How stress can affect your ability to get pregnant

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How stress can affect your ability to get pregnant

Infertility can affect relationships with family and friends, cause financial difficulties, affect the relationship between partners, and negatively affect the couple’s sexual relationship. In short, infertility can cause stress affecting your ability to get pregnant.

But does this stress have an impact on fertility? Is it a fact that you can be infertile due to stress? Let’s dive in!

How stress affects your ability to get pregnant

The Research Behind Stress and Fertility

Alpha-amylase

Researchers have long been trying to figure out exactly how stress limits fertility. A study published in the Journal Fertility and Sterility found that women with high levels of alpha-amylase, an enzyme that correlates with stress, have a harder time getting pregnant. In this study, saliva samples were collected from 274 women over six menstrual cycles (or until they became pregnant). It showed that the women with the highest levels of alpha-amylase during their first menstrual cycle were 12% less likely to become pregnant than women with lower levels of the enzyme.

Cortisol

Another Emory School of Medicine study, conducted by Sarah Berga, MD, found that women who had not ovulated for more than 6 months had high levels of cortisol, a stress hormone. The same brain regions that can regulate hormones needed for ovulation also respond to stress hormones such as cortisol. Of these women, seven of the eight participants who received stress management therapy began ovulating again, compared to only two of eight participants who did not receive therapy. The same link between stress and fertility exists in men, in whom high levels of stress can reduce testosterone production, so both partners may be affected by stress.

Depression & Anxiety

Finally, a study in Taiwan found that 40% of participants who received treatment for infertility were diagnosed with depression or anxiety. Other researchers have found that women struggling with infertility are affected by anxiety and depression at the same rate as women diagnosed with HIV or cancer. Since infertility is a real medical problem with a significant impact on lives, it is not surprising that it can cause the same anxiety as other serious medical problems.

Many researchers have also pointed out that most women who cannot conceive have physical reasons, but this is not always the case. Regardless, the woman feels more and more stress over time. So even if a physical cause is medically treated, it is possible that high stress levels make conception difficult.

Does stress actually cause infertility?

While it’s unlikely that stress alone can cause infertility, stress interferes with a woman’s ability to get pregnant. Research has shown that women with a history of depression are twice as likely to experience infertility. Anxiety also can prolong the time needed to achieve pregnancy.

Stress can affect the part of your brain (the hypothalamus) that regulates your hormones, which in turn regulate your menstrual cycle. If stress takes a toll on your body, then it could mean you ovulate later than usual, or not at all (stress-induced anovulation).

If you’re stressed, your cervical mucus may indicate that something’s not right. Rather than noticing increased wetness as you approach ovulation, you might find patches of wetness interspersed with dry days. It’s as if your body is trying to ovulate but the stress continues to delay it.

Being very stressed for a long time may make it harder to conceive. But trying for a baby can also be stressful in itself. In general, it makes sense to take steps to reduce stress while you’re trying for a baby, if only for your own peace of mind.

Does stress affect the ability to get pregnant?

Yes, and no.

The American Psychological Association notes that “psychological factors–while important–are secondary to biological ones.” Another leading authority on fertility research, the American Society of Reproductive Medicine explains that “even though infertility is very stressful, there isn’t any proof that stress causes infertility.”

A review of over 50 studies in Fertility and Sterility noted that, in men:

“Although some trends have been identified, larger-scale studies that adequately control all confounding variables are needed before conclusions can be made about the relationship between stress, psychotropic agents, and male infertility.”

A 2015 study in Nature Reviews Urology notes a similar sentiment.

If you have a stressful job or work long hours, you can stop beating yourself up about it. How you react to stress—whether channeling it into exercise or unhealthy habits like overeating—plays a bigger role.

What about everyday stressors/unhealthy habits?

There is some evidence that everyday stressors can have an impact on your chances of getting pregnant. Most experts, however, believe that this isn’t due directly to the stress, but from the unhealthy habits that most people turn to when they’re stressed out.

These may include:

  • Smoking
  • Drinking
  • Overeating
  • Avoiding sex
  • Neglecting to exercise

Unhealthy habits affect both women and men when it comes to fertility.

5 tips to reduce stress when trying to get pregnant

Tips to reduce stress when trying to get pregnant
Tips to reduce stress

If you are currently struggling with infertility, or just stress in general, there are many ways to reduce stress! Give one of the following options a try:

Learn

Educate yourself about the normal responses to infertility. Talk to other people going through infertility. Understand your medical condition and ask about treatment options.

Communicate

Talk to your partner about your feelings and needs, and allow your partner to feel and cope differently. Talk about your differences and avoid conflict. Keep communicating with family and friends to avoid isolating yourself. Understand that you can talk about your situation without going into details and tell others how they can support you.

Stay active/exercise

Doing activities you enjoy or exercising lightly can help release endorphins and serotonin, both of which improve your mood. Try moderate exercises such as swimming or walking. Even just setting aside time to do your favorite activities can relieve stress. 

Meditation or yoga

Meditating can help clear your mind and relax your body. Not into sitting still? Try doing an hour of yoga a few times a week. Hatha yoga specifically focuses on breath and movement, without concentrating on mediation specifically. Both meditation and yoga can reduce stress hormones.

Deal with sexual stress

Sexual stress is common among couples with infertility, mostly because couples feel that this is an obligation or a duty rather than a fun activity. Couples can deal with this in several ways, including taking a break from baby-making, distinguishing between work and fun sex, and learning sensual contact that doesn’t lead to pregnancy.

What Are the Chances of Getting Pregnant After 40?

Interestingly, more women above the age of 40 are having babies. The Centres for Disease Control and Prevention (CDC) estimates that the rate of above 40 pregnancies has increased since the 1970s. Between 1990 and 2012, the number of first-time births in women aged above 40 has more than doubled.

The notion that life begins after 40 could be true for some. 

However, for women, turning 40 their chances of getting pregnant reduces with age. The likely reason for this is as you age, your ovary count declines. Women in the 20 to 30 age range have a high likelihood of getting pregnant in every menstrual cycle. Unfortunately, this probability reduces with increased age.

If you’re reading this and you’re in your 40’s, wondering what your odds are at getting pregnant, worry not; there is a silver lining. You can still get pregnant at 40 and have a healthy baby. A few years back, this was different although statistics showed an increase in the birth rate for women aged 40-44. 

Thanks to advances in modern medicine, fertility treatments are significantly improving women’s reproductive health. To understand more about your chance of getting pregnant at 40, we’ve detailed all the fundamentals to guide you through a healthy pregnancy. Let’s dive in.

Getting Pregnant at 40

The Centers for Disease Control and Prevention (CDC) estimates that 30% of women aged 40-45 are infertile. As alarming as the statistic may be, a woman is most fertile  between her late teens and 20s. Once you hit 30, your fertility starts to decline. The decline becomes more rapid by your mid-30s. By the age of 40, your fertility becomes low and natural conception becomes difficult.

