Chelsea Natural Health Clinic

Infertile or impatient? Self help guide to natural conception by Lynda Mathewson, Acupuncturist at Chelsea Natural Health Clinic, Fulham Road, SW10

Does it seem like ages since you’ve been trying? Has sex become more obligation than pleasure? Is everyone around you ‘falling’ pregnant? Lynda Mathewson sorts out the facts from the fiction surrounding infertility to help you decide when you really need to seek help.

The National Institute of Clinical Excellence (www.nice.org.uk) recommends that “infertility should be defined as failure to conceive after regular unprotected sexual intercourse for 2 years”.

84% of couples will conceive within 1 year if they do not use contraception and have regular sexual intercourse. Of those who do not conceive in the first year, about half will do so in the second year.

With regular unprotected sexual intercourse, 94% of fertile women aged 35 years, and 77% of those aged 38 years, will conceive after 3 years of trying.  So if it is taking you longer than a year, it’s not abnormal. But there are things you can do to help yourself before attempting assisted conception.

DO…

HAVE REGULAR SEX

Sunday mornings and his birthday may be regular to some couples but it will probably take 20 years to conceive. Regular sex is subjective but when it comes to conception the guidelines are clear. Couples are advised to have sex every 2 to 3 days, so no binge sex on the weekend. Reason for this is based on the life span of the egg (up to 12-24hrs after ovulation) and sperm (average 2 – 5 days, although super sperm can survive for up to 7 days). The sperm will survive within a woman prior to ovulation and seek out the egg when ovulation, reducing the need for the joyless ‘timed sex’. (www.hfea.gov.uk).

Don’t store up sex until the 10 days around ovulation as if ejaculation occurs more than 5 days apart, the number of dead sperm in the semen is increased. If sex is not possible then masturbation is required. Daily sex may be unsustainable over a number of months, and is no benefit to conception.

In conclusion, without sex all the lifestyle changes or investigations you do are academic. Immaculate conception only worked once (allegedly) so if you are trying unassisted conception – have sex.

KNOW WHEN YOU OVULATE

An average cycle is 28 – 29 day, and between 26 – 32 days is ok. Ovulation occurs mid cycle, usually 14 days before the period starts. Keep a diary of ovulation and menstruation to avoid any inaccuracies.

Ways to identify ovulation:

●         Cervical Mucus – usually detectable a couple of days to ovulation and is the best indicator. Some women detect a slippery feeling when wiping after going to the toilet, others can see excess slippery egg white like discharge in their pants. It should be clear and odourless.

●         Ovulation Predictor Kits (OPK) – such as Clearblue Digital. OPKs detect the Luteinising Hormone (LH) surge which occurs 12 – 48 hrs before ovulation.

●         Cervical position – This takes practice; the best description is “feeling the difference between your nose and your lips”. At the start of a cycle, your cervix is low, closed and firm. At ovulation it softens and feels more open, indicating it is more favorable to allowing sperm through to the uterus.

●         Basal Body Temperature charts – Useful at showing if OPK LH surge corresponds with the thermal shift, but indicates after ovulation has occurred. Some people find interpreting the subtle changes confusing, and late nights and some foods can cause fluctuation. It also has to taken on waking, at the same time of day, which can be a disadvantage to those with irregular waking times. It is best done in conjunction with cervical mucus and/or position checks, and stop if they cause stress.

SPERM TEST

Every test on a woman is a surrogate test, like reading the packet to establish what is inside. Sperm tests are direct, ie actually emptying the packet and seeing what is inside. A woman’s egg quality is hard to influence, but sperm takes 3 months to make and the quality can be effected (lifestyle, fevers, injury). The Doctors Laboratory (http://www.tdlpathology.com) offers a comprehensive sperm test for £135, available with a referral from a doctor or other therapists (including acupuncturists). As sperm quality can fluctuate a couple of tests will be required. If a man has a history of local injury, fevers, severe mumps or hormonal irregularities then it is worth contacting an andrologist for detailed investigations. Whereas women appear to take a pragmatic approach to fertility tests and investigations, men can be sensitive so address the situation cautiously.

