0c41" \u0c28\u0c41\u0c02\u0c21\u0c3f "\u0c39\u0c47, \u0c28\u0c47\u0c28\u0c41 IVF \u0c1a\u0c15\u0c4d\u0c30\u0c02\u0c32\u0c4b\u0c15\u0c3f \u0c28\u0c46\u0c1f\u0c4d\u0c1f\u0c2c\u0c21\u0c4d\u0c21\u0c3e\u0c28\u0c41" \u0c05\u0c28\u0c3f \u0c35\u0c46\u0c02\u0c1f\u0c28\u0c47 \u0c1a\u0c46\u0c2a\u0c4d\u0c2a\u0c26\u0c41. \u0c07\u0c26\u0c3f \u0c2e\u0c40 \u0c36\u0c30\u0c40\u0c30\u0c02 \u0c0e\u0c32\u0c3e \u0c38\u0c4d\u0c2a\u0c02\u0c26\u0c3f\u0c38\u0c4d\u0c24\u0c41\u0c02\u0c26\u0c4b, \u0c2e\u0c40 \u0c17\u0c30\u0c4d\u0c2d\u0c3e\u0c36\u0c2f \u0c36\u0c4d\u0c32\u0c47\u0c37\u0c4d\u0c2e\u0c02, \u0c2e\u0c40 \u0c2c\u0c47\u0c38\u0c32\u0c4d \u0c2c\u0c3e\u0c21\u0c40 \u0c1f\u0c46\u0c02\u0c2a\u0c30\u0c47\u0c1a\u0c30\u0c4d\u200c\u0c28\u0c41 \u0c28\u0c47\u0c30\u0c4d\u0c1a\u0c41\u0c15\u0c41\u0c02\u0c1f\u0c41\u0c02\u0c26\u0c3f... \u0c15\u0c3e\u0c2c\u0c1f\u0c4d\u0c1f\u0c3f \u0c2e\u0c40 BBT\u0c28\u0c3f \u0c1a\u0c3e\u0c30\u0c4d\u0c1f\u0c4d \u0c1a\u0c47\u0c38\u0c4d\u0c24\u0c42 \u0c09\u0c02\u0c21\u0c02\u0c21\u0c3f; \u0c05\u0c26\u0c3f \u0c05\u0c02\u0c1a\u0c28\u0c3e \u0c35\u0c47\u0c2f\u0c21\u0c3e\u0c28\u0c3f\u0c15\u0c3f \u0c38\u0c39\u0c3e\u0c2f\u0c2a\u0c21\u0c41\u0c24\u0c41\u0c02\u0c26\u0c3f \u0c0e\u0c02\u0c26\u0c41\u0c15\u0c02\u0c1f\u0c47 \u0c2e\u0c28\u0c02 \u0c28\u0c3f\u0c1c\u0c02\u0c17\u0c3e \u0c06 \u0c2a\u0c46\u0c30\u0c41\u0c17\u0c41\u0c26\u0c32\u0c28\u0c41 \u0c1a\u0c42\u0c21\u0c3e\u0c32\u0c3f. \u0c15\u0c3e\u0c2c\u0c1f\u0c4d\u0c1f\u0c3f \u0c05\u0c32\u0c3e \u0c1a\u0c47\u0c38\u0c4d\u0c24\u0c42 \u0c09\u0c02\u0c21\u0c02\u0c21\u0c3f. \u0c05\u0c26\u0c3f \u0c2e\u0c02\u0c1a\u0c3f \u0c35\u0c3f\u0c37\u0c2f\u0c02.<\/p>\n\n\n\n

Can you have a consult without using the nine cycle tab in the app?<\/strong><\/p>\n\n\n\n

Yes, you can set up a consult by only being two or three cycles in. So I\u2019ve worked with moms who have both done the six cycles and who haven\u2019t conceived yet. And they\u2019re part of that pregnancy guarantee, I\u2019ve done those. And then you can come in right on in and set up a consult, no matter how many cycles you\u2019ve done. Obviously, the more data that you\u2019ve logged, the more it can help you just because I can see all of that information.<\/p>\n\n\n\n

At the more tab, if you go to the bottom right of your app, it\u2019ll give you all those little bubbles, and one of them is \u201cSchedule Consultation\u201d, so you can tap there and find everybody in there.<\/strong><\/p>\n\n\n\n

Yeah, then it will say like doctors, nurse practitioners, nurses. I\u2019m under the nurse practitioner column. You\u2019ll find me there. My name is Stephanie Kagan, my headshot is there, and you would just click,\u00a0\u00a0If for some reason there\u2019s not a time in the app that you\u2019re seeing that works for you, if you message me on here, I can try and open up some flexibility for you because the more moms I can help just one step towards that goal, the happier I\u2019ll be.<\/p>\n\n\n\n

Next question: after ovulation my basal body temperature doesn\u2019t rise right away, usually taking three to four days. Is it a bad sign? Do I have low progesterone?<\/strong> <\/p>\n\n\n\n