Age plays a significant factor in your TTC journey. As you get older, your chances of conceiving reduce. Every month, women above the age of 40 have a 5% chance of conceiving compared to women aged 30 whose probability lies at 20%.

However, women above the age of 40 are getting pregnant using fertility treatments such as Assisted Reproductive Technology (ART). ART is a method for treating infertility where the sperm and eggs are mixed outside the body and later introduced into the woman’s body. An example of such a treatment is In Vitro Fertilization.

While ART may produce significant results that lead to conception, our recommendation is to opt for ART after prescribed fertility medication fails to yield positive results. For starters, the technique is expensive and is barely covered by insurance. You may run up a bill of $10,000 or more for ART treatments. In comparison, fertility drugs are more affordable and can similarly lead to conception. Depending on your doctor, the medical treatments will cost you less than $1,500.

While getting pregnant at 40 is possible, it has its fair share of risks. It is fundamental to understand what these risks are and how to go about them.

Advantages of Getting Pregnant After 40

Getting pregnant at 40 has plenty of benefits to it. Don’t let our biological clock fool you; you can still have a beautiful family at your prime age.  Most women opt to get pregnant at an older age for valid reasons. Here are some of the benefits to it:

Well-Established Life

Raising a child requires financial preparedness. As such, people opt for having kids after achieving a better financial status. This allows them to cater for the child’s needs fully. A child’s medical care can run up your bill, especially if you’re partying out-of-pocket. By the age of 40, most women have worked, saved, and invested enough not to feel the overwhelming financial burden of raising a kid.

More Time for Family

By the age of 40, it is assumed that you’ve checked off items on your bucket list. The road trip with your friends; done and dusted. A reckless expedition in an unknown town; done. You probably feel it’s the right time to settle and have a family. With the other activities out of the way, you can spend more time nurturing your child and growing your family.

It is also the pinnacle of experience, having lived close to half a decade. You’re more experienced and mature to handle the responsibility of bringing up a child.

Longer Lifespan and Better Cognitive Abilities

Studies suggest that children born to older women tend to have a higher IQ demonstrated by high graduation rates and test scores. Besides, children can promote a longer life span in their parents and reduce mental decline as they age.

You Are Certain About Your Path

Statistics suggest that 45% of early marriages often lead to divorce. Although there are other underlying reasons, we often don’t end up spending forever with partners we met in our 20s. At 40, you are certain of your life choices and the path you are on. Evidently, this is the right time to have a child. You are also certain of the partner you met, reducing the chances of divorce or separation that affects the child’s welfare and upbringing.

Healthier Lifestyle

An older mindset comes with better decisions. We can’t deny that our teens and 20s were filled with impulsive decisions with less regard for our health. At age 40, your choices matter, and most people advance towards a healthy lifestyle. This means by 40; your body is in a healthy position to support a pregnancy.

What Are the Chances of Getting Pregnant Per Age Cluster?

Age is a factor that affects fertility. However, it’s not the only factor. Undeniably, advancing in age reduces the number of eggs and their quality as well. A person in their 20s has more viable eggs compared to someone who just turned 25.

To understand infertility, it’s essential to understand all factors around it. For starters, you’re born with close to 7 million eggs, and by the time you hit puberty, you have about 300,000 to 400,000 remaining. To shed more light on fertility, here’s how your chances of conception change with age:

20s Pregnancy

The chances of conceiving in your 20s are predominantly high. At this age, your body is healthy so are your eggs and sperms. Moreover, you have more eggs being released during ovulation. Although, the drawback sits in emotional and financial preparation. Most women or couples are never adequately prepared for the highs and lows of bringing up a child. Regardless, the chances of conception for a 20s pregnancy ranges between 57% to 62% after six cycles and 70% to 78% after 12 cycles.

30s Pregnancy

At age 30, your chance of getting pregnant slightly declines. The decline becomes more rapid at age 35. Compared to your 20s, your chance of getting pregnant ranges between 61% to 46.3%  after six cycles and 77% to 67% after 12 cycles. The decline in the percentage signifies the increase in age. The more you age, the lower your chances of conception.

40s Pregnancy

Despite the highlight that 35 marks the rapid decline of fertility in women, more mothers are getting pregnant at age 40 and above. An underlying reason for this is the introduction of assisted reproductive technology (ART) that improves fertility in aged women. 

What Is the Fastest Way to Get Pregnant at 40?

Due to the declining number and quality of eggs in women above 40, the chances of getting pregnant at age 40 and above become slimmer. Despite most women appearing quite young and youthful in their 40s, their biological clock is ticking away.

Based on statistics, at age 40, you have a 5% chance of conceiving during your menstrual cycle. However, this should not alarm you. There are steps you can take to improve your fertility and likelihood of getting pregnant at 40 and above. Here’s how:

Get Pre-conception Advice

To get the best out of your pregnancy journey, it’s best to walk it with your doctor. Seeking an obstetrician and gynecologist (OB/GYN’s)counsel before Pregnancy helps you understand your body and its preparedness for Pregnancy.

Additionally, it’s also essential to outline any underlying conditions that would complicate your Pregnancy. Prevention is often better than cure, and for a woman in your prime age, preconception counseling will aid you in planning your Pregnancy while watching out for risks. The planning journey could constitute fertility treatments or medication to balance your hormones.

Take up Healthy Habits

At age 40, it’s the right time to double back on unhealthy living and take up dieting and exercise. In your 20s, an unhealthy lifestyle wouldn’t hinder you from getting pregnant. However, at 40 and above, your system is slowing down, and the best way to keep it active is with healthy habits. Eating a nutrient-rich diet and exercising helps keep you in impeccable shape. Not to say that your body’s shape is a prerequisite to getting pregnant; however, having a healthy weight is prudent.

What’s more, it is advisable to steer clear of caffeine and alcohol. Some doctors would prescribe eating a high-fat diet. No, this doesn’t mean consuming loads of junk but fats in ketogenic diets. Fats, such as cholesterol,  play a crucial role in producing reproductive hormones such as Progesterone, Estrogen, and Testosterone. 

Consider Taking Supplements

The CDC advises all women embracing the trying to conceive (TTC) journey to take 400 micrograms (400 mcg) of folic acid daily. Folic acid is vital in preventing the development of congenital disabilities known as Neural Tube Defects (NTDs).

In addition to taking folic acid, adding coenzyme Q10 (CoQ10) to your daily supplement is advisable. CoQ10 is an antioxidant that is found in the human body’s cells. The enzyme exists in the form of ubiquinone, an oxidized state, and ubiquinol, an active and reduced state. CoQ10 plays an active role in energy production. The enzyme supports various metabolic functions and protects cells from free radical damage. However, we’ll focus on its role in Pregnancy.