CHECK YOUR WEIGHT

In women, being overweight can raise oestrogen levels and cause a greater chance of luteal phase defect (LPD) or polycystic ovary syndrome (PCOS).  In men, it can contribute to subfertility. http://www.nhs.uk/Tools/Pages/healthyweightcalculator.aspx

THE AGE FACTOR

Conception is not always an option for women under 30 years old; if that’s the case for you, and you are over 30 now, focus on what can be improved and don’t dwell on what cannot. Maternal age does affect quality of eggs and conception rates. Women are born with all the eggs they are going to produce throughout their life, and the quality does decline with age. There are significant drops in female fertility at 35 years, again at 38 years, and then at 40 years. Conception is possible, but maybe less predictable. Basic factors like reduced energy and sex drive occur as people get older, which do not help the situation.

TRY ACUPUNCTURE

Research has shown acupuncture:

●         Increases libido and energy

●         Regulates cycles

●         Increases blood flow to uterus

●         Improves sperm quality

●         Improves IVF success rates by up to 60%

●         Alleviates stress

– see www.thelittleclinic.co.uk

DON’T….

SMOKE OR TAKE RECREATIONAL DRUGS

I only forbid two things when trying to get pregnant, that is smoking and taking recreation drugs. Not negotiable.

BINGE DRINK

Consume in moderation (¼ bottle wine, or a beer 3-4 times per week).

WHEN SHOULD YOU START TESTING?

The older you are, the sooner you should start testing (not necessarily IVF). If you are:

●         Under 35 years old, after one year of regular, unprotected sex

●         Over 35 years, from 6 months

●         Over 38 years of age, consider testing sooner

If you suffer from other factors, such as amenorrhoea (no periods), oligomenorrhoea (abnormally light or infrequent periods), endometriosis, pelvic inflammatory disease infections, HIV+, undescended testes, diabetes and epilepsy medication, consider testing as soon as possible.

WHAT TYPE OF TEST?

●         Sperm test – 25% of infertility cases are due to sperm defects. At least two tests will be required.

●         Cycle Day 3 (CD3) – blood test for follicle stimulating hormone (FSH) and oestradiol (can indicate potential premature menopause)

●         Cycle Day 21 (CD21) – blood test to confirm ovulation occurred by measuring progesterone levels 7 days after ovulation.

●         AMH – anti-Mullerian hormone blood test. Establishes ovarian reserve (remaining eggs).

●         Thyroid Stimulating Hormone (TSH) and Luteinising Hormone (LH) levels – blood test.

●         Genito-urinary medicine– go to an NHS GUM clinic (www.nhs.uk ). Chlamydia can be symptomless and cause infertility. HIV, Hep B & C tests are required before IVF cycles.

●         Hysterosalpingogram (HSG) – Check uterus and fallopian tubes not blocked.

WHERE TO GO?

●         Easiest is your GP for blood & semen analysis and hysterosalpingogram (HSG) referral.

●         Go to a GUM clinic for chlamydia, and other sexually transmitted infections (STI).

●         Go private if you feel that your GP is not proactive, or you are aware of any existing menstrual, sperm or medical conditions.

Contact Lynda to discuss your options, at the www.chelseanaturalhealth.co.uk on 020 7352 3087 or use the form above to email Lynda directly. See also www.thelittleclinic.co.uk

Mother’s Shoulder

by Philip Waldman, Registered Osteopath of Chelsea Natural Health, London, SW10

I have a special interest in antenatal and post natal osteopathic care and have been working in this field for nearly 20 years.   During that time I have been a lot of new mothers and more often than not, at some point during the first year of their child’s life, treated them for what I know as Mother’s shoulder.   I have also seen fathers with the same complaint , so maybe it should be called parent’s shoulder?