The only way to diagnose low progesterone and a lot of people think they have low progesterone. It\u2019s very, very rare. It\u2019s okay if your body takes a few days to rise after ovulation. Because remember, ovulation is typically 36 hours after your LH peak. However, it may be 12 hours, it could be 36. So that day or two fluctuation is normal, I wouldn\u2019t stress it. However, if you\u2019re certainly concerned that you have low progesterone, there\u2019s a really easy test to do. And that would be a blood test. You can get it through your OBGYN or a reproductive endocrinologist. It would be drawing a progesterone level about seven days after you ovulate that progesterone level should be greater than 10. If it\u2019s greater than 10, you\u2019re good. Lower than 10 might have some low progesterone going on.<\/p>\n\n\n\n

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\u0c32\u0c47\u0c26\u0c41, \u0c05\u0c15\u0c4d\u0c15\u0c21 \u0c09\u0c28\u0c4d\u0c28 \u0c2e\u0c40\u0c30\u0c02\u0c26\u0c30\u0c42 \u0c2a\u0c4d\u0c30\u0c2f\u0c24\u0c4d\u0c28\u0c3f\u0c38\u0c4d\u0c24\u0c41\u0c28\u0c4d\u0c28\u0c3e\u0c30\u0c41: \u0c28\u0c47\u0c28\u0c41 \u0c28\u0c3f\u0c28\u0c4d\u0c28\u0c41 \u0c28\u0c2e\u0c4d\u0c2e\u0c41\u0c24\u0c41\u0c28\u0c4d\u0c28\u0c3e\u0c28\u0c41. \u0c07\u0c26\u0c3f \u0c1c\u0c30\u0c41\u0c17\u0c41\u0c24\u0c41\u0c02\u0c26\u0c3f. \u0c2e\u0c47\u0c2e\u0c41 \u0c2e\u0c3f\u0c2e\u0c4d\u0c2e\u0c32\u0c4d\u0c28\u0c3f \u0c05\u0c15\u0c4d\u0c15\u0c21\u0c3f\u0c15\u0c3f \u0c24\u0c40\u0c38\u0c41\u0c15\u0c41\u0c35\u0c38\u0c4d\u0c24\u0c3e\u0c2e\u0c41. \u0c07\u0c26\u0c3f \u0c15\u0c20\u0c3f\u0c28\u0c2e\u0c48\u0c28\u0c26\u0c3f, \u0c15\u0c3e\u0c28\u0c40 \u0c1a\u0c47\u0c30\u0c41\u0c15\u0c4b\u0c35\u0c21\u0c3e\u0c28\u0c3f\u0c15\u0c3f \u0c15\u0c42\u0c21\u0c3e. \u0c08 \u0c35\u0c02\u0c27\u0c4d\u0c2f\u0c24\u0c4d\u0c35 \u0c2a\u0c4b\u0c30\u0c3e\u0c1f\u0c02\u0c32\u0c4b \u0c09\u0c28\u0c4d\u0c28 \u0c1a\u0c3e\u0c32\u0c3e \u0c2e\u0c02\u0c26\u0c3f \u0c35\u0c4d\u0c2f\u0c15\u0c4d\u0c24\u0c41\u0c32\u0c41 \u0c07\u0c02\u0c26\u0c41\u0c32\u0c4b \u0c0e\u0c02\u0c24 \u0c2e\u0c02\u0c26\u0c3f \u0c07\u0c24\u0c30 \u0c35\u0c4d\u0c2f\u0c15\u0c4d\u0c24\u0c41\u0c32\u0c41 \u0c15\u0c42\u0c21\u0c3e \u0c09\u0c28\u0c4d\u0c28\u0c3e\u0c30\u0c4b \u0c24\u0c46\u0c32\u0c3f\u0c2f\u0c26\u0c41. \u0c15\u0c3e\u0c2c\u0c1f\u0c4d\u0c1f\u0c3f \u0c2e\u0c40 \u0c38\u0c2a\u0c4b\u0c30\u0c4d\u0c1f\u0c4d \u0c38\u0c3f\u0c38\u0c4d\u0c1f\u0c2e\u0c4d\u200c\u0c28\u0c3f \u0c09\u0c2a\u0c2f\u0c4b\u0c17\u0c3f\u0c02\u0c1a\u0c02\u0c21\u0c3f \u2014 \u0c05\u0c26\u0c3f \u0c2e\u0c47\u0c2e\u0c47 \u0c05\u0c2f\u0c3f\u0c28\u0c3e \u0c2e\u0c30\u0c3f\u0c2f\u0c41 \u0c2e\u0c47\u0c2e\u0c41 \u0c2e\u0c40\u0c15\u0c41 \u0c38\u0c39\u0c3e\u0c2f\u0c02 \u0c1a\u0c47\u0c2f\u0c17\u0c32\u0c2e\u0c3e \u2014 \u0c32\u0c47\u0c26\u0c3e \u0c2e\u0c40 \u0c38\u0c4d\u0c28\u0c47\u0c39\u0c3f\u0c24\u0c41\u0c32\u0c41, \u0c2e\u0c40 \u0c15\u0c41\u0c1f\u0c41\u0c02\u0c2c \u0c38\u0c2d\u0c4d\u0c2f\u0c41\u0c32\u0c24\u0c4b \u0c2e\u0c3e\u0c1f\u0c4d\u0c32\u0c3e\u0c21\u0c02\u0c21\u0c3f, \u0c05\u0c2a\u0c30\u0c3f\u0c1a\u0c3f\u0c24\u0c41\u0c32\u0c41 \u0c2e\u0c30\u0c3f\u0c2f\u0c41 \u0c2c\u0c4d\u0c32\u0c3e\u0c17\u0c4d\u200c\u0c32\u0c24\u0c4b \u0c2e\u0c3e\u0c1f\u0c4d\u0c32\u0c3e\u0c21\u0c02\u0c21\u0c3f, \u0c2e\u0c40 \u0c2e\u0c3e\u0c28\u0c38\u0c3f\u0c15 \u0c06\u0c30\u0c4b\u0c17\u0c4d\u0c2f\u0c3e\u0c28\u0c3f\u0c15\u0c3f \u0c24\u0c4b\u0c21\u0c4d\u0c2a\u0c21\u0c47\u0c02\u0c26\u0c41\u0c15\u0c41 \u0c2e\u0c40\u0c30\u0c41 \u0c1a\u0c47\u0c2f\u0c35\u0c32\u0c38\u0c3f\u0c28\u0c26\u0c3f \u0c1a\u0c47\u0c2f\u0c02\u0c21\u0c3f. <\/p>\n\n\n\n

