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