This section of my site is dedicated to informing the small section of people I reach, about fertilty and preconception. I will try to provide the most accurate information I am able. If you have any suggestions or can think of any information to add please email me.
Each month, a woman's reproductive system undergoes a complex cycle to prepare for pregnancy. Thought preparation for pregnancy actually begins a few days before her menstrual period begins, day one of the cycle is considered the day the woman's menstrual period starts. During her period, the lining of her uterus isshed in response to falling hormone levels from the prior month's cycle. the putuitary gland--a small endocrine gland in the brain--releases hormones into the bloodstream. One of the hormones--follicle-stimulating hormone (FSH)--begins to recruit (or develop) follicles in the ovaries. Follicles are round, fluid-filled compartments, each containing an egg, and the FSH helps them grow and mature. As they grow, these follicles produce estrogen. Estrogen makes the uterine lining thick and receptive to embryo implantation later on. The increasing estrogen level also allows glands near the cervix (the opening into the uterus) to release thing, strechy, clear mucus. This mucus helps sperm enter the uterus through the cervix.
When the estrogen level reaches a peak, the pituitary gland releases a hormone called luteinizing hormone (LH) into the bloodstream. The LH is releases in a surge, which signals mprtant genetic divisions to take place in the egg; these divisions mature the egg so that it can be fertilized. The LH surge also causes the follicle to rupture. Ovulation (the release of the egg) takes place about 34 to 36 hourse after the beginning of the LH surge.
After the egg is releases, the follicle transforms itself into what is called the corpus luteum, which produces and releases the hormone progesterone. Progesterone makes the uterine lining soft, nutritive, and able to support a pregnancy. It also causes the vervical mucus to thicken and behave like a barrier to the uterus. (This is exactly the opposite of what estrogen did around the time of ovulation!) Unless directed otherwise, the corpus luteum will last for 9-11 days before it begins to regress (or shrink); when it regresses, the estrogen and progesterone levels drop, the uterine lining sheds, the mestrual period begins --and the whole cycle starts again.
If, however, an egg is fertilized by a sperm, the resulting embryo will implant into the soft uterine lining and begin producing a hormone called human chorionic gonadotropin (hCG). The hCG signals the corpus luteum that progesterone and estrogen are still required, so taht it will not regress. THese hormones maintain the embryo (an make the uterine lining not shed)until the placenta can take over hormone production.
Schedule an exam with your OB/GYN to be sure that everything is okay. Your physician will not test you for infertility but this visit is to insure that you have your annual pelvic exam - to check for cancer and STD's and to see that you appear to be healthy. Ask them about a time limit for the pregnancy to occur before starting infertility tests. Some doctors will say 1 year, some will say 6 months and depending on your age, some may say as little as 3 months.
Right now is a good time to practice proper nutrition. It is a good idea to have "daddy" on a proper nutrition diet as well, to insure healthy sperm. Limit the intake of caffeine and quit smoking, drinking alcohol and absolutely no drugs. During the process of trying to conceive you will have about 2 weeks where you could be pregnant but may not know it yet.
Buy a basal body temperature thermometer. These come in either traditional glass or digital. Both are good. Learn the techniques of proper charting and begin this as soon as possible. This helps in two areas - 1. You will know when and if you are ovulating. 2. You will know if you may possibly have an infertility problem. A doctor will appreciate at least 3 months of charts if you suspect an infertility problem - this will help them to come to a diagnosis sooner.
A quick run down of proper charting is to start taking the temperature the first day of your cycle. Have a good chart ready - these can be downloaded off of the Internet - or they can be found in the back of books on fertility or in the box the thermometer came. Take your temperature first thing every morning - at the same time - before rising or moving or speaking. Record this reading. The first half of your cycle, estrogen is the prominent hormone and will surge right before ovulation. Your temperatures will be in the low range - normally in the 96 -97 range. The day after ovulation your temperature should rise about .4 a degree. This is caused from the release of progesterone. This shift should stay high until either your next menstrual cycle begins (which it will drop at that point) or it will remain high if pregnancy is achieved.
There are ways to chart your cervical fluid and your cervix, as well, - if you so desire. See my Fertility Awareness pages.
