Optimizing Fertility Health for Women

Is there anything more natural than having a baby? If you have normal menstrual cycles and take good care of yourself, you should have a good chance of getting pregnant. One in eight people struggle with infertility.

A woman’s age is the most critical factor predicting fertility:

• If you’re over 40, see a reproductive endocrinology and infertility specialist right away.
• If you’re 35 to 40, see a reproductive endocrinology and infertility specialist after you’ve tried to conceive for 6 months without success.
• If you’re under 35, see your OB/GYN if you have not conceived for 6 months without success. If it has been a year or more without success, see a reproductive endocrinology and infertility specialist.

Other reasons to seek care from a fertility specialist right away is if you already know you have:

• Endometriosis
• Pelvic adhesions
• Blocked fallopian tubes
• Polycystic ovary syndrome
• Your male partner has a sperm problem.

It’s a good idea to consult with your OB/GYN physician for preconception counseling. This gives you an opportunity to explore what is necessary to improve fertility health and make all preparations necessary before you get pregnant. This may require some changes in lifestyle choices. Depending on what is discovered, simple measures may be all that is needed. Sometimes, problems are discovered that require the expertise of a Board Certified Reproductive Endocrinology and Infertility specialist here at MRM. Your OB/GYN may refer you to our specialist or you may wish to contact us directly and schedule a consultation with one of our doctors.

Lifestyle Factors:

You Have the Power to Take Control and Make a Good Difference.

Here are a few things to optimize fertility health and improve your chance of getting pregnant:

Smoking

• Results in women entering menopause at younger ages and likely results in reduced fertility at younger ages as well.
• No one knows the minimum duration of smoking in years or amount that harms fertility. The sooner you quit, the better!

Diet and Exercise to Optimize Weight

• For women who are overweight, losing 10% of your body weight will result in an amazing improvement in your fertility.
• Are you a ‘CARBOVORE’? Our cultural food chain is loaded with carbohydrates. You need a PhD in organic chemistry to read and understand the contents listed on food labels at the grocery store. We are discovering that although carbohydrates are essential for us, the preparations and dosing of ‘carbs’ has a toxic effect on our health including fertility.
• Lower carbohydrate/higher protein diets such as a Mediterranean or South Beach diet are good for most everyone.
• Women with sugar metabolism disorders are particularly responsive to improvements in their diet. These disorder of insulin resistance include polycystic ovary syndrome. Women tend to be “carbovores”. Symptoms and signs often include erratic menstrual cycles, low blood sugar (hypoglycemia) demonstrated as lethargy, feeling ‘HANGRY’, headaches along with excess hair growth and often, but not necessarily overweight.
• High intensity exercise and lean body mass can also lead to reduced fertility and even erratic menstrual cycles. A woman’s body fat composition of less than 16% is associated with infrequent or complete absence of menstrual cycles.
• Read more about NUTRITION for FERTILITY and schedule a consultation with our Dietician Expert, Nancy Padilla, RD to develop a tasty and effective diet and exercise plan.

Reducing Stress

• Stress can effect fertility indirectly through changes in behavior and lifestyle choices. It can effect eating habits, food choices, mood with depression or high anxiety. Medications often prescribed to reduce anxiety and depression can affect the menstrual cycle and the ability to ovulate. It can directly affect fertility by reducing libido and the frequency of intercourse. It is not clear that it impairs fertility if intercourse is well timed with ovulation.
• Exercise is a great stress reducer. Commit thirty minutes of continuous aerobic exercise with a sustained heart rate of about 140 beats per minute, four days per week. You will experience a big improvement.
• Discover the source of stress and seek to modify the conditions that cause stress as well as your reaction to the conditions. Our Patient led Support Group has been a great source of relief to so many of our patients. Being able to talk to others that are experiencing similar challenges with having children and listening to the stories of those who have succeeded shed the bright light of hope over the shadows of frustration and despair. Everyone who joins our Patient Support Group.  One-on-one counseling with a psychologist expert in infertility is also available.
• Integrative medicine with Reike therapy, massage and acupuncture have assisted many of our patients in reducing stress and enhancing fertility. Learn more about our Integrative Medicine services here.

Figure Out When You Ovulate

If you are having normal menstrual cycles in a range of 24 to 32 days long , then there is usually about an 80% probability of becoming pregnant within the first 6 months of trying to become pregnant and about 85% within the first year of effort.

The time interval starting first day of menstrual bleeding to the first day of your next menstrual bleeding.

How do you know when you are most fertile?

• If you have regular menstrual cycles, you will likely release an egg (ovulate)14 days before the first day of your next menses. For example, if you have 26 day menstrual cycles, then 26 – 14 = 12. You will likely ovulate about the 12th day from the start of your menstrual cycle.
• A urine ovulation predictor kit from the pharmacy will assist indicating you are about to ovulate in about the next 24 hours.
• Other physical signs include tracking the changes in your cervical mucus—your production of slippery clear mucus, which peaks around ovulation time.
• Basal body temperature charts can assist in showing whether you have ovulated and if you ovulate consistently month after month. They are not so good in predicting when you are about to ovulate because your temperature rise, the sign of ovulation, may occur after you have ovulated.

When is the best timing of sexual intercourse to become pregnant?

Once you have determined the day you consistently ovulate, have sexual intercourse every other day for one week. starting three days earlier than the day of expected ovulation.

Hormone Balance

There can be subtle or obvious signs and symptoms of hormone imbalances.

Thyroid Gland

• Overactive or underactive thyroid gland can cause irregular and infrequent menstrual cycles and impair the release of an egg (ovulation).
• Thyroid gland imbalances can raise the risk of miscarriage and birth defects.
• A simple blood test called Thyroid Stimulating Hormone (TSH) is the most sensitive screening test for a thyroid hormone imbalance.
• Women are six times more likely to have a thyroid imbalance than a man.
• Thyroid imbalance tends to be inherited , commonly discovered among many family members.
• It is very treatable to reduce infertility and risks of complications to mother and baby.

Pituitary Gland

• The most common hormone imbalance of the pituitary gland is when an excess of prolactin hormone is released. Prolactin is essential in so many normal body functions. If you are having infrequent menstrual cycles and/or breast milk discharge when you’re not pregnant or just delivered, then a blood test measuring prolactin level should be obtained. Excess prolactin can shut down the hormones that are needed to ovulate regularly, estrogen becomes very low and menstrual periods become infrequent or may stop altogether.
• Excess prolactin can be caused by a thyroid disorder or by totally independent release from the pituitary gland.
• The imbalance is easily treated with a medication Cabergoline with minimal side effects. Another medication can be prescribed called Bromocriptine (Parlodel), but this medication can cause some substantial daily side effects. Cabergoline is the treatment of choice.

Adrenal Gland

• Less common are hormone imbalances of the adrenal gland. Excess male type hormones called androgens can be released from the adrenal gland causing:
  • Excess hair growth on the face, chest, upper arms, abdomen, back or buttocks. These signs are called hirsutism.
  • In more pronounced instances, lowering of the voice, increase size of the clitoris and enlarging of the voice box in the neck can occur. These signs are called virilization.
  • Menstrual cycles can become infrequent are absent.
  • This disorder can be inherited as a genetic hormone imbalance.

• Adrenal gland hormone imbalances are treatable best done in advance of becoming pregnant.

Misconceptions About Conception

The following common assumptions about infertility are NOT TRUE:

• All the sperm leaked out of my vagina.
• Lying on my back with my hips up improved my chance to become pregnant.
• Use of lubricants will reduce fertility. This is usually not the case, but try to avoid lubricants if possible.