MORE FERTILITY ISSUES

Irregular periods: does this mean I am less fertile?
by Toni Wechsler


My periods are very irregular. Usually, they come every 45 to 60 days, but sometimes I only have one period every few months. Can irregular periods mean I am less fertile? If so, why?



Yes and no. Irregularity, per se, is not necessarily a problem if you learn how to chart your fertility signs (especially cervical fluid) to determine when you are approaching your small window of fertility. But, if cycles are as long as yours, it means by definition that you are not ovulating as often as the somewhat typical monthly cycle.
There are numerous factors that determine how fertile a woman is, such as her age, whether and how often she ovulates, whether her cervical fluid is wet enough to sustain sperm, and whether her fallopian tubes are open. But the most important of all is the release of the egg itself. If you don’t release an egg that often, you don’t have as many opportunities to get pregnant.

Women with irregular periods are often prescribed fertility drugs like Clomid to increase the number of times they ovulate. But if you would rather try a more natural approach, you might want to see a naturopath first to see if they can prescribe a less invasive option for you.

Ultimately, what may determine your decision regarding whether or not you want to be aggressive in your approach is your age. The younger you are, of course, the more time you have to alter your cycles naturally.

Is fertility all in the mind?
by Ronita Dutta



Niravi B Payne, controversial author of The Fertility Solution, talks to Ronita Dutta about her holistic approach to fertility
Niravi B Payne, whose supporters include ER's Alex Kingston and country singer Kenny Loggins', believes a woman's fertility is often affected by stress and emotional upsets dating as far back as her childhood.

With over 17 years of experience in the field of mind-body medicine, she speaks passionately about her subject. According to Payne, her book - which encourages women to look deeper into the psychological reasons behind their inability to conceive - 'is not just challenging the medical system's view of fertility. Its basic intent is to heal the unnatural split between mind and body and to offer a very comprehensive, solid, well tried, documented and highly successful programme. It invites the reader to look at herself as an individual, not as an age group or by the quality of her eggs'. Payne's programme encourages women to delve deeper into their psyche and to question the medical system's diagnoses of 'unexplained infertility'.

From the waist up
Payne is worried that the medical profession is only interested in women and fertility 'from the waist down, as though everything above the waist has no bearing.' Her method known as The Whole Person Fertility Program, on the other hand, is concerned with looking at a patient's emotional history alongside their medical history. 'The book is telling women that they're unique, they're not just an age or a numerical fact. They are individual and here's an incredible programme to help them.'

On their first visit clients are given a 'health attitudinal and lifestyle profile questionnaire.' It includes questions about every aspect of their life, from their medical history through to questions about whether they do any sort of relaxation or physical exercise, whether they have plants or animals at home, what their sexual life is like, what they consider to be the most tension provoking trauma in their life, whether they've ever had an abortion, and so on.

CONT'D

Once the questionnaire is completed Payne and the client go through it together. 'Everything that is done is not just me looking at [the individual] saying 'Well, I think this'. It all comes out of their own voice. They write their own story and going over their responses helps them realise things. As I get the profile we review it together; she has a copy, I have a copy, we look at it together and then we map out a chart of her siblings, her parents and their siblings and begin to see the connections.' Often, once the process is underway, the woman conceives.
Changing roles
In Payne's experience, certain issues crop up again and again which are crucial in determining the reason for the lower fertility rates among women today compared with that of their mother's generation. She cites the shift of women's role within society as a major reason for this change. Many of the women who come to see her have had at least one abortion at around the same age that their mothers gave birth to them. Their reasons for termination were because they didn't want to replicate the lives of their mothers. 'Getting pregnant in their early 20s would mean a loss of autonomy, a loss of economic independence and consequently a loss of freedom. This is the dichotomy that many women are faced with when they now decide they do want a child. All of these have physiological consequences. They're not simply things happening in a bell jar. They're happening in the body and those issues produce disruption of all the hormonal balances.'

Payne has this to say to critics and cynics who accuse her of giving women false hopes: 'I'm not offering guaranteed pregnancy, all I'm offering is a right to investigate and I'm giving women the tools to investigate. I've put my heart my soul and my vast experience into this book. The evidence is not purely anecdotal. Don't accept the medical profession's final word. Here's the book, here's the documentation. Try it!'

Birth control: can it affect future fertility?
by Toni Wechsler


I have heard that different methods of birth control can affect your ability to conceive. Can you elaborate?



The two forms of birth control that can pose the most problems for future fertility are the IUD and all forms of hormonal birth control. In the case of the IUD, the insertion of the device itself, as well as subsequent exposure to sexually transmitted diseases, put women at greater risk of developing pelvic inflammatory disease (PID). During insertion, bacteria can enter the sterile environment of the uterus and cause a serious infection. The notorious discontinued Dalkon Shield had a twisted string that acted as a type of wick drawing bacteria from the non-sterile ****** to the sterile uterus. This often resulted in PID, wreaking havoc on the woman's fallopian tubes.
In the case of the Pill, many women find that it takes a long time to resume a regular cycle after having been on hormones. Once women start their cycle again they tend to revert back to their former pattern. So, for example, if you had an irregular cycle before going on the Pill, your cycle would probably revert back to that irregular pattern.

