What you need to know if you’re trying to get pregnant
What you need to know if you’re trying to get pregnant and may have fertility questions. *By definition “fertility is the natural capability to produce offspring.” FERTILITY: Such a beautiful word! The image one might conjure up in his or her mind is of something lavish. After all, some of the synonyms associated with this word could be: abundant, arable, fruitful, lush, productive and rich. All of which bring allurement to consciousness. Close your eyes and try imagery with this word. Impossible to think of anything gloomy. Now try this exercise in relation to humans and conception. First thoughts may have been a beautiful, perfect, angelic baby or some of you may have given in to thoughts of the activities involved in producing this angel. Both are pleasing symbolisms. It’s assumed throughout a woman’s childhood that she will be able to reproduce someday. She likely spends a lot of time dreaming of what her children will look like in the future. Maybe she’s even explored her ancestry and or that of her love, fantasy partner. Even men presume his sperm will do what’s needed to bring life into this world. Neither male nor female child will have reason to consider the unthinkable: INFERTILITY. Unless a person is told otherwise, there really is no argument to contemplate a different outcome. Innocence is bliss. Infertility *By definition “the inability to conceive or carry a pregnancy to term after 12 months of trying to conceive through unprotected intercourse.” The word “infertile” conjures up somber thoughts. Feelings of inadequacy, impotence or sterility may come to the heart, even when the word does not pertain to you. There is likely nothing anyone can say or do to help alleviate those grim feelings when you are the couple given that diagnosis. Statistically speaking, approximately 6.1 million or 10% of couples between the ages of 15 and 44 will encounter this conversation with their caregiver. A third of the issues are female, a third are male and the final third is a combination of the two. With the right support and knowledge more than ¾ of those families will go on to give birth to their own offspring. Let’s start at the beginning: A Love Story Egg= Maiden Sperm= Knight in Shining Armor Approximately every month an egg (maiden) will mature and be released from the ovary and travel into the fallopian tube to wait for her “knight in shining armor” (sperm). After ejaculation takes place inside the vagina, it’s a race to the “maiden”. A true “fight to the finish”. The vagina is a potentially hostile environment and can kill off weaker “knights” by the millions. This acidic territory is prepared to fight off invaders to prevent infections. Only the strong “knights” will make it to the cervix where the habitat is hospitable. Once he makes it past the enemy territory, the “knights” have a long, arduous journey to find their “maiden.” Assuming she (egg) is waiting for him (sperm), the “knight” will have to keep up his stamina to enter the “maiden” before the other robust “knights” (sperm). If he (sperm) is strong enough to penetrate his love (egg), fireworks go off in the form of a blastocyst and they will multiply and divide millions of times. Together they will continue the journey into the lining of the uterus (and live happily ever after), which has thickened to prepare for this fertilization. Once implanted, you have officially achieved pregnancy. Incidentally, if the knight and his maiden (sperm & egg) don’t make it, the lining and blood will shed. This is called menstruation. Who knew there were love/war stories inside our bodies every month? Read on for basic facts to consider: Females: Each woman is born with millions of immature eggs that are awaiting ovulation to begin. Ovulation can be affected by stress, illness or disruption of normal routines. The health of the woman determines the health of her egg and the chances of a viable pregnancy. The egg can only live 12-24 hours after leaving the ovary. Normally, one egg is released each time. Implantation of a fertilized egg normally takes place 6-12 days after ovulation. Some women will experience pain or aching near the ovaries during ovulation called mittleschmerz or “middle pain”. Some women may experience light blood or spotting during ovulation. A menstrual period can occur even if ovulation has not occurred. Ovulation can occur even if a menstrual period has not occurred. If an egg is not fertilized, it disintegrates and is absorbed into the uterine lining. Males: A single sperm is tiny, invisible to the naked eye. Millions of sperm will be released with just one ejaculation. The health of the male determines the health of his sperm and chances of impregnation. If sperm hit the air, they die within minutes. Sperm must be strong and vibrant to make the journey. Sperm must stay energized to swim from one end of the womb to the other. Sperm must move in a forward-moving