Typically they complain of pain under the shoulder blade and in the base of the neck, sometimes with pain further up the neck and / or into the upper arm.   If it is very bad they can get pins and needles and   / or numbness into the arm as far as the fingers, or if it is the neck, they can get bad headaches.   It is usually on the side opposite their dominant hand and come on gradually and continues to worsen.   It usually takes the form of a dull ache under the shoulder blade, like a tooth ache, and nothing really seems to shift it.     Massage can help for a while but the pain returns.   Often I hear of people pushing their mid-backs up against door frames to try and self-massage the knot of muscle that builds up by their shoulder blade.

After ruling out anything more serious, very often what is left is a musculo-skeletal strain pattern that I know as Mother’s Shoulder.   This involve a jamming of the joints between the ribs and the spine and the resulting muscle spasm that builds causes all the symptoms.   To cut the story short, basically what happens in that the ribs jam up due to the mechanical strain on them but the body still wants them to move (hey, we still have to breath).   Two different muscle groups battle it out, one saying to the ribs “Move”, the other saying “Stay still”.   They tussle and wrestle with each other and then get their mates involved, and before you know it the whole shoulder and neck musculature is involved.   This can be very painful and cause nerves to get squeezed (thus the pins and needles / numbness that can occur).   I have found that until the mechanics of the ribs are corrected the pattern will continue, and this is where I as an osteopath can help.   Patients have often reported great improvements soon after treatment.

Why? What?

The reason this all comes about in the 1st place is due to the combination of several mechanical factors at a time when the mother is undergoing great change.   In the post natal period the mothers body is having to adapt to not being pregnant any more.   All those postural changes during pregnancy have to be “undone” and the body has to re-organise, and all of this whilst raising a child.   This is a very physical task and mothers tend to carry their child over the shoulder of their less dominant hand so that their dominant hand is free (to write, use keys etc etc).   Another, and I think the most important factor is what mothers do when they feed their child, and what happens is very similar for both breast and bottle fed babies.   Mum sits down to feed, gets herself and her baby nicely positioned using pillows and alike and starts to feed.   All is well but then mum, as we all would do, looks down lovingly at the bundle of joy in her arms.   She spend the whole feed doing this but in doing so she places a postural and mechanical strain into her neck and shoulder (if the baby is feeding from say they left breast then looking down at it places a strain through the muscles on the back right of the neck into the right shoulder blade and mid-back – try mimicking this posture and see if you can feel what I am talking about).   It is this, along with the increased lifting and carrying that the mother does that kicks off this pattern. Bear in mind that all of this is happening at a time when the mothers ligaments are still soft as a result of the hormones in her body from when she was pregnant.   This is especially the case for breast-feeding mothers as the ligaments stay softer for longer in breast-feeding mothers.     If the ligaments are softer then the muscles have to work harder to support the joints, and this can exacerbate problems like this.

So what can be done about this?

Don’t get me wrong, I am not saying don’t look at your beautiful child, I am saying be aware of your posture when you do this and do some gentle shoulder rolls and stretches to keep your shoulders.   Flexibility is important, keeping the mid-back and shoulders mobile with greatly reduce the likelihood of this complaint.   Find a mother and baby yoga class to go to as here you will learn fun and safe techniques that will keep you moving, and be great for you baby as well.   If you start to suffer then some osteopathic treatment may well help.   If you would like to see an Osteopath then please consult http://www.findanosteopath.co.uk/ to find your local Registered Osteopath.   In treating complaints like this it is often a case of helping manage the situation.   Parents can’t stop being parents, so it is a case of offering treatment for the mechanical factors whilst advising on “lifestyle” changes that reduce the chance of it happening again.

If you have any questions about this, please do feel free to contact me using the form below.   However, please note that this article describes a pattern I often see, but that this may not be what you a suffering from if you have these or similar symptoms.   Please seek an appropriate medical opinion rather than consider this article definitive advice as there are other reasons why you could be suffering these symptoms and these will need to be ruled out.