Taking CoQ10 helps improve your egg quality and promotes successful IVF outcomes. As you may know by now, aging causes a natural decline in your fertility and egg quality. With CoQ10, you can counter the effects of ovarian aging by revitalizing the energy and mitochondrial production roles. In turn, this promotes the development of a quality embryo, increasing your chances of a healthy above-40 pregnancy.

In addition to improving embryo quality, CoQ10 also enhances the rate of fertilization and Pregnancy while reducing the cases of stillbirth.

Steer Clear From Stress

Evidently, every human faces a stressful situation. Being pregnant is no different. It comes with an overwhelming sensation of stress and mixed emotions. Some of it stems from the body changes or hormones that induce mood changes. As a woman over 40 looking to get pregnant, you should avoid stress at all costs. Stress causes several health problems, especially during pregnancy. It can cause high blood pressure and heart complications.

Taking up practices such as tai chi or yoga will help balance the stress levels in your body, promoting blood supply in your uterus. The pressure of getting a child may get to you as you hit 40, but be wary. Stressing about it may counter your efforts to get pregnant.

Track Your Menstrual Cycle

Women who hit 40 often ovulate earlier than usual. Women in their 20s to 30s stand a chance of getting pregnant between the 12th to the 14th day if they’re on a 28-day menstrual cycle. Therefore, if you’re trying to get pregnant, it’s best to understand the right time to have sex. In most cases, you may ovulate on day nine or day 10.

The ideal way to know the right time is through tracking your menstrual cycle. Ovulation happens a fortnight before your next scheduled period. With a period tracker app, you can time your next ovulation. You can also use an ovulation kit and check for cervical mucus. Timing your ovulation increases your chances of getting pregnant. It is advisable to have coitus with your partner before, after, and during ovulation. This is because the eggs and sperm stay in the body for a few days before absorption.

Consider an Egg Donor

Sadly, most women above the age of 45 cannot conceive with their eggs because the quality of eggs is quite low to support a healthy pregnancy. However, that doesn’t mean you can’t carry a child.

A suitable alternative for an over-40 pregnancy is donor eggs. With donor eggs, you can still have a biological child. Your partner’s sperm will fertilize the egg while your blood will nourish the fetus. Moreover, it is an affordable option compared to other fertility treatments.

If you’re planning to have a baby later in life, you should consider the following methods and discuss them with your doctor.

Oocyte Preservation

Also known as egg freezing, oocyte preservation is a medical procedure that preserves a woman’s eggs. Women use this technique to postpone their Pregnancy to a later date. The doctor extracts some eggs from your ovaries and freezes them for later use in an IVF procedure.

The procedure is common in women who are yet to start radiotherapy or chemotherapy and those undergoing Assisted Reproductive Technologies who don’t wish to freeze their embryos. Over and above that, if you’re thinking of a later pregnancy and your family has a history of early menopause, it’s advisable to preserve a few viable eggs.

Intro Vitro Fertilization (IVF)

IVF is a popular assisted reproductive technology (ART) that involves complex steps and procedures to combat infertility and genetic complications. When planning a pregnancy above 40, IVF is a common procedure that doctors recommend.

It involves collecting eggs from your ovaries and fertilizing them with sperm in the lab. As mentioned, IVF also gives you a chance to raise your biological child since you get to use your partner’s sperm and your eggs. After fertilization, the egg(s) are injected into the uterus for implantation. An IVF cycle takes three weeks or longer.

In other cases, you can also have a surrogate carry the baby. This procedure will still involve your eggs and your partner’s sperm. However, the surrogate will take your baby to term. The surrogate option is ideal if you’re experiencing medical problems with your uterus or have a condition that makes Pregnancy a huge risk for you.

Fertility Medications

An inexpensive fertility treatment option is fertility medications. If you have trouble conceiving, your doctor will perform several tests to ascertain the root cause. Some of these tests include ovulation testing, ovarian reserve testing, hysterosalpingography, imaging, and hormone testing.

The treatment you receive depends on the reason for infertility, age, personal preferences, and length of infertility. Fertility drugs invoke ovulation as your body’s hormones would. Sometimes the treatment would trigger ovulation or simulate the ovary to produce a better egg. Notably, since fertility is a complex process, fertility medication requires financial, physical, and psychological commitments.

Intrauterine Insemination (IUI)

IUI is a form of artificial insemination where concentrated sperm is directly inserted into your uterus. The procedure involves using a small catheter and a speculum to place the sperm in your uterus during ovulation.

It is a common method used by women who wish to become pregnant by donor sperm. It’s also a to-go-to procedure for unexplained infertility as the first treatment option.

Chances of Getting Pregnant at 40 During Ovulation

By the time you hit 40, you have a 5% chance of conceiving during ovulation. Although your fertility declines with age, it is still possible to get pregnant. The only drawback is that it’s harder to conceive naturally in your 40s compared to previous years.  

While there are many underlying reasons for this aspect, a significant factor is the deterioration of your egg’s quality which can lead to the onset of genetic abnormalities in the infant. Furthermore, your ovarian reserve dwindles with age. This means by the time you hit 40; you have fewer eggs in store than you did probably 15 years back.

How Many Eggs Do You Have at 40?

Surprisingly, babies are born with ovaries that hold approximately 1 to 2 million eggs. This means you are born with the egg cells you’ll need your whole life. No other development takes place during your lifetime.  However, before puberty, you’ll lose close to 10,000 eggs each month.

At the onset of puberty, that’s when your menstrual cycle starts. This is after your brain triggers the hypothalamus to produce gonadotropin-releasing hormone (GnRH). At puberty, your ovarian reserve has around 300,000 to 400,000 eggs.

During your menstrual cycle, a group of eggs is selected as contenders for ovulation. The dominant bearing follicle will proceed with ovulation while the rest of the immature eggs are reabsorbed by the body (atresia). This further translates to a loss of 1,000 eggs each month. Even so, as you age, the number of eggs you lose each month decreases.

By the time you approach 40, you have close to 20,000 eggs in your body.

Good news, thanks to medical advances, women can now find out the number of eggs in their ovarian reserve. Doctors use the  Anti-Mullerian Hormone blood test to assess a woman’s ability to produce eggs; The test shows how many viable eggs you have left. The lower the AMH levels, the fewer eggs you have in your ovarian reserve.

FAQ

What Risks Are Associated With Getting Pregnant After 40?

Generally, women may face pregnancy complications at any age. However, at 40 and above, the likelihood of these complications occurring is more. Besides, getting pregnant may also be an uphill task because of menopause. Menopause is a normal biological process women over 40 go through. An indication of menopause is not having your periods. Some women may think they’re pregnant, but it is a sign their body is no longer ovulating.