\u0c38\u0c30\u0c47. \u0c05\u0c2f\u0c3f\u0c24\u0c47 \u0c38\u0c30\u0c47. \u0c08\u0c30\u0c4b\u0c1c\u0c41 \u0c2e\u0c3e\u0c24\u0c4b \u0c1a\u0c47\u0c30\u0c3f\u0c28\u0c02\u0c26\u0c41\u0c15\u0c41 \u0c27\u0c28\u0c4d\u0c2f\u0c35\u0c3e\u0c26\u0c3e\u0c32\u0c41. \u0c26\u0c2f\u0c1a\u0c47\u0c38\u0c3f \u0c2e\u0c3e\u0c15\u0c41 \u0c2e\u0c46\u0c38\u0c47\u0c1c\u0c4d \u0c1a\u0c47\u0c2f\u0c02\u0c21\u0c3f, \u0c2e\u0c46\u0c38\u0c47\u0c1c\u0c4d \u0c38\u0c4d\u0c1f\u0c46\u0c2b\u0c4d. \u0c2e\u0c30\u0c3f \u0c2a\u0c4d\u0c30\u0c47\u0c2e\u0c4b\u0c2e\u0c4d\u200c\u0c32\u0c4b \u0c15\u0c32\u0c41\u0c26\u0c4d\u0c26\u0c3e\u0c02. <\/strong><\/p>\n\n\n\n

\u0c05\u0c35\u0c41\u0c28\u0c41, \u0c28\u0c47\u0c28\u0c41 \u0c24\u0c4d\u0c35\u0c30\u0c32\u0c4b \u0c2e\u0c3f\u0c2e\u0c4d\u0c2e\u0c32\u0c4d\u0c28\u0c3f \u0c15\u0c32\u0c41\u0c38\u0c4d\u0c24\u0c3e\u0c28\u0c41 \u0c05\u0c2c\u0c4d\u0c2c\u0c3e\u0c2f\u0c3f\u0c32\u0c41. <\/p>\n\n<\/div>","protected":false},"excerpt":{"rendered":"

From an Instagram LIVE interview with Steph Kagan on September 16th, 2020 We\u2019re really excited to have Steph here today. She is one of our Premom virtual consultants right in app. We\u2019re super excited to have her. And you can get to know her a little bit and see if she\u2019s someone you\u2019d like to \u2026 Read more<\/a><\/p>","protected":false},"author":17,"featured_media":4122,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[36],"tags":[46,50,57],"class_list":["post-4121","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fertility","tag-fertility-specialists","tag-irregular-periods-and-spotting","tag-pcos"],"acf":{"premom_author_by_label":"By"},"yoast_head":"\nA Nurse Practitioner Answers Questions About When To Schedule A Fertility Consultation - Premom India<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/premom.in\/te\/when-to-schedule-a-fertility-consultation-with-nurse-practitioner-steph-kagan\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A Nurse Practitioner Answers Questions About When To Schedule A Fertility Consultation\" \/>\n<meta property=\"og:description\" content=\"From an Instagram LIVE interview with Steph Kagan on September 16th, 2020 We’re really excited to have Steph here today. She is one of our Premom virtual consultants right in app. We’re super excited to have her. And you can get to know her a little bit and see if she’s someone you’d like to ... 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