If you know when you are ovulating - try to have intercourse for several days before ovulation, as well as the day of and a day or two after. Usually an egg will only live for 12 to 24 hours. Sperm can live up to 5 days in good quality cervical fluid. Drink lots of water - this will help to increase your cervical fluid. Also, start taking prenatal vitamins - either from what your physician prescribed or over the counter. The folic acid is very important to start taking before pregnancy occurs - this helps to eliminate neural tube defects with the baby.
Ovulation predictor kits may be used to help pinpoint ovulation. Follow the instructions in the package to insure their proper use. These can be expensive and are not necessary - if you desire to go ahead and try them.
Check on your insurance to see if maternity is covered. If not see about assistance with your state and check with your doctor and hospitals about cash charges. Most doctors and hospitals want the entire bill paid by the 7th month of pregnancy, so keep this in mind.
And last, but certainly not least - relax. Try to take this journey one day at a time and try not to obsess about it. Armed with the above knowledge, you are well on your way to conceiving your dream!
One Dozen Super New and Time-Tested Ways To Encourage A Natural Conception At Any Age!
Although timing intercourse to coincide with ovulation is the best way to ensure conception, it is not the only way! You and your partner can take a number of steps to encourage not only a quick conception, but also a healthy one. Here are 12 new but also time-tested ways to do just that.
1) MAKE LOVE WITH THE LIGHTS ON
Studies have shown that artificial light, like a lamp kept on at night can have an effect on your fertility, encouraging regular menstrual cycles, and keeping ovulation on schedule. In one study, a woman was able to control the regularity of her menstrual cycle for three months by simply sleeping with the lights on, on the fourteenth, sixteenth and seventeenth nights. In addition, she could increase the length of her cycle according to the number of hours the light was turned off (half a night as opposed to a whole night).
As a result of studies like these, some researchers believe that sleeping with the lights on for several weeks, and making love in that environment as well, could encourage conception by helping to keep ovulation regulated.
2) MAKE LOVE BETWEEN OCTOBER AND MARCH
According to brand new reports in the "British Medical Journal", making love from October to March can DOUBLE your chances of getting pregnant! Researchers speculate that egg quality, as well as positive changes in the uterus, can increase in direct relation to the changes in the temperature, climate and light that occur during these months.
The worst times to attempt conception? August and September. According to recent research, published in the "American Journal of Obstetrics and Gynecology", births drop dramatically during April and May, indicating that August and September may not be fruitful months in which to conceive.
3) MAKE LOVE ON YOUR BIRTHDAY
As reported in "Gynaekologe", a respected Japanese medical journal, the fertility of some women may be season-sensitive, increasing around the time of their birthday. According to the study, making love close to the day you were born may make conception faster and easier.
4) BE TURNED ON WHEN YOU MAKE LOVE
Because being sexually stimulated can influence the flow of reproductive hormones, research indicates that couples who are very turned on when they try to conceive may have a faster, easier time getting pregnant. In addition, the very latest studies show that the sperm count of men, who ejaculate when they are turned on and making love, is higher and more potent than that of men who masturbate.
And don't forget the power that simple touching and caressing can have to boost your fertility! Studies show that just 20 to 40 minutes of stimulating sexual caresses prior to intercourse can increase hormone levels and encourage fertility.
In short, whatever turns both of you on is a great conception booster.
5) DON'T MAKE LOVE UNDER AN ELECTRIC BLANKET
The very latest studies show that the low voltage emitted by electric blankets may adversely affect fertility. There is also evidence that conception which takes place under an electric blanket may yield a higher rate of birth defects and miscarriage. So, if you're trying to get pregnant, let your love keep you warm!
6) MAKE LOVE CLOSE TO THE TIME OF OVULATION AND AVOID MISCARRIAGE
In a fertility study of 965 women, all of whom kept detailed records of sexual activity, it was shown that the likelihood of miscarriage decreased when conception took place at the time of ovulation. When fertilization took place 3 days after ovulation, when the egg is on its' way to disintegration, miscarriage rates tripled!