Some women experience menopause in their 40s to 50s. Nonetheless, in the United States, the average menopause age is 51. You may beat the odds and get pregnant at this age. However, there are significant risks to it, such as;

Birth Defects

Birth defects in infants can occur with Pregnancy at any age. However, an over 40 pregnancy has a high probability of birth defects for the baby. A liable cause is the genetic abnormalities found in the eggs of mothers above 40. As you age, your eggs become more chromosomally absorbed.

There are many attributions to these abnormalities, such as the stress cumulation in the egg’s DNA strands or reduced levels of normal oocytes. According to the U.S National Birth Defects Prevention Study, women above the age of 40 are highly likely to deliver babies with birth defects that affect the lungs, heart, esophagus, skull, and genitals. The most common birth abnormality in infants is Down Syndrome. The chance of having a baby with down syndrome at age 40 increases to 1/70 compared to age 33, which stands at 1/400.

Preeclampsia

Being pregnant causes various changes in your body. Aside from putting a strain on your heart, it also causes the release of the progesterone hormone that raises your cholesterol and blood levels. This increase potentially leads to the onset of preeclampsia, especially for women with high blood pressure. Moreover, giving birth at age 40 and above raises your risk of preeclampsia by 3.1%.

Preeclampsia, also known as toxemia, manifests symptoms of kidney damage due to high protein levels in urine as well as other signs of organ malfunction. If not treated, preeclampsia can prove to be fatal or lead to severe complications for the baby and mother. Preeclampsia can lead to the development of eclampsia, a condition that causes seizures.

In most cases, as a proactive measure, doctors recommend early delivery of the baby. However, this depends on the condition’s severity and how far along you’re pregnant.

Low Birth Weight

Women above the age of 40 are likely to deliver babies with low birth weights. Infant low birth weight (LBI) refers to a baby born weighing less than 5 pounds, eight ounces. Babies with LBW are smaller with minimal body fat. Also, they have large heads that are disproportionate to their body.

The primary cause of LBW is growth restrictions by the fetus and premature birth (before 37 weeks). Growth restrictions occur if your baby is not getting adequate nutrition to gain weight during Pregnancy. An above-40 -Pregnancy comes with complications that can induce premature delivery of the baby leading to low birth weight. Infants born with low birth weight often spend time in the neonatal intensive care unit before getting discharged from the hospital.

Miscarriages

A woman above the age of 40 runs the risk of miscarriage. This risk increases with age, where 1 in every two pregnancies by women above the age of 45 results in a miscarriage. Fetal abnormalities cause miscarriages during gestation. The abnormalities are mostly genetic, and studies estimate that nearly half of all miscarriages occur due to missing or extra chromosomes.

As a woman ages, her egg quality declines, leading to a high risk of fetal genetic abnormalities. Therefore, the abnormalities are not inherited; rather, they occur during the splitting of cells during Pregnancy.

Still Birth

Going past your due date is risky. Although sometimes it may not be alarming, for women above 40, it could be a sign of stillbirth. After 40 weeks of gestation, the risk of a stillbirth heightens. It is crucial to monitor your baby’s movements and report any incidents to your doctor if you feel your baby moving less.

Large Baby

As an older mom, you pose the risk of having a large baby, a condition known as Macrosomia. This is when you deliver a baby over 4.5 kg or 10lb. Medical practitioners attribute this condition to gestational diabetes, which is prevalent in women above the age of 40.

Gestational Diabetes

Gestational diabetes is a type of diabetes that develops in pregnant women. The conditions affect how your body absorbs sugar (glucose). It tends to cause high blood sugar, complicating your Pregnancy and affecting your baby’s health. Women above 40 have a higher chance of developing gestational diabetes than women between the ages of 20 to 30.

The good news is you can control it. Eating healthy meals, doing light exercises, and taking medication help to regulate sugar levels. Keeping your blood sugar levels in check is ideal to ensure safe delivery and keep your baby healthy.

Gestational Hypertension

As mentioned earlier, being pregnant puts a strain on your organs, including your heart. Older women have a high risk of gestational hypertension, a condition where you develop high blood pressure during Pregnancy. You may confuse it with preeclampsia. Yet, the two are medically different.

Gestational hypertension often arises after 20 weeks of Pregnancy. In most cases, it goes away after delivery, but some women who get diagnosed have a high likelihood of developing chronic hypertension.

Cesarean Delivery

As you age, your uterine muscles become less effective. As a result, an above-40 pregnancy will likely lead to a cesarean delivery. Moreover, your doctor may advise having a cesarean delivery due to the risk of having a large baby.

Ectopic Pregnancy

The risk of an ectopic pregnancy rises with age; hence women over 40 tend to develop this type of Pregnancy. Ectopic Pregnancy refers to the implantation of the fertilized egg in the fallopian tube. In a normal pregnancy, the egg is fertilized in the fallopian tube and is expected to travel down to the uterus for implantation. If an ectopic pregnancy occurs, the embryo needs to be removed since there is less room for growth. In worst cases, the pregnancy could lead to a rapture of the fallopian tubes, which is fatal for the mother. Other symptoms of ectopic pregnancy include sharp abdominal pains and severe uterine bleeding.

Do Abnormal Eggs Ovulate?

As indicated, the quality of your eggs goes down with age. It is not unusual for a sperm to fertilize an egg that is deemed to be abnormal. However, your body can tell that the egg is abnormal, resulting in the embryo not implanting in the uterus.

In the rare case where implantation takes place, a miscarriage may ensue since the embryo will fail to develop.

Final Thoughts

Despite people’s opinion, getting pregnant at 40 and above is possible. There is never a defined time to start your family, so take your time and don’t succumb to the pressure. When you’re ready to have a child at 40, talk to your doctor about the risks and ways to mitigate them in order to achieve a successful pregnancy. All the best!

How Do I Use Ovulation Tests When Trying To Get Pregnant?

Best Days to Get Pregnant

Are you looking forward to getting pregnant and may be pondering what ovulation tests are and how do I use ovulation tests when trying to get pregnant? Ovulation tests are a popular method of tracking your most fertile days, but they sometimes need clarification.

LH surge is a clear indicator of ovulation
LH is a clear indicator of ovulation

Learning to use ovulation tests is an integral part of increasing your chances of conception. With a bit of practice and learning, you will be an expert in no time.

Below are tips and illustrations that seek to explain how ovulation tests work. Also to note are insights on how to interpret and comprehend results. Moreover, we will provide tips that educate you on ways to use them most effectively when trying to get pregnant.

What Is An Ovulation Test?

If you have been trying to get a baby and haven’t succeeded yet, these tests can be a valuable tool. This is because they can assist you in pinpointing your most fertile days. By having intercourse on these days, you can potentially increase your chances of conceiving.

The tests are carried out to measure the amount of luteinizing hormone (LH) in your urine. The pituitary gland produces the Luteinizing hormone and helps to stimulate ovulation. When LH levels rise, ovulation will occur within 24-48 hours.

