When is it time to call a fertility specialist?

We know fertility specialists can help women get pregnant, but the question of when to enlist their help is a pretty big gray area. Many women are hesitant to see a fertility doctor because they don’t want their families to find out, they are afraid of having multiples, or they feel like seeing a specialist is a sign that they “failed” at getting pregnant on their own.

But the truth is that if you’ve been trying to get pregnant without having any luck, a specialist can help you figure out if there’s an underlying medical reason why you’re struggling, recommend some timing or lifestyle factors you might need to modify, or help you develop a plan that may involve medication or procedures to help you reach your baby goals.

It’s time to call a fertility specialist if:

• You are under age 35 and have been trying to conceive for 12 months.

• You are 35 to 39 and have been trying for 6 months.

• You are 40 or above. 

• You don’t have a regular period every 21-35 days with bleeding that lasts five to seven days.

• Either partner has a family history of genetically passed diseases or disorders like the BRCA1 gene for breast cancer, cystic fibrosis, muscular dystrophy, and more.

• Your mom or sister experienced early menopause.

• You have an abnormality in your pelvic organs like endometriosis or a fibroid uterus.

A note about age: When we talk about age in fertility discussions, it’s because age has a direct effect on a woman’s eggs. Women are born with all the eggs they’ll have in their lifetime, and every year they reduce in number and quality. While egg count can be measured, unfortunately there are no lab test to determine their quality.

What does “trying” mean?

“Trying” is a term people who are actively attempting to get pregnant use a lot, but its meaning varies from person to person. For some, it means they’ve stopped using birth control and are letting things happen whenever they may. For others, trying means an intricate system of calendars, tests, apps, rituals, prayers, potions, and a relentless amount of sex.

To increase your odds for success, here are habits and tactics that should be part of “trying.”

• Use an ovulation predictor kit.

The kit includes a test that detects the surge of a hormone in your urine that indicates you’ll release an egg within 24 hours. Knowing when you’re ovulating allows you to time intercourse when it’s most effective. The test is done each morning starting on ninth day of your menstrual cycle (with day 1 being the start of actual flow) if you have regular monthly cycles. Look for a kit that is easy to interpret; some have lines that are hard to read, while others have a smiley face that’s super obvious.

Many women also use apps designed to help determine fertility. While they can be useful to figure out if your menstrual cycle is regular and keep track of the specific dates, they are not as useful as an ovulation kit to detect actual ovulation. Using both gives you the clearest data to work with.

• Limit caffeine.

Yes, a few grande mocha cappuccinos can really get you through the day, but coffee should really be reduced to one or two actual (8-ounce) cups per day for women trying to conceive. More than that can affect pregnancy outcomes.

• Stop smoking.

Smoking is detrimental to fertility for both a woman and her partner. Smoking depletes egg supply and quality, increases risks for abnormality and miscarriage, and affects the function of fallopian tubes.

• Avoid vaping, CBD, and herbal supplements.

These are not well studied, so doctors recommend both partners avoid using them if you are trying to conceive.

• Focus on good health.

Balanced nutrition, adequate sleep, regular exercise, reduced stress — doing what you can to keep your overall health in tip-top shape can help your body get ready to conceive. Women who are planning to become pregnant should also be taking a prenatal supplement that includes folic acid and B vitamins to reduce the chances for birth defects.

• Consider your partner’s health, too.

A woman can do all the right things to get her body ready for pregnancy, but guys also need to get themselves in order. Men should by practicing all the same healthy habits as a prospective mom when it comes to eating right, exercising, sleeping, and reducing stress. A men’s multivitamin is also a good idea. Men should cut out smoking and illicit drugs, including steroids, limit alcohol, and see a doctor right away for unaddressed erectile dysfunction.

Busting myths about fertility

Let’s set the record straight on some the rumors you’ll probably hear about how to increase your chances of getting pregnant.

• Standing on your head or laying down for 30 minutes after sex doesn’t really help anything.

• You don’t need to reach orgasm to conceive.

• There is no sexual position that is more likely to help you get pregnant.

• There is no special diet that can increase your fertility.

• Basal body temp isn’t an accurate predictor of ovulation. By the time you see that your temperature has gone up, you’ve missed the ovulation window.

• Weight is a tricky topic when it comes to fertility; it’s even a topic of debate for many fertility specialists. Some would argue that there should be a BMI limit above which you shouldn’t try to conceive, but that’s not well proven scientifically. A high body mass index (BMI) may make it harder to get pregnant and carry to term, but you can also have a high BMI, exercise regularly, have no health issues, and still be healthy enough to conceive. It is helpful to bring weight down before trying to get pregnant, but it’s not mandatory. Similarly, being underweight can affect fertility, especially if there is an underlying eating disorder that can be detrimental to overall health.  For additional resources and to find a specialist in your area, visit https://resolve.org/support/professional-services-directory/.

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