7) LIMIT MOVEMENT AFTER INTERCOURSE
By remaining in bed for 20 to 30 minutes (you don't have to stand on your head) preferably on your back, with a pillow under your pelvis, you can help encourage sperm to remain in your body and flow upward toward your fallopian tubes.
8) UTILIZE FAST WITHDRAWAL
Research suggests that by withdrawing his penis immediately after releasing the first squirt of his ejaculation, your partner can increase sperm concentration and thereby improve chances of conception.
9) RETAIN SPERM IN YOUR VAGINA
Immediately after intercourse, lightly press the labia (lips) of your vagina together with your finger, and hold for several minutes. This can help keep the sperm inside your vagina and ensure that what has been deposited has the opportunity to swim toward your fallopian tubes.
10) AVOID ALCOHOL AND DRUGS AT THE TIME OF CONCEPTION
Although some couples are accustomed to increasing sexual stimulation and enjoyment through the use of alcohol and/or drugs prior to making love, I cannot emphasize enough the importance of avoiding this practice, especially at the time of conception. Mounting evidence shows that alcohol in your bloodstream or your partner's at the time of conception can have overwhelmingly negative effects not only on your fertility, but on your baby as well. Do not use either of these substances on or around the time you plan to conceive.
Robitussin, which contains the active ingredient guaifenesin and helps to clear the mucus in your lungs, can also alter cervical fluid, making it thinner and better able to transport sperm. Many studies have shown that women who were unable to conceive have helped solve their fertility problems by using this method. Take the dosage stated on the bottle, beginning three to four days prior to ovulation.
12) LIMIT INTERCOURSE AND/OR MALE MASTERBATION
Avoiding ejaculation for 2 to 5 days prior to attempting conception will increase the sperm count and ensure that your partner retains the highest percentage of perfect sperm for your conception.
The OPK is a test that checks your urine for the presence of LH, luteinizing hormone. Normally, LH is in a steady state, at a low level (negative test). But when it rises very quickly (LH surge) it stimulates the developing egg (follicle) and ovulation (release of the egg) follows shortly thereafter.
The OPK helps you predict when you are about to ovulate. Ovulation usually happens within 12-36 hours after the OPK first turns positive.
Q. At what time of the day should I test with my OPK?
A. In general, it's suggested to test in the early afternoon, usually within a couple of hours before or after 3 p.m. or so.
Many women can have an LH surge after waking up, but it can take four to six hours for the LH surge to first show up in the urine.
Some women test twice a day, just to make sure they don't miss the very first surge.
Q. My OPK was positive on CD 12. Today is CD 19 and I still haven't seen a typical rise in my BBT curve. Could I have a positive OPK without ovulating?
A. It's possible to have a positive OPK without ovulating. The OPK does not test for ovulation, but for the LH hormone, which usually precedes ovulation and which stimulates the egg to ovulate. A positive OPK without ovulation can happen under the following circumstances:
1. LUFS (luteinized unruptured follicle sydrome) where there is a surge in LH but no egg is released.
2. Premature ovarian failure
3. Menopause
Q. My OPK tests faint in the result window for many days in a row. Is that a problem?
A. It's normal to always have some LH in your body. It's shortly before ovulation when it rises significantly. Most tests do not become clearly positive until a certain LH is reached, and many will show a faint line with lower LH levels. If your result line often has significant color, you should consider trying another brand, and if it's still positive for many days in a row, then you may want to see your doctor and test your LH levels on the third day of your next cycle to see if your hormone levels are elevated.
Q. I see a faint line in the OPK test window. Is that positive and does that mean I will ovulate soon?
A. A line in the OPK that's fainter in the test window than the control window does not mean you are going to ovulate.
Unlike home pregnancy tests where any line in the result window indicates a positive, OPKs are only positive if the test-result line is the same color or darker than the reference line.
You should read the manufacturer's instructions to verify if a positive means that it's the same or darker than the control window.
Q. I had sexual intercourse with my husband late at night, and the next day my BBT showed was elevated, indicating ovulation the day before. Can I find out whether I ovulated in the morning or at night?
A. It's impossible to determine from your BBT curve whether you ovulated at night or in the morning. We can't even be 100% sure of the day. Once there is a typical rise in the temperature, all we can say is that ovulation probably happened about 24-36 hours prior to that rise.