These tests are available in home test kit form and as strips that you can purchase at your local drug store. They are relatively affordable and straightforward to use. Follow the instructions that come with your chosen ovulation test.

You must use a urine strip test to collect your urine in a cup. Dip the strip in the urine and wait for the specified time in the instructions. After the time has elapsed, compare the strip to the color chart included with the kit. If the strip changes color, this indicates that LH is present, and ovulation will likely occur in the next 24-48 hours.

If you are using a digital ovulation test, the process is similar. Collect your urine in a clean cup and dip the test in the urine. Wait for the specified time in the instructions. The digital test will then display a message showing whether or not LH is present. If it is, ovulation will likely occur in the next 24-48 hours. Once you have determined that ovulation is imminent, you and your partner can start trying to conceive.

Best Days to Get Pregnant using ovulation prediction kit
Best Days To Get Pregnant

When Should I Start Using The Test?

If you are working towards getting pregnant, you may be wondering when to start using an ovulation test. The response to this question will depend on a few factors, including your cycle length and how regular your periods are. Generally, it’s best to start testing around the time you expect to ovulate. For most women, this is around day 14 of their cycle. However, if your cycles are longer or shorter than average, you may need to adjust the timing of your tests.

For most women, testing once per day is sufficient
For most women, testing once per day is sufficient

It’s also important to consider how often you’ll need to test. For most women, testing once per day is sufficient. However, if your cycles are irregular or you have other fertility issues, you may need to test more frequently. Ultimately, speaking with a fertility specialist is the most incredible way to determine how often you should test.

Types of Ovulation Tests

When trying to conceive, many women use ovulation tests to help predict when they are most fertile. There are a variety of different ovulation tests on the market, with each having its own merits and demerits. Here are the various types of ovulation tests:

1. Sticks

If you’re trying to get pregnant, ovulation test sticks can be a great way to help you track your ovulation cycle and improve your odds of conceiving.

Ovulation test sticks work by detecting the presence of the luteinizing hormone (LH) in your urine. This hormone increases just before ovulation, so the test sticks can tell you when you’re about to ovulate

There are a few fundamental ways to use ovulation test sticks. Some women use them to track their cycles, while others use them in conjunction with fertility treatments. When used correctly, ovulation test sticks can be up to 99% accurate in predicting ovulation.

There are many different brands of ovulation test sticks on the market, so it’s crucial to do your research to find the appropriate one for you. But once you’ve found a brand you trust, using ovulation test sticks is simple: pee on the stick and wait for the results. Most sticks will give you a positive or negative result within a few minutes.

2. Strips

Strips are a quick and easy way to test for ovulation at home. Most test strips have clear instructions and can be used with little to no fuss. Ovulation test strips detect luteinizing hormone (LH) presence in your urine. This hormone is released once the egg is released from your ovary and triggers ovulation.

Wet the strip with urine to use an ovulation test strip and wait for the results. Most test strips will show a positive result within a few minutes. If the strip turns positive, you are ovulating and should have sex that day or the following day to maximize your chances of conceiving.

Ovulation test strips can be found at most drugstores and are relatively inexpensive. Using these strips can help you to better time intercourse around your ovulation period, which can improve your chances of conception.

3. Digital Ovulation Tests

Digital ovulation tests are a type of fertility monitor that uses sensors to track changes in a woman’s body temperature. The sensors are worn under the arm and take readings throughout the day. The data is then sent to a fertility app which can help predict when the woman is ovulating.

Digital ovulation tests have several pros over traditional ovulation tests. They are bona fide, cheaper, and more convenient to use. Consequently, digital ovulation tests can be used by women who have irregular periods or are taking certain medication types.

Mira is one the popular digital ovulation tests in the market.
Mira is one the popular digital ovulation tests in the market.

If you are trying to conceive, a digital ovulation test can be a helpful tool in your fertility journey.

How Do I Interpret The Results Of My Ovulation Test?

If you’re hoping to get pregnant, you’re probably wondering how to interpret your test results. While these tests can be accurate, you should keep a few things in mind when trying to determine if you’re ovulating. The tests identify the amount of luteinizing hormone (LH) in your urine. This hormone spikes just before ovulation, so the test can predict when you’re about to ovulate.

Most ovulation tests come with instructions on how to interpret the results. Holistically, you will take the ovulation test at the same time each day, starting on a particular day of your cycle. The test will have a control line and a test line.

If the test line is the same color or darker as the control line, you have a high LH level and are likely to ovulate within the next 12-24 hours. If the test line appears lighter in color than the control line, that means your LH level is low, and you’re not likely to ovulate soon. There are also digital ovulation tests that will give you a positive or negative result, depending on your LH level.

While ovulation tests can be accurate, a few circumstances can bring about errors in the results. If you take the test at a different time than usual, your LH level may be different than it would be at your regular testing time.

Certain medications, such as fertility drugs, can also affect the test results. Talk to your doctor if you’re unsure how your medicines might affect the test. If you experience irregular periods, you may have a more challenging time predicting ovulation.

How Accurate Are Ovulation Test Strips?

Just how accurate are ovulation test strips? Anyone who has tried to conceive will tell you that much waiting is involved. And often, the waiting feels like an eternity. All you want is a positive pregnancy test, but you’re left distraught invariably.

If you’re struggling to conceive, consider using ovulation test strips. But how accurate are they? Ovulation test strips detect the presence of the luteinizing hormone (LH) in your urine. This hormone is produced by the pituitary gland and helps to regulate ovulation. When your LH levels surge, it signals that ovulation is about to occur. 

To use an ovulation test strip, urinate on the strip and wait for the results. If the strip changes color, your LH levels are high, and ovulation is likely to occur in the next 24-48 hours.

Ovulation test strips are generally very accurate. In fact, studies have shown that they can be up to 99% accurate in predicting LH surges. However, it’s essential to keep in mind that ovulation test strips only work if you use them correctly. This means using them at the same time each day and following the instructions carefully. 

You need to use them correctly to get an accurate result. 

Another thing to remember is that certain medications, such as clomiphene and menotropins, can affect ovulation test strips. If you’re taking any medicines for fertility, be sure to speak to your health professional to see if it will affect the results of your ovulation test strips.

How To Use Ovulation Tests In An Irregular Cycle

If you have an irregular cycle, you will be unsure when to ovulate. This can make it challenging to identify when to use an ovulation test. However, you can do a few integral things to increase your chances of success. First, it is poignant to understand how the ovulation process works. Hormones control the ovarian cycle. These hormones cause the ovaries to mature and release eggs. 

Ovulation usually happens about 14 days before the start of your next menstrual period. However, this varies from woman to woman or from cycle to cycle. This is why it can be challenging to predict when ovulation will occur.