A more insidious problem with the Pill is the undetectable effect it has on the cervical crypts within the cervix. These channels produce the healthy, slippery cervical fluid necessary for conception to occur. The Pill often destroys the cells that line the channels, preventing a woman from producing the wet cervical fluid which allows the sperm to swim through the cervix around ovulation. Often a woman's body will be able to regenerate the destroyed cells, but if not, she may need to resort to intrauterine insemination (IUI) in order to bypass the ‘biological gate’ which is preventing the sperm from reaching their prized destination of the egg.

Conception – fed up trying with no result
by Dr Howard Lee


My husband and I are trying for another baby. We have a four-year-old child already but I am getting fed up trying for another. We seem to be doing everything right but nothing is happening. I don’t know what to do and it’s really getting me down. Could you give me any advice on this?
Clare



Dear Clare,
I do understand your anxiety and concern. Remember that fertility problems are very common – affecting 15% of all couples. For about 50% of couples a pregnancy will be achieved in the first two to three months – for 10% it will take a year or more. It’s encouraging to learn that you have had one baby four years ago. I presume that you have no internal abdominal inflammations which could have affected your reproductive organs, and that your periods are still regular, etc. Smoking and alcohol intake also need to be taken into consideration as they do affect fertility. Even your own cycle, after the pill, may not have settled into regular ovulation.
Look at our articles about your fertile time and also secondary infertility.

Even the act of ‘trying too hard’ has been shown to affect a couple’s ability to conceive. It’s not uncommon for couples to give up trying and book an expensive holiday to cheer themselves up – and discover that it happened when they relaxed.
Obviously, if you have serious worries about your past medical history as a couple, you need to consult your doctor

Excess discharge: normal while trying or is it an infection?
by Peg Plumbo


I have more ******l discharge than normal; sometimes so much I am afraid that I have some type of infection. I have no other symptoms. I have mentioned this to my GP, who says there is nothing wrong. I'm trying to conceive and I'm afraid that an untreated infection could affect my ability to have a baby.



While it’s true that some women have more than ‘normal’ amount of ******l discharge, this is hard to quantify. The associated symptoms that may point to infections are: odour, itching and irritation or pain with intercourse.
A yeast infection will usually have a characteristic white, cheesy discharge (although it can be profusely watery at times), and there is almost always itching associated with this.

Bacterial vaginosis, trichomoniasis, chlamydia and gonorrhoea have been shown to have an adverse impact on pregnancy or a baby as they may cause premature rupture of membranes and/or pre-term labour. Gonorrhoea, HPV (human papilloma virus or venereal warts) and herpes can be transmitted to the baby with major complications possible.

Ideally, women should have a clear, stringy (egg white-like) lubricative mucus sometime at mid-cycle, which indicates fertility and ovulation. At other times of the month, the discharge may be milky white but should not ‘run’ out.

Every woman contemplating a pregnancy should be examined and checked for all STDs and vaginitis as well as rubella. They should also start taking folic acid and read information on nutrition, the dangers of smoking and drug use and discuss early pregnancy and relationship issues.

In your case, this could be very normal, but if you are still worried ask your GP if you can have a test to rule out infection, which could interfere with fertility or with the pregnancy.

It’s great that you’re thinking ahead. Good luck.

Body fat level and conception
by Peg Plumbo


I am a healthy 31-year-old and my husband and I would like to start a family this year. I do a lot of exercise and eat a balanced diet. My concern is with my weight and body fat level. I am 5'7 inches tall and weigh 8.5 stone. My body fat is about 17 percent. I have heard that body fat should be 18 percent or higher to get pregnant. Is this true?



Body weight, specifically body fat, plays an essential role in the reproductive life of women. And, once you’re pregnant, the existing amount of body fat at conception, and weight gain during pregnancy, appear to influence the pregnancy outcome.
Some women with minimal body fat have no menstrual periods or very irregular ones. About 6% of cases of primary infertility in which there is a problem with ovulation result from being excessively underweight. More than 70% of these women conceive spontaneously if their weight disorder is corrected through weight gain. If a woman weighs less than 95 percent of the predicted ideal body weight for her height, she should receive counselling about increasing her weight to an ideal level.

Body fat affects the release of the hormones that stimulate the ovary to produce an egg and regulate the menstrual cycle. When body weight is within 5% of ideal body weight, these hormones generally return to normal and the ovulatory cycle resumes.

If your cycles are regular and you are ovulating, you should have no difficulty conceiving and carrying a pregnancy to term at your weight. You are at the lower, but still normal, range for your height and not at the ‘less than 95%’ category.

In my experience, it is the women who lose weight (up to one-third of their total weight) or begin strenuous athletic training who have problems with infertility – primarily because it causes them to cease ovulating.

I would recommend that you go ahead and try to conceive. After one year, if you have not conceived, discuss this with your GP