manner for success. Most sperm will not make it to the awaiting egg due to exhaustion. Some sperm look for their maiden (egg) in the wrong fallopian tube. Some sperm may have been neutralized by natural antibodies or hostile cervical fluids. Hundreds of sperm will compete to enter the outer layer of the egg and only one will win the prize. Putting all of this into perspective, keep in mind that there is a very small window of opportunity to have the Knight and his Maiden unite. Odds are low if you’re a betting person. Achieving pregnancy may take more than throwing away your condoms or birth control pills. If you are new to this, start simple: change your lifestyle to bring out the healthiest forms of you and your partner. It takes at least a cycle of 4 months to replenish egg and sperm. This should give you enough time to optimize their vitality and ensure the love story has a happy and healthy ending. Don’t forget
When You Need More Fertility Help
When you need more fertility help it can be confusing. The medical jargon and technical terms are beyond the layperson’s understanding. Infertility is already stressful so let’s unveil the puzzle in simpler terms. We’ve covered a lot of ground on a subject that should not be this burdensome. As I mentioned in the beginning, humans grow up believing that it is a right of passage to produce offspring, not a difficult feat with blood, sweat, and tears. If you’re reading this and have seen your tale told here, I’m sending you a hug and positive energy. While that may not be enough, getting the people you associate with on board with your dilemma could change your passageway. Surround yourself with a supportive, loving, and understanding community while you navigate this very personal journey. Talk to those closest to you and share your deepest feelings. Sometimes what’s holding up a viable pregnancy comes from the heart. Treatments to facilitate conception when you need more fertility help Medication– keep in mind that fertility medications can increase the chances of multiple pregnancies, and you may have a high-risk pregnancy as well as a premature delivery. Most commonly used: Clomid or Femara (an alternate to Clomid)- both suitable for treating ovulatory dysfunction, unexplained infertility and may be used in men. This oral tablet is used alongside other medications/treatments or alone. Side effects and risks are mild compared to injectable fertility drugs. Gonadotropins-These are the most potent ovulation stimulating drugs. Taken by injection and can be used alongside other medications or during IUI or IVF treatment. Men can also use this medication for the improvement of testosterone levels and semen health. Side effects are more extreme, and the chances of having multiples are significantly higher. Ovulation Suppression Medications- help, especially during IVF treatment or to coordinate cycles with a potential egg donor or surrogate. These medications can help doctors manage the release of the egg making retrieval more successful. Birth control pills & GnRH antagonists (they work against the LH & FSH) are most popular. They can be pills, injections, nasal sprays, or implants. As with other fertility meds, there are risks and side effects. Aspirin or heparin- used to treat women with recurrent miscarriages or bleeding disorders. Progesterone- The most frequently used medication during IVF, luteal phase defect, or recurrent miscarriages and placed as a vaginal suppository or injection. Estrogen-used to improve cervical mucus, thicken the endometrial lining, or if there is pain during intercourse due to vaginal dryness, which can all be a side effect of Clomid as well. Most commonly used as a vaginal suppository or patch. Glucophage or Metformin- used to treat insulin resistance but can also restart or regulate ovulation in women with PCOS. Antibiotics- if there is an infection in the reproductive tract. When left untreated, scarring can form and block the passageway for egg and sperm to meet. Parlodel or Dostinex are sometimes used to lower high prolactin levels. Prolactin is the hormone responsible for breast development and lactation. This malfunction can cause ovulation problems in women and low sperm count in men. Thyroid regulating medications are for an under or overacting thyroid. A misfiring control center (your thyroid) can create fertility problems in men and women. Surgical– clear any blockages in the reproductive organs of male or female. Types of surgeries; Hysteroscopy- a doctor will use a hysteroscope to look at the lining of the uterus, check shape and size and check for blockages. Laparoscopy- this tool is minimally invasive, uses a telescopic camera system, and can help medical professionals get a clear picture inside the abdominal cavity and reproductive organs. Most suspicious abnormalities can be taken care of during the procedure. Tubal ligation reversal- this can help reopen the Fallopian tubes to help