There are a few ways to increase your chances of painstaking your ovulation day. One way is to chart your basal body temperature (BBT). This is your temperature when you wake up in the morning before attending to other responsibilities. You will need to take your temperature every day for the next few months to get an accurate idea of when you ovulate.

Another way to predict ovulation is to pay attention to changes in your cervical mucus. This mucus changes in consistency and amount throughout your cycle. Just before ovulation, you may notice an increase in mucus. It will be thin, slippery, and clear. This is called fertile mucus.

Once you have been charting your BBT and cervical mucus for a couple of months, you will have a good idea of when you ovulate. You can then start using ovulation tests. 

Are There Any Risks Associated With Using Ovulation Tests?

Ovulation tests are not just for those who are trying to conceive. In fact, any woman who wants to know her most fertile days can benefit from using one. However, as with any medical procedure or test, there are always some risks involved. So, what are the potential risks associated with using ovulation tests?

The most common risks associated with using ovulation tests are false positive and false negative results. A false positive result means the test says you are ovulating when you are not. This can be frustrating and confusing, especially if you are trying to conceive. A false negative figure means that the test says you are not ovulating when you are. This can also be frustrating and can lead to unnecessary stress and anxiety.

Another potential risk is that ovulation tests can be expensive. If you are not trying to conceive and you want to know your most fertile days, you may not want to spend the money on an ovulation test.

Finally, there is always the potential for human error. You must use the ovulation test correctly to get accurate results. This is why it is essential to follow the instructions carefully and to contact a healthcare professional if you have any questions.

Overall, the risks associated with using ovulation tests are relatively low. However, it is imperative to be well aware of them(ovulation tests) before you embark on using one. If you have any concerns or issues, be sure to speak to your healthcare provider.

Where Can I Get Ovulation Tests?

If you’re having trouble getting pregnant or if you have irregular periods, your doctor or physician may recommend that you take an ovulation test.

There are two types of ovulation tests: urine tests and blood tests. Urine tests are the most common and are available without a prescription. Blood tests are more expensive and are only done if you’re having trouble conceiving. If your doctor recommends an ovulation test, they will likely give you a prescription for one. Get in touch with us if you need one. However, you may be able to find ovulation tests at your local pharmacy or online.

When you are ready to take the test, you will need to collect a sample of your urine. The best time to do this is first thing in the morning before you’ve had anything to drink. You’ll then need to place the sample on the test strip and wait for the results.

If the test is positive, it means you’re about to ovulate. This is the best time to be intimate if you are trying to conceive. If the test is negative, then you are not about to ovulate. You may consider trying again in a few days or speak with your doctor about other fertility treatments.

Conclusion

Ovulation tests are simple, inexpensive, and easy to use, and they can be a great tool in your TTC (trying to conceive) arsenal. But like any tool, they work best when used correctly. 

LH is produced by the pituitary gland and leads to ovulation. When levels of LH surge 48-72 hours prior to ovulation, it signals the release of an egg from your ovary. The egg only lives for 12-24 hours, making this a very brief window of opportunity for fertilization.

Ovulation tests typically come in the form of midstream tests that you can use at your own convenience at home. To use them, urinate on the absorbent end of the test strip or midstream cup and wait for the results. Most tests will show a positive result (indicating the presence of LH) within 5 minutes.

To increase your chances of getting pregnant, you’ll want to start testing for LH about five days before you expect to ovulate. Most women ovulate mid-cycle, around day 14 (counting Day 1 as the first day of your period). Keep in mind, if you have been diagnosed with PCOS or other forms of reproductive disorder your results may be inconclusive, so it is alway safer to seek an advice from a licensed medical doctor.

However, this can vary from one individual to another. Likewise, cycle to cycle- so it’s best to use ovulation tests to identify your own personal LH surge. Once you detect the LH surge, you’ll want to have intercourse within 24-36 hours. By understanding how ovulation tests work and how to interpret their results, you can increase the chance of getting a positive pregnancy test.

How likely is it to get pregnant with PCOS?

how many women have PCOS

While probability of childbirth is similar between groups, women with PCOS need longer time to get pregnant.  Earlier diagnosis and intervention can shorten the time to get pregnant with PCOS and improve the chances for live birth. You need to educate yourself and seek care from fertility specialists. It is also important that you start as early as possible. Let’s take a deeper look at PCOS.

What is PCOS?

PCOS, as the name implies, is a syndrome, a collection of symptoms. These symptoms vary between individuals.  Your reproductive endocrinologist specialist (REI) will conduct a thorough health history review and order hormone analysis that can help with a diagnosis.  

The three features of PCOS are:

  1. High levels of “male” sex hormones, such as testosterone
  2. A large number of immature ovarian follicles (fluid-filled sacs that develop and release eggs)
  3. Irregular menstrual cycles (typically less than 10 per year)

If you have two out of three, yes you do have PCOS. Later we will explain how to find out.

How many people suffer from PCOS?

Millions. 1 in 10 women. Moreover, 70% of people with PCOS are either misdiagnosed or undiagnosed. So you may suspect you have PCOS, but still not know for sure. Get checked.

What causes PCOS?

Although we do not currently know the exact underlying cause of PCOS, we think it is due to abnormal hormone secretion in the brain along with abnormal insulin sensitivity in the muscles, and here is how it works:

1. Your cells are not responding normally to insulin which leads to its high levels of insulin. It’s called insulin resistance. Insulin controls how food is changed into energy. As a result of resistance, your insulin blood levels become higher.

2. Insulin resistance can also lead to high levels of androgens (male hormones) can prevent the ovaries from releasing an egg during each menstrual cycle, also causing extra hair growth and acne.

Why is it harder to get pregnant with PCOS?

Because PCOS makes women ovulate irregularly or not at all. Ovulation is a key requirement for getting pregnant. 

  1. If an egg is not released, there is nothing for the sperm to fertilize and create an embryo.
  2. If the ovulatory process is irregular, it is difficult to identify a fertile window.

How do I know I have PCOS?

Help us to help you:

  1. Track your menstrual cycles. How frequently they occur and how long they last ( and how painful or heavy they are). Report if your cycles are greater than 45 days apart or less than 10 per year
  2. Complete the work up recommended by your REI: get bloodwork done or order home test kits to check certain hormone levels
  3. Confirm polycystic ovaries using an ultrasound

Remember! PCOS is a spectrum and will have variable presentation and symptoms. The diagnosis is made when two of the three criteria are present.

Can I get pregnant with PCOS naturally?

Is it likely to pregnant with PCOS? Yes, but it takes 2.5 years longer to get pregnant with PCOS. Combined with effects of age on fertility, it can be a risky situation. You can work on eating healthier, losing weight, or quitting smoking. However, lifestyle interventions alone do not work for the majority of women, and they will need additional interventions to establish regular ovulation.

