This article is for all the women and girls out there I think they want to wait to have children. I get it completely. I was you. I happily accepted the line that I was fed as a young girl that went something like this.....
- Go to College
- Go to more college
- Don't get pregnant along the way
- Concentrate on your career, maybe open a business or two
- When you find the right person your body will naturally be ready to have a baby
Most women my age can relate to this. I'm 37 btw. Yes, I realize you should never admit your age, but I'd like to change that so cheers to complete transparency and vulnerability.
I'm willing to bet that most of you were taught how NOT to get pregnant and never taught when your fertility actually starts to decrease.
I'm all for feminism. Clearly it's help get me where I am today, however, I do think there are some things I wish someone had told me that you should consider well before you make such a serious decision to put your fertility on hold. Here are some tips to help you make that decision and possibly preserve your fertility along the way.
1. Chances of Conceiving- Humans are poor reproducers. You only have a 25% chance of falling pregnant each month and that starts to decline at about age 27.
I know, it’s startling. I about fell out of my chair in graduate school when I learned this not so fun statistic. Mind you I was 30, had involuntarily ended a relationship with a great guy I was convinced I would marry and there was not a decent candidate in sight. Never mind that whole, “I’ve invested a shit ton of money in my education and now I need to finish, start a business, and rocket to success,” thoughts that were playing loudly in my head. There didn’t seem to be a lot of room in there for finding said mate and procreating successfully.
For decades I was taught that I could never be too careful. A boy might look at me wrong, knock me up, and ruin any chances I had at being a self sufficient woman. Boy did I swallow that one without asking any questions.
Regardless of age, two days prior(-2) to ovulation(0) is statistically your highest chance of conceiving and male age does matter!. https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/17.5.1399
I know I’m not alone in this either. I would say on average, about twice a day, I have a conversation with a woman in my clinic who states, “I never knew that the chances of conceiving were so low. No one ever told me this,” or “Where was this information in health class? They only talked about birth control and tampons.”
2. It can take a while to get Preggers even if you are young and healthy. (Due to above stat)
Let’s do some math. If there are 12 months in a year, and you only have a 25% chance of falling pregnant naturally, that means your chances of falling pregnant is about three months out of that year. (Yes, my college stats professor would slaughter me for this one as technically it’s 25% each month that doesn’t apply to the entire year.) It’s pretty close though to what I observe clinically. It takes most healthy fertile couples over 30, 6-9 months to conceive and KEEP the pregnancy to term.
Now, you could strike it hot on try number one. You always hear those couples that complain, “We didn’t even get to have any fun and try, it happened the first time.” Clearly these couples have NOT been to infertility land where not succeeding poses a pretty good threat of actually ruining your sex life, psyches, and bank account.
3. The average rate of miscarriage is about 30%
Now this is not something you will likely hear at your next dinner party, but boy is it true. It’s sad, because it’s part of our biology that ensures we don’t over populate with weak versions of ourselves. It’s devastating when it happens, but because no one talks about it, who do you turn too? Most husbands aren’t fully equipped to deal with this kind of loss and grief for themselves let alone what their wife is feeling. They certainly aren’t talking with buddies at their next fishing trip about how much they cried over it and let’s face it, most men, when faced with the inability to fix something for their partner when they are emotionally distraught can revert into not so great versions of themselves. (I realize this is a gross generalization and probably applies more to those men under 35 who haven’t quite developed stellar emotional intelligence just yet.) The stigma around miscarriage can be worse that around depression or STD’s.
Charting BBT’s (basal Body temperatures) can actually help you see when your chances for miscarriage will drop significantly giving you the green light to charge ahead the NEXT month.
4. Multiple Miscarriages- Having a DNC for a miscarriage can actually create scar tissue and harm your chances of successful implantation for the next pregnancy.
If you are one of the women that has been dealt the blow from mother nature of enduring a miscarriage, please try and go through it naturally if at all possible. For many women, the simple act of giving yourself permission to take a time-out and grieve the loss while it’s happening drastically helps you to put it to bed and move on, not to mention preserving the integrity of your uterine lining.
Acupuncture and internal herbs can help to move the process along if it doesn’t start right away or seems to be taking longer than it should. (if you were on Progesterone supplements this can prolong the release of the lining.) Getting your OBGYN to agree to follow you on ultrasound through the process to make sure everything comes out is the wisest approach. If you aren’t past 8 weeks, it hasn’t taken more than a week to start on it’s own since the fetus stopped growing, and you aren’t pregnant with twins and your doctor still disagrees with you doing it naturally you may want to be shopping for a new doctor ASAP.
Some red flags to watch out for while going through it at home…
- Try not to be alone during the process. At the very least have a trusted friend or health care professional that is checking on you periodically by phone if you don’t feel that you want anyone in your space.
- Soaking a pad or filling a diva cup faster than every 90 minutes at the peak of blood loss is too much. This type of blood loss could very easily lead to fainting which is exactly why you don’t want to be alone if at all possible.
5. Abortions, DNC, and IUD's can increase infertility by creating scar tissue in the uterus leading to higher rates of miscarriage when you are ready to conceive.
This is a sticky one to put out there as a fertility specialist, I am Pro-Choice though. I do believe a woman should always have the right to manage her fertility. What I am against is women not being educated about how this could potentially harm their physical chances later in life when they are ready.
