Infertility: It’s not just the Eggs

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Many of you might remember looking up at the clock in school during exams and watching the long red second hand tick, tick, tick.

As you tracked your time and filled in your scantron sheet (remember those!), your only worry was having a number 2 pencil. Unfortunately, sometimes the idea of your “biological” clock ticking is a lot more worrisome. Whether you would like to have children in the future, or you have struggled to get pregnant, infertility is an important topic for many women.

Typically, physicians classify infertility as either primary or secondary.

Primary Infertility: This is when a couple has not been able to conceive after a year of unprotected intercourse.

Secondary Infertility: This is the term used when a couple that has been pregnant before has not been able to conceive again.

Women are born with all the eggs they will have during their lifetime (typically this is about 1-2 million). Only about 400 of these eggs will actually mature. In men, on the other hand, new sperm are produced daily. The release of a viable egg and fertilization by sperm can be influenced by many factors.

When couples are faced with infertility, 50% of the time they may be attributed to female reproductive factors such as ovulatory dysfunction, polycystic ovarian syndrome, pelvic infections, or sexually transmitted infections. As women age, fertility also declines. Women are most fertile in their late teens and early twenties. Fertility begins to decline around age 35.

In about 30% of cases, the infertility may be attributed to the male partner. Common causes of decreased fertility in men are low sperm count, retrograde ejaculation, or hormone deficiency.

In about 20% of cases, the cause of infertility is unknown and is not clear even after medical examination.

Despite the multiple physical issues that can influence fertility, stress plays a large role. As the body becomes chronically stressed, the natural cycle of menstruation, ovulation, implantation and pregnancy is disturbed. Have you ever been under a significant amount of stress or pressure and missed a menstrual cycle? Not surprisingly, becoming pregnant under stress is also difficult.

Worried there’s no “honey-boo-boo” in your future? (Or perhaps that’s what you want to avoid!). Don’t panic. Here are some simple guidelines to improve your fertility and health:

1) Take a Prenatal Vitamin: The modern American diet often lacks important nutrients and minerals that are needed for a healthy pregnancy and immune function. Taking a prenatal vitamin can help you prepare for pregnancy by supplementing nutrients your body may be lacking. Additionally, if you happen to get pregnant, prenatal vitamins include an adequate supply of folic acid, a vitamin that is vital to neonatal brain development. Aim to get 400 mcg-600mcg daily.

2) Track your cycle: Each woman’s menstrual cycle varies in length. Based on this fact, ovulation can also be variable. Generally, women ovulate about 12-14 days before the next period. Predicting this may be more difficult in women with irregular periods. At the time of ovulation, the egg can be fertilized for 12-24 hours. Male sperm remains viable for 2-3 days, so having intercourse 2 days before ovulation and on the day of ovulation may increase your chances of pregnancy.

3) Watch out for Obesity and Diabetes: Diets rich in trans fat, simple carbohydrates, and preservatives can increase your body’s glucose load and create insulin resistance. Problems with glucose metabolism and obesity can affect hormones like estrogen and progesterone, and in turn affect ovulation. Attempt to eliminate refined sugars and add more fruits and vegetables to your diet. (Apple pie doesn’t usually count as a fruit!) Visit your physician for further testing for diabetes or hormone imbalance.

4) Dial Down Your Stress: Everyone says, “Duh”, to this one, yet stress is one of the most common symptoms cited by couples struggling with infertility. It turns out that as the body faces increased stress, a hormone called cortisol is released. Cortisol may decrease the formation of progesterone and impact ovulation. Consider focusing on another goal for a few weeks or months. This may ease your anxiety about fertility and improve your chances of getting pregnant sooner.

5) Visit your physician: If you have been trying to become pregnant for 6 to 8 months and have not been successful, speak to your doctor. He or she may recommend waiting a few more months without intervention, or check blood tests to evaluate your hormones and other causes of infertility.

Remember: Many couples that are faced with infertility often conceive naturally, or become pregnant after medical intervention. Try your best to have a positive outlook during this difficult time, and express your concerns to your physician. He or she can provide support and resources to help guide you in the right direction.

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