Is it possible to get pregnant with PCOS quickly?

Is it hard to conceive with PCOS? Yes. However, getting pregnant in general is not a quick process. While a completely healthy young couple has a 25% chance of getting pregnant during a single cycle, chances of “absolutely healthy” individuals reduce with aging. PCOS makes it even more complicated. A few of our patients have conceived on their first cycle using standard medicated treatment. Although this is a rare case, Charity W from Oklahoma decided to share her experience with you:

Can I get pregnant with PCOS and no periods?

Is it impossible to conceive with PCOS without having periods? No. As you’ve seen in the testimonial above, Charity didn’t have periods at all and she got pregnant during her first cycle of treatment. Although medical miracles are rare, women with PCOS have one of the best prognosis when undergoing fertility treatment and most of them will eventually become pregnant. Even if they didn’t have periods before the treatment.

How to get pregnant with PCOS?

The good news is that with treatment, most patients would get pregnant. If the initial lifestyle changes like losing weight are not successful in initiating regular menses or you are not able to delay treatment, we recommend you start acting immediately, especially if you are over 35 years old, as the chances of pregnancy begin to decline. Also, there are some medical disorders that can mimic PCOS, so we strongly recommend you visit a Reproductive Endocrinologist with experience in evaluating and managing women with PCOS. Please, do not wait and do not lose your precious time.

There are two types of medicines used in fertility treatments for patients with PCOS:

Clomiphene or Letrozole

are usually the first medication type recommended for women with PCOS who are trying to get pregnant. Both medicines induce ovulation by encouraging recruitment, growth, and the monthly release of an egg from the ovaries (ovulation).

Metformin

Makes the body more sensitive to ovulation inducing medications if Clomiphene or Letrozole are unsuccessful in encouraging ovulation.

We can also recommend as appropriate supplements  from Theralogix™ that have been proven to help with fertility.  They include CoQ10, Inositol, and prenatal vitamins.  There are also supplements available for men to improve sperm quality.

Metformin is often used to treat type 2 diabetes, but it can also lower insulin and blood sugar levels in women with PCOS. As well as stimulating ovulation, encouraging regular monthly periods, and lowering the risk of miscarriage, metformin can also have other long-term health benefits, such as lowering high cholesterol levels.

Are there any real success stories of getting pregnant with PCOS?

There are millions of stories like this, including our own patients. The following one is also real and very complicated at the same time. Keep in mind that you should not take it as treatment advice. Every case can be individualized.

Tiffany came to Fertility Cloud after three cycles of Clomid and two cycles of Letrozole ovulation induction. She was a twenty-eight-year-old woman who had not been pregnant previously, diagnosed with PCOS at age twenty-one and has been on birth control until she started trying to get pregnant.

Testing confirmed the diagnosis of PCOS. Unfortunately, she did not ovulate on clomiphene and her initial trial of letrozole. Our approach was to make her ovaries more sensitive to ovulation induction. We started her on metformin and a small dose of dexamethasone. Then we increased her dose of letrozole. She ovulated in the first month and became pregnant after three cycles. 

So, what does it mean for me?

Although while it is hard to get pregnant with PCOS, the good news is that women with PCOS typically have some of the best prognosis when undergoing fertility treatment. Most of them will eventually become pregnant. Treatment has improved significantly and has become more effective as well. The general rule in fertility treatments is the sooner you begin, the more likely you are to succeed. And it’s smart to choose an experienced doctor with an understanding of PCOS.  Don’t delay!  A consultation with a qualified REI can clear up any confusion or concerns you may have about getting pregnant with PCOS.


 

Getting Pregnant after 30, 35 or even 40, written by a fertility specialist.

Is it possible to get pregnant after 30, 35 or even later?

According to research over the last 40 years, a healthy 30 year old woman has about a 20% chance of getting pregnant each month. A healthy, ovulatory 40-year-old woman’s chance per month is 5% (1,6). The decline is slow and steady up until the age of about 35. After that the decline becomes steeper. These ranges and time frames have been established through multiple studies and have been consistent for the last 30+ years. The decline in fertility is attributed to depletion of ovarian oocyte (eggs) reserve and is determined by genetic, environmental, and lifestyle factors.(2).

How hard is to get pregnant after 40
How likely is to get pregnant at certain age

What makes it hard to get pregnant after 35 or 40?

Although your changes of getting pregnant after 35 or 40 are decreasing, there are good news. Age at conception does have bearing on time to pregnancy in a healthy, ovulatory woman. In general, fecundity (a woman’s physiological ability to have a child) is reported as age ranges because it is difficult to correlate a specific age to a specific chance of success. There are also factors that can affect reproductive aging. These include other medical conditions that can have an effect such as endometriosis, fibroids, genetic conditions (errors in number of chromosomes), environmental influences, obesity, smoking, thyroid gland dysfunction, history of sexually transmitted diseases (STDs), and ovulatory dysfunction, to name a few (2,3).

PCOS stands for Polycystic Ovarian Syndrome, it is the most common form of ovulatory ovarian dysfunction.  The pathology of PCOS makes ovulation irregular and unpredictable, making the timing of intercourse for conception difficult. 

There could also be issues with male fertility such as erectile dysfunction and sperm quality issues. Male evaluation initially consists of a semen analysis and potentially other endocrine blood testing to evaluate any severe sperm abnormality.

How can fertility specialist can help to conceive after 35 or 40?

Most of the factors other than extreme reproductive age are usually treatable. When you get started, the first step is a comprehensive evaluation of both you and your partner (if applicable). We test your ovarian reserve to gauge likelihood of adequate number of eggs produced per cycle, prolactin levels since the elevated levels can affect regularity of ovulation, and PCOS testing. If there are any positive findings, we can offer prescription medications or supplements beneficial for conception (5).

There are supplements that both partners can take that have been shown to be beneficial for conception.  Lifestyle modification and diet changes (such as following the Mediterranean diet) can also positively impact your chances.  Controlling your stress and regular moderate exercise also confer benefits (3,4).

Please click the link below for a consultation with an experienced Reproductive Endocrinologist. You can also follow us on Facebook or return to our website for updated information about your fertility journey.

References

1.   Menken J, Trussell J, Larsen U. Age and infertility.  Science. 1986;233:1389-1394.

2.   Utting, D., & Bewley, S. (2011). Family planning and age-related reproductive risk. The Obstetrician & Gynaecologist, 13(1), 35–41. https://doi.org/10.1576/TOAG.13.1.35.27639

3.   Collins GG, Rossi BV. The impact of lifestyle modifications, diet, and vitamin supplementation on natural fertility. Fertil Res Pract. 2015 Jul 25;1:11. doi: 10.1186/s40738-015-0003-4. PMID: 28620516; PMCID: PMC5424364.