The other part no one talks about around the potential for abortions to harm your chances is the emotional realm, specifically shame. I’ve never met a woman that had an abortion that was proud of it. I do find clinically though, those that did not grieve that loss, go through some kind of counseling, or do a lot of self work around the event can have more emotional blocks when it comes time to try. If you feel like their might be some seeds of shame lurking in your closet that are subconsciously sabotaging your chances I encourage you to reach out to a trusted friend, aunt, or ask around for a good mental health counselor. Also, anything by the esteemed and sometimes painfully hilarious author Brene Brown is a good starting place for cleaning out your shame cave. Check her out on youtube first. This is such an integral piece of the unexplained infertility piece, that Erin Gray and I did an entire Podcast episode about it called Unfinished Business.
6. Male Fertility Tests- It takes two to tango- yes, male factor infertility is alive and well and actually part of the problem about 40% of the time.
For eons women have simply taken it on the chin when we couldn’t conceive. If it didn’t work, clearly we were barren and useless and should be banished as a result. Well, modern research actually shows that male factor infertility is the problem way more than we have ever been led to believe. Typically about a third of the time in my clinic it’s the woman, another third it’s the man, and the remaining third there are issues on both sides.
Here’s a quick biology lesson.
- Women are born with all of their eggs and will carry them for life exposing them to every chemical, food, substance, thought, and emotion that they encounter. Despite this, it’s never too late to clean up your act and try to affect epigenetics.
- Men make brand new spanking sperm every 90-120 days. Yes there are such things as at home test that measure count as well as DNA.
- https://trakfertility.com/pages/how-trak-works
- https://www.episona.com/seed/
- Epigenetics is the science of gene expression based on environment - external and internal environment. This means that cleaning up your diet, kicking bad habits, taking fertility vitamins and supplements known to affect egg and sperm quality, and learning how to be less emotionally reactive thus curbing that internal conversation you are having with yourself 24/7 can drastically change what genetics are expressed via sperm and eggs. Like most things, men get a pass for bad behaviour an d can clean it up a bit quicker than females- 3 months vs about 9 for females.
7. Is a Fertility Diet Necessary? Poor food choices can decrease your chances of conceiving naturally for up to a year prior.
Eating food full of GMO”s that bind to your estrogen receptors can drastically F*c?-Up your hormonal signaling. Not only do GMO’s drop your chances of conceiving, they increase your rate of contracting estrogen related cancers. Eating unclean sources of meat and dairy full of hormones and antibiotics aren't helping your endocrine system either.
Not eating regularly, consuming too many carbs and binging on sugar can cause damage as well. Unstable blood sugars drive inflammatory conditions like fibroids, endometriosis, and PCOS. And it’s not only high blood sugar that is the culprit.
Low blood sugar also causes insulin resistance. So if you skip breakfast, live off of coffee until 3pm, are known to get HANGRY, trust me when I say you are potentially doing just as much harm to your fertility as someone that is overweight and flirting with type II diabetes.
8. Advanced Maternal Age -If you think you will be putting off conception off until your mid thirties, get some testing to see if that’s possible for your biology.
The idea that we are all created equally when it comes to our biology and physicality is a farce! Not everyone was given the genes to be captain of the football team or a blinged out olympian like Simone Biles and Michael Phelps. Much the same way, not all of us were designed, thanks to heredity, to make babies at age 40. And thank God we weren’t. We would have ended the planet in a blaze of glory a loooong time ago if everyone had been able to conceive past 35 and our chances were more than 25% each month.
Here's the skinny on which tests you need, when to get them and what they will tell you.
FSH (follicle stimulating hormone), Estradial, and LH-
These need to be taken on day 2 or 3 of your cycle. *Day 1 of your cycle is the first morning you bleed, not spot. In conjunction, these tests can show start to paint a picture of what your egg quality is like and if there is anything lurking like PCOS. *It's a myth that you have to skip periods to have PCOS.
AMH1
Otherwise known as Anti-Mullerian Hormone -This test can be taken any day of your cycle. It is thought to point to ovarian reserve, meaning all the eggs you have left. If we are born with all of our eggs though this number should never go up and sometimes it does. What this means is that is more likely that it is a representation of the ovarian reserve that is actually making it out of deep within the ovaries due to good circulation and all the micronutrients needed to grow eggs from germ cells to actual eggs- NERD alert!
Progesterone
This lovely hormone helps to balance estrogen making us less crazy versions of ourselves. It lets us fall asleep peacefully and when tested at the correct time of the cycle day 21, in conjunction with above tests, it can indicate whether or not we are ovulating. It can also point out things like estrogen dominance, or low progesterone that could increase your risk of infertility and miscarriage. High levels can also be the culprit of excessively heavy bleeding during your period.
9. When to call in the big guns, i.e. see a Fertility specialist- This means a Reproductive Endocrinologist, NOT an OBGYN
If you are under 35 and it has taken longer than a year to conceive
If you are over 35 and it has taken longer than 6 months to conceive
If you are over 40, go directly to an REI. It doesn't mean you can't conceive naturally. I see it all the time in my practice, however, it's best to do all necessary testing and know where you are at so you can relax through the process instead of feeling like a ticking time bomb.
You're in your late 20's, can't possibly see yourself reproducing any time soon and you are considering freezing your eggs now so you don't have to use donor eggs later.
If you fit these criteria and absolutely hate doctors, visit an acupuncturist who is board certified in Reproductive Medicine that can run and evaluate these tests and will be a straight shooter. If something comes back out of whack, more than likely they will refer you to an REI they know, trust and work with on a regular basis.
If all of this has you completely stressed out, don't be. Take a deep breath and come back to present moment so you clearly devise an action plan. If you don't know where to start, call on me. I'm totally here for you.