restore a woman’s fertility. DaVinci robotic surgery is a great tool to use if you have an appropriately trained physician. It is for exploratory, reversal, or restoration of the reproductive system. Artificial treatments Artificial insemination- the medical procedure of injecting semen into the vagina or uterus to achieve pregnancy without sexual intercourse. Helping couples deal with: Male factor infertility Unexplained infertility Single and needing donor sperm The two types of artificial insemination; IUI- intrauterine insemination-is the most common insemination procedure used today. The sperm go through a process of “washing” to increase the concentration and decrease chances of an allergic reaction and or toxic chemicals. ICI- intracervical insemination- sperm is placed into the vagina and deposited into the cervix with a soft catheter. Less effective. If donor sperm is used, it will then be analyzed for a variety of health conditions and viruses, including HIV and other infections. Current guidelines recommend donor sperm be quarantined for at least six months to ensure its safety. Assisted reproductive technology “ART”- this includes all fertility treatments in which both eggs and embryos are handled. ART involves surgically removing eggs from the ovaries, combining them with sperm in the lab, and returning them to the woman’s body or donating to another woman. Learn more about ART below: IVF-In Vitro fertilization-involves the joining of egg and sperm in a dish and transferring the resulting embryos into the womb. Most commonly used ICSI- intracytoplasmic sperm injection- is a variant in IVF in which a single sperm is injected into each egg. Used when there are semen abnormalities or for couples who’ve failed fertilization. Donor egg IVF- used when the female partner has poor quality eggs and requires healthier, younger eggs from a donor. Gestational carrier IVF-the procedure is the same, except the resulting embryos, are transferred into a gestational carrier. This woman will grow the child, give birth, and hand baby over to the couple whose embryo was implanted. GIFT- Gamete intrafallopian Transfer- the eggs are harvested just like IVF. Still, the eggs & sperm are put into the Fallopian tube where fertilization happens, instead of fertilizing in the lab. ZIFT- Zygote Intrafallopian Transfer- similar to IVF but involves transfer of the fertilized egg (the zygote) into the Fallopian tube at the time of laparoscopy. TET- Tubal embryo transfer-same as
Reasons You’re Not Getting Pregnant
There may be many reasons you’re not getting pregnant that you haven’t explored yet. Aside from the low odds of sperm and egg meeting due to lifestyle factors, let’s take a more in-depth look at other arguments, often overlooked, that couples struggle with when trying to conceive. Men and Reasons they’re not Getting you Pregnant Healthy sperm are made and transported effectively to meet the egg for successful conception. Some of the below conditions are irreversible, but almost all have alternative ways to achieve their goals. Lifestyle changes can help with other sperm conditions. Read everything to give yourself the best odds for success. The most common cause of infertility in men is varicocele (overheating). When the veins in the testicles are too large, similar to varicose veins in your legs, this, in turn, can cause heat to build up in the scrotum and reduce sperm count and viability. Approximately 10-15 of every 100 men have this problem. The cause is not clear but starts in puberty. He probably doesn’t even know he has this condition, or he may have felt some discomfort but didn’t understand why. It usually shows up above one of the testicles (left side is more common). A doctor may find the mass quickly or send him for an ultrasound. There are no medications to help with this condition. To help with fertility, he can have a procedure done to tie off blood supply to the spermatic cord. New sperm will grow in 3-4 months, and the doctor will check the sperm count. For some men, it can take a few cycles of new swimmers before conception is achieved. Low sperm count or oligospermia means that the semen he ejaculates during an orgasm contains fewer than 15 million sperm per milliliter. The complete absence of sperm is called azoospermia. Some signs of a low or no sperm count are; problems with sexual dysfunction (low sex drive, erectile dysfunction, etc.), pain-swelling or lump in testicle area, and decreased facial or body hair. Celiac disease is a digestive disorder caused by a sensitivity to gluten — chances of fertility increase after adopting a gluten-free diet. Certain medications: testosterone replacement therapy, long term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs, and other treatments can cause sperm problems. Talk to your doctor about fertility and these medications. Prior surgeries; vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and extensive abdominal surgeries