4.   Dimitrios Karayiannis, Meropi D Kontogianni, Christina Mendorou, Minas Mastrominas, Nikos Yiannakouris. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Human Reproduction, 2018; DOI: 10.1093/humrep/dey003

5.   Unfer, V., Nestler, J. E., Kamenov, Z. A., Prapas, N., & Facchinetti, F. (2016). Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials. International journal of endocrinology, 2016, 1849162. https://doi.org/10.1155/2016/1849162

6. Sozou PD, Hartshorne GM (2012) Time to Pregnancy: A Computational Method for Using the Duration of Non-Conception for Predicting Conception. PLOS ONE 7(10): e46544. https://doi.org/10.1371/journal.pone.0046544

Understanding Your Menstrual Cycle

Menstrual Cycle

By Fertility Cloud Head Nurse Svetlana Izrailevsky, BSN, RN.

What is a menstrual cycle? 

In reality, a menstrual cycle consists of 3 broad categories of cycles:  Ovarian (follicular) cycle, Endometrial lining cycle, and Cervical mucus development cycle.  It is important to understand that these cycles are taking place in tandem, and in relationship to each other.  That means that what happens in one of these cycles will affect the developments in the other ones.  

First, lets review the hormones involved in the menstrual cycle:

FSH – FSH helps control the menstrual cycle and stimulates the growth of eggs in the ovaries. FSH levels in women change throughout the menstrual cycle, with the highest levels happening just before an egg is released by the ovary. This is known as ovulation.

LH – LH helps control the menstrual cycle. It also triggers the release of an egg from the ovary. This is known as ovulation. LH levels quickly rise just before ovulation.

Estradiol, also called E2, is the main estrogen in nonpregnant females of childbearing age. It’s mostly made in the ovaries and is important for uterine lining development.

Progesterone is a hormone that’s made mainly by the ovaries. Each month, progesterone prepares your uterus for pregnancy. During a normal menstrual cycle, an ovary releases an egg and your progesterone levels begin to rise. Progesterone makes the lining of your uterus grow thicker so that a fertilized egg can attach (implant) inside of the uterus and grow into a baby. If you don’t become pregnant, your progesterone levels will fall. The lining of your uterus will become thinner again. When your uterus starts to get rid of the extra blood and tissue, your menstrual period will begin.  If you become pregnant, progesterone levels will continue to rise to about 10 times higher than usual to support the pregnancy.

3 main time frames of the cycle:

menstrual cycle - 3 phases
follicular phase
Ovulatory phase of menstrual cycle
post ovulation and endometrial secretory phase
Luteal phase
These different cycles communicate via hormone messengers. For example, when the egg inside the follicle is mature, it sends a signal to the pituitary gland via the increased levels of Estradiol hormone. This stimulates the rise in LH hormone levels which finishes the maturation of the egg and allows it to break out of the follicle–ovulate. At the same time, Progesterone level rises to support the uterine lining and the uterine lining undergoes a transformation where the receptors for the embryo become activated and stand ready.

The connection between different cycles

menstrual cycle phases


LET’S LOOK AT SOME COMMON QUESTIONS THAT COME UP:

What is the best time to get pregnant during my cycle? What should I be doing to maximize the potential for conceiving?

When we are speaking of a regular 28-30 day cycle, your fertility window is between cycle day 10-15.  We would recommend intercourse every other day starting on cycle day 10.  Once you note your LH surge by using ovulation predictor kits, you should have intercourse daily on the day of the LH peak/surge and the subsequent 2 days.  

Please remember that LH hormone stays elevated for a very short time, just about 24 hours so we do not recommend that you keep checking your LH after you see the peak.  

Male partners, if applicable, should do ejeculation every 2-3 days starting with your cycle day 1.  We would like to have the freshest sperm sample available for insemination.  Please do not hold off on regular ejaculation because that increases the number of dead and dying sperm in the sperm sample that will be produced for the insemination.

Wait!  What if my cycles are not regular?

For some patients, the cycles are regular and predictable, but long.  It is possible to have a regular ovulatory cycle with the overall length of 35 days, for example.  However, there are also women who have irregular ovulatory cycles due to ovarian dysfunction.  This dysfunction is usually related to improper hormone levels of Estradiol and FSH.

What does the follicle stimulating hormone (FSH) do again?

FSH – FSH helps control the menstrual cycle and stimulates the growth of eggs in the ovaries. FSH levels in women change throughout the menstrual cycle, with the highest levels happening just before an egg is released by the ovary. This is known as ovulation.  

What about Estradiol?

Estradiol, also called E2, is the main estrogen in nonpregnant females of childbearing age. It’s mostly made in the ovaries and is important for uterine lining development.  As you can see in the diagram above, Estradiol rises slowly before ovulation and stays elevated for a period of about 7 days after the ovulation.  This is so that there is no ovarian follicular recruitment happening during the period of potential fertilization and implantation.   Elevated levels of Estradiol can interfere with production of FSH so if the Estradiol levels are high at the beginning of the cycle it impacts the regular growth and development of the follicles. 

Estradiol can be elevated as a result of conditions such as polycystic ovarian syndrome (PCOS) or presence of elevated levels of BPA in the system. Bisphenol A (BPA) is a chemical produced in large quantities for use primarily in the production of polycarbonate plastics. It is a part in various products including shatterproof windows, eyewear, water bottles, and epoxy resins that coat some metal food cans, bottle tops, and water supply pipes. https://www.niehs.nih.gov/health/topics/agents/sya-bpa/index.cfm.  

I ovulated 2 days past normal ovulation days, does that mean my period will start two days later than expected?

The next menstrual period will start once the Progesterone and Estradiol levels fall, if there is no conception.  They typically occur 10-14 days after ovulation occurs.  If you ovulate 2 days later than you usually do, your menses mostly likely will be 2 days late.

I have been taking Progesterone to support my uterine lining.  Will that impact my menses?

Yes!  If you are taking Progesterone, you are not likely to start menses even if you are not pregnant. Take a home pregnancy test, and if it is negative stop taking the Progesterone. You can expect your menses 2-5 days after stopping the medication.  Some patients may begin spotting even before stopping Progesterone.  The spotting/bleeding you will get after the Progesterone may be a little heavier than your usual menses and the first day of bleeding will count as cycle day 1 for next treatment.

It was my first time taking Clomid, is it normal that I expect menses to be delayed even with negative HPT?

Clomid does not directly impact the length of menses.  However, it does help regulate the ovulatory process so your menstrual cycle will look different.  For some patients, cycles are a bit shorter and for others they are longer as Clomid works to increase production of FSH hormone.

What does LH hormone timing look like in the cycle?

LH rises slowly only a few days before ovulation and then has a sharp rise known as LH peak or surge, 24-36 hours before ovulation.  It only stays elevated for about 24 hours and then drops sharply.  It does not begin to rise again with the start of the menses, at least not right away.