 Fertility Facts Fertility Difficulties are complex and are important to sleuth out with the help of specialists (OBGYNs, both general and specialized), Urogynecologists (particularly for those with persistent pelvic pain), Other specialists (eg. if you have UC or CD, your Gastroenterologist or if you have RA or Lupus, your Rheumatologist) and your GP/NP. Fertility challenges are 40% due to the female partner + 40% due to the male partner + 20% of unknown/interactive (i.e. woman's allergic response to the man's sperm) issues. 1 in 6 couples in the UK sought fertility help in 2019. Over 80% of UK couples will conceive within 1 year of trying and a further 50% of the remaining will conceive within the second year. When we struggle with fertility, it's an often overlooked, challenging, difficult journey (ref: youtube channel of Lauren Mancell (https://celebratemuliebrity.com/2018/09/trauma-awareness-in-womens-health/). 30% of all pregnancies end up in miscarriage. A Woman's "Normal" Cycle
- luteal stage = holding, implanting, high progesterone (maintaining implantation) Know When You Ovulate and Track it Yourself Duration of cycle Ovulation day 22 day cycle day 6 - 10 24 day cycle day 8 - 12 26 day cycle day 10 - 14 28 day cycle day 12 - 16 36 day cycle day 20 - 24 32 day cycle day 26 - 30 Ovulation Information Mittelschmertz - a stabby kind of pain on one side of your lower pelvis when the egg is released. Your mucous is like egg white (stretchy, springy) and is more receptive to sperm, drying out a little after ovulation passes; the neck of your cervix is more open and welcoming. Your basal body temperature (taken first thing in the morning, prior to arising/warm drink) dips slightly at ovulation and rises slightly in the luteal stage. Keep a pen, paper (or phone tracker) and thermometer right beside your bed. Test and record your temperature daily and learn about how your body navigates the monthly-ish cycle. This is to create self-knowledge and to provide helpful information, not for complete focus. It's a "know thyself" moment. A BMI of >19 and <30 is the "golden window" for conception. Habits that help: no alcohol, no smoking, active lifestyle, manage diseases (Hep B/C/HIV), avoid occupational (chemical) exposures, wear loose-ish undies (especially the men), manage/address Endometriosis/PCOS/PID before/during fertility times, wait 3 - 13 mos. after coming off OCPs (the pill) while your body re-establishes its own natural hormonal cycles, avoid use of Ibuprofen (Advil, Motrin). Specific Dietary Recommendations: Mediterranean Diet, plant focused (at least 5 plants/day with a variety of up to 30 different plants per week), nutrient dense, organic/healthy protein sources that aren't processed, add Omega 3's that are algae based, look at your micronutrients (Folic Acid, B12, Zinc, Iodine, Vit D, Selenium, Iron with Vitamin C and without caffiene), Dairy should be high fat, Eliminate transfats, meat < 3x/week with fish > 1x/week, pass on alcohol + caffiene for both women and men, All the Dietary Recommendations equally affect both partners! Sleeping well/restoratively/consistently + Stress management/reduction are hugely important in themselves and need their own special focus! Daily exercise - some cardio, some strength, some flexibility, some restorative….."moderate physical activity" boosts conception success (including IVF) so think Goldilocks (not too little, not too much, just right). Get your hormonal profile checked if you're over 35 or not successfully pregnant within 1 year of trying and/or if you've had miscarriages (2+) to track/check your ovulation and/or have had 3 miscarriages. Egg Meets Sperm Facts Your egg is ready/fertile at 24 - 28 hours after you ovulate. Your sperm can be lively/ready to fertilize an egg for 5 days after being released in a hospitable environment. Find a Pelvic Physio trained in Fertility Support Manual Physiotherapy doubles IVF success rate (specifically myofascial + lymphatic + visceral) by improving the mobility/health of the implantation neighbourhood. Ongoing studies suggest the same result of these therapies for natural pregnancies. Addressing depression + anxiety is helpful. Studies recommend calming yoga (gentle hatha, restorative and/or yin) + Cognitive Behaviour Therapy + mindfulness practices + lifestyle changes to improve sense of self-efficacy and confidence. Consistency is the key, trying one new practice at a time for 4 - 6 weeks, 4 - 7 days/week before adding a second change. Remember small, consistent baby steps (1% change per week) is the best and most helpful, long-term approach. Weight management is vital for both partners so that BMI is stable between 19 and 30. Managing and stabilizing all chronic diseases including coeliac, endometriosis, adenomyosis and PCOS particularly. Cease smoking asap for both partners (refer to Alan Carr's "Easy Way to Stop Smoking" book). Addressing sleep disorders is vitally important as sleep is restorative and a key health factor. This means consistency with bed times, awakening times, cool room, warm feet, darkened windows, quiet or white noise, no blue light 1 - 2 hours prior to bedtime, no cell phone/ipad/laptop in the bedroom, warm bath/shower prior to bed, no snacks after 7 pm….make restorative sleep a priority. Identify and address all physical + emotional + relational stressors in your life. Craft a life that is calm, enjoyable, consistent and with comfort, predictability and joy. If you've had a miscarriage (or 2,3), you may feel loss and grief. It may help to speak with someone with whom you can be vulnerable and open. If you're able to be open and find support, it may help lift the veil of grief for you. IVF adds a whole new adventure/challenge. You may experience heightened anxiety when patience and care, sensitivity and support are what you need. Practicing daily/consistent mindfulness, breathing practices, progressive muscle relaxation and pelvic relaxation/release may be helpful. You may find that psychotherapy (particularly CBT) is an additional self care strategy. Biofeedback (self-taught or mindful training) to reduce stress hormones + improve sleep are recommended. Big self care, self compassion and calm are the bywords to repeat. Your individualized plan:
Property of Joanne Gailius, Full Circle Physiotherapy, Not to be copied without permission.
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