performed for testicular and rectal cancer. Most of these can be reversed, or sperm can be retrieved directly from epididymis and testicles. Tumors, cancers, and nonmalignant tumors can affect the male reproductive organs directly through the glands that release hormones related to reproduction, such as the pituitary gland or through unknown causes. Depending on where the tumor is, retrieval of healthy sperm may be Possible. Industrial chemicals- extended exposure to benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials, and lead will cause sperm disorders. Change in the environment can reverse most fertility issues related to toxins. Radiation or X-Rays-low doses shouldn’t pose a fertility problem once eliminated from the body. High doses of radiation can permanently reduce sperm count. Talk to your doctor about alternatives. Hormone disorders- hypothalamus, pituitary, thyroid, adrenal glands, diseases of testicles, low testosterone, gynecomastia (abnormal breast growth), and other hormonal problems have several possible underlying causes related to infertility. Usually, working with your health care team to adjust medications associated with these conditions can prove productive. Chromosome defects; inherited disorders such as Klinefelter’s syndrome- in which a male is born with 2 X chromosomes and 1 Y chromosome (instead of 1 Y and 1 X)- causes abnormal development of the male reproductive organs. Other genetic disorders that can cause issues with fertility include cystic fibrosis, Kallmann’s syndrome (inability to smell), and Kartagener’s syndrome (recurrent bronchitis and sinusitis). Your physician can help you evaluate your options with these problems. Injury to scrotal area; may be reversible with time and healing; talk to a physician. Heavy alcohol use-alcohol can lower testosterone, sperm quality, quantity, and motility. Sometimes it causes reduced libido and impotence. With the cessation of alcohol use, healthy sperm will regenerate with time. Drug use; while all drugs-legal and illegal- can have effects on sperm, the most commonly used is marijuana. THC (the active ingredient in marijuana) decreases sperm production and weakens sex drive by interfering with the creation of testosterone. It can directly affect the movement of sperm and prevent them from reaching their mark. Smoking- stop or reduce smoke exposure for increased odds of victory. Age; conception has a higher likelihood in men under the age of 40. Men between 20 and 80 have declining semen, sperm vitality, and sperm motility. Obesity; leads to a drop in testosterone, and erectile dysfunction is at a higher rate. Studies confirm male sperm counts are declining, and environmental factors may negatively impact spermatogenesis. Even global warming has recently been named as a factor in the decline of sperm. Stress from heatwaves reduces sperm number and viability in the latest research, including radio-frequency electromagnetic radiation from technology. Keep your cell phones and laptops off your lap. Anytime scrotum is being heated up, there is a chance of lower sperm and quality. Women and why they aren’t getting pregnant Producing a healthy pregnancy and baby will help build healthy eggs for the next generation. Females are born with the complete volume of eggs they will ever have. Taking good care of yourself through pregnancy will afford your female offspring the very best start to her motherhood journey. More Fun Facts about the Female Egg Eggs are enormous in comparison to other cells in the body. Eggs are precious and worth more than sperm because there’s a limited supply. Egg cells take years to grow up, unlike other cells in the body. Eggs are fragile. When “freezing” eggs, it involves the outer shell-like encasing them in glass. The insides do not freeze. Eggs age fast. After age 20, the percentage of viable eggs declines rapidly. Eggs are monogamous. Only
The Magic of Cervical Mucus
The magic of cervical mucus is part of a series of fertility blogs. Be sure to read them all to gain the most insight and have the best chance of success. Cervical mucus (CM) is a fluid or gel-like discharge from the cervix (the neck of the uterus), the production of which is stimulated by the hormone estrogen. You are aware of this by feeling “wet” in your underwear. Its’ purpose is to accept, filter, prepare, and release sperm for successful transport of the egg for fertilization. Throughout a woman’s menstrual cycle, hormones will predict the amount and thickness of this fantastic material and let you know when ovulation is optimal. Without CM, the sperm will not be able to reach the ova. In this part of fertility enlightenment, we will learn about the magic of cervical mucus and discover how to optimize it to increase the odds of conception. A little biology lesson first: The four phases of the menstrual cycle Follicular– starts on the first day you begin to bleed and ends with ovulation around day 13, when