Q. When and how often should we have sex after the OPK turns positive?
A. The perfect time for sex is the day just prior to the ovulation predictor FIRST turning positive.
And this may sound like a surprise, but making love only after first getting a positive OPK may not get you pregnant at all.
Ovulation can happen as early as 14 hours after the OPK first becomes positive.
Let's say you test with the OPK at 8 a.m. and it was negative. Then, the OPK turns positive at 11 a.m. So ovulation could then happen 14 hours later, at 1 a.m. the next day.
If you test every 24 hours you will only find out about the positive OPK at 8 a.m. the next day, which may be too late for getting pregnant if you only have sex at that time.
Testing every 12 hours may be more reliable to predict ovulation.
Making love after ovulation won't get you pregnant, so if you rely on the OPK and you wait to have sex only when the test becomes positive, you may decrease your chances of getting pregnant.
That's why it's generally suggested to make love two to three times each and every week. That way you are unlikely to miss ovulation.
In addition, you may want to make love once a day when the OPK turns positive, just to make sure.
Q. We like to time our sex so that we can make love during the most fertile days. Which is better, OPKs or fertility monitors?
A. There is no proof that timing sexual intercourse based exclusively on OPKs or fertility monitors actually increases your chances of getting pregnant.
Studies have shown that even in women with regular cycles, ovulation can happen on many days of the cycle.
Because making love after ovulation won't get you pregnant, it's suggested that you make love regularly, two to three times a week, every week of the month, if you want to improve your chances of getting pregnant. You can still make love daily during the 4-5 "fertile" days prior to and during ovulation, but if that's all you do, then it won't likely increase your pregnancy chances.
Q. I know both ovulation predictor kits (OPKs) and BBT charting can determine ovulation. But which is a better indicator of actual ovulation?
A. The OPK and BBT curves really function differently.
An ovulation predictor kit changes color before you ovulate, based on a surge in your luteinizing hormone (LH), usually 1-2 days before ovulation. OPKs usually predict when you are about to ovulate.
A BBT chart reflects your progesterone level. It's close to zero before you ovulate and goes up dramatically after ovulation. This is reflected by a rise in temperature after ovulation. Your basal body temperature (BBT) chart can detect ovulation only afterward, because your temperature goes up only after you ovulate, usually 1-2 days later.
You can't use a BBT chart to determine when to have sex (or uterine insemination) that same month, but an ovulation predictor kit can predict ovulation early on.
You must be aware that sometimes neither will work: Both ovulation predictor kits and basal body temperature/cervical mucus charts can be wrong.
Q. I was told that I may not ovulate. Are there any reliable methods to detect ovulation and to find out if I am ovulating normally? What are the usual symptoms and signs of ovulation?
A. The following are ways to detect ovulation with some certainty, in order of decreased probability:
A typical temperature rise on the BBT chart.
An endometrial biopsy that shows typical changes 7-10 days after ovulation.
An elevated blood progesterone level about 7-10 days after ovulation.
Seeing on ultrasound a follicle that measures 18mm+ and not seeing it anymore several days later and seeing fluid around the ovary.
A positive OPK (ovulation predictor kit).
Mittelschmerz (ovulation pain).
Cervical mucus changes like egg-white cervical mucus (EWCM).
A regular, 28-day-or-so menstrual cycle is usually a good indication of regular ovulation. But not always. One important way to detect regular ovulation is to keep a menstrual calendar. When you see your doctor, the menstrual calendar helps to explain your cycles.
Other ways to detect ovulation include checking for fertility signs such as watching for your mittelschmerz, and evaluating changes in the cervical mucus and the cervical position. But even with the typical fertile egg-white cervical mucus (EWCM), there is insufficient certainty that ovulation has happened.
The major question is always, "how can I predict ovulation ahead of time?" Besides calculating your ovulation based on your cycle length, prediction of ovulation is often done with OPKs. As soon as they turn positive, ovulation usually happens within 12-36 hours. You cannot predict ovulation ahead of time with the BBT curve.
Obviously, a positive pregnancy test is the very best indication that you ovulated.