your pituitary gland secretes a hormone (FSH) that stimulates egg cells in the ovary. It takes this long for the full maturity of the egg. All the while, your uterus is creating a nutrient-rich environment by thickening the lining for the assumption that implantation will take place. CM will increase in quantity and moistness and have a cream-like color. Towards the end of this phase, conception can occur. Sticky to creamy phase=non fertile to semi fertile. Ovulation– usually, on day 14, the pituitary gland secretes more hormones (LH) to send the matured egg out into the Fallopian tube. The cilia will sweep the egg to the end of the tube and wait 24 hours for sperm to impregnate her. CM is most plentiful and has the texture of raw egg whites (thin and stretchy) while your basal body temperature will rise slightly. Highest likelihood of conception. Clear, very wet & slippery phase=fertile. Luteal– days 15-28 (or until menses begins): if sperm did not make it in time, the egg cell disintegrates. The hormones that kept the uterine lining thick, just in case of success, get used up, and the next phase begins. **The luteal stage is equally essential for the success of pregnancy to occur. The hormone progesterone is released to prepare the bed (uterine lining) for the expectation of embryo implantation. If this phase is too short, the embryo will not embed successfully due to low hormones. CM begins to decline and become thicker. Potential for fertilization can occur at the beginning of this phase. Menstruation– begins on day one and usually ends on day 5, when the uterus sheds its lining of soft tissue and blood vessels & only occurs when conception did not take place. CM is at its driest phase, but over the next several days will begin again: yellowish-whitish, cloudy, and somewhat sticky to the touch. Least likely time that conception will take place. Dry or sticky phase=non fertile. Sperm survival and cervical mucus The short explanation is this; the sperm need help to transport past the vaginal fluids of which are all revved up to keep invaders out. This fascinating mucus needs to have low acid to keep the sperm alive along the way. While the body is smart and knows how and when to release the appropriate CM, you too can facilitate the sperms fate. Creating a favorable environment for the sperm to make it past the vagina is critical. PH is a measurement of how acidic or alkaline a substance is. The scale runs from 0-14, and the vaginal pH is generally self-regulating, ranging from 3.8-4.5- a little acidic. If the levels go too high or too low, this can cause infections that impede the chances of sperm survival. To keep the pH at a consistently healthy level, try these: Take probiotics to restore the balance of healthy bacteria to your system. Don’t douche. Eat unsweetened, natural yogurt. Don’t overuse antibiotics. Use condoms when not trying to get pregnant. These conditions can jeopardize you CM: Yeast or candidiasis Bacterial vaginitis Sexually transmitted diseases Anti-sperm antibodies or a high diet in acidic foods Dehydration Increased inflammation or infection of the cervix High progesterone Low estrogen Fertility medications (yes, they REDUCE CM) Cervical polyp or fibroid LEEP or cryosurgery to treat cervical dysphasia or HPV Talk to your health care provider about testing for any of the above conditions. It could be as simple as taking an antifungal or antibacterial supplement to get your mucus on track and increase the probability of conception. Once the pH is restored and balanced, achieving a fertile environment should be a cinch. Other ways to keep the magic alive in your CM Hydrate! Hydrate! Hydrate! CM 90% water. Drink eight full glasses of clean, double-filtered water every day. Nutritional supplements- essential fatty acids, evening primrose oil, borage seed oil, L-arganine & vitamin c. Herbs- Shatavari, dandelion, licorice root, marshmallow root & red clover. Sperm friendly lube before intercourse. Emerita is great! Avoid caffeine and nicotine. Drink grapefruit juice. Keep chemicals out of the vagina- including anything with fragrance and dyes (check your toilet paper). Expectorant cough syrup- thins mucus in the body and may create the perfect consistency of CM. Eat raw garlic, dark green vegetables, carrots, and flaxseed. Avoid anything that dries up mucus in the body, like pseudoephedrine or allergy medications. Alternative therapies: chiropractic, aromatherapy, acupressure, acupuncture & reflexology are a few choices to assist in a healthier body. If you’ve been struggling with vaginal issues and can’t seem to get the CM just right, talk to an expert about a more detailed investigation. Some things may be out of your control, and delving past the obvious will get you on the right track. With proper guidance, you can get your vaginal environment optimal for a successful outcome. Learning the magic of cervical mucus can be a game-changer. Happy Parenting-to-be!
