TTC Archives - Baby Chick

Fertility Treatments: Options and What Is Involved

Rande Ludwig — Mon, 16 Oct 2023 10:00:47 +0000

Having children is a desire for many adults, but infertility struggles dampen that dream for some people. For couples experiencing infertility, the complex world of fertility treatments can be a daunting journey to face.

Infertility is the inability to become pregnant after 12 or more months of regular unprotected sexual intercourse.¹ Around 17.5% of the worldwide adult population will experience infertility. For women aged 30-39, the likelihood of experiencing infertility is around 1 in 5, and for women younger than 30 years old, the rate is closer to 1 in 8.²

This article will help give you a better understanding of the potential causes of infertility and the fertility treatments most commonly used to help you conceive.

While there can be various reasons a woman has trouble conceiving, the most common causes of female infertility are:^1,2,3

Endometriosis
Structural problems of the reproductive tract, fibroids, or polyps
Autoimmune or kidney disease
Pelvic inflammatory disease
Polycystic ovary syndrome or PCOS
Poor egg quality and follicular disorders
Infrequent or absent menstrual cycles

PCOS is a condition that causes a woman to ovulate irregularly or not at all. It causes elevated testosterone levels in a woman’s body, which causes acne, excessive hair growth, and infertility.^2,8

While some causes of infertility are due to factors out of a woman’s control, some risk factors predispose a woman to infertility. These factors include:²

Advanced age
Smoking and tobacco use
Excessive alcohol intake
Being overweight, obese, or underweight
Extreme weight gain or weight loss
Excessive physical or emotional stress causes a loss of periods

The first step your doctor will take to determine the possible cause of your infertility is to obtain a complete medical and sexual history.² This will give them a better picture of your overall health and help them identify any risk factors that may predispose you to infertility.

Once your doctor has your history, they will examine you for any structural or hormonal explanations for your infertility before recommending fertility treatments. This typically involves a pelvic exam, ultrasound, and blood work to determine your hormone levels.³ It may also involve a fallopian tube exam with an X-ray and an exam of your uterus using a flexible camera inserted into your uterus through your vagina, known as a hysterosalpingogram (HSG).³ Your doctor can guide you to the correct fertility testing based on your health history.

There has been a long-standing belief that only women experience infertility, but men also experience infertility struggles. Causes of male infertility include the following:³

Problems with the shape, movement, or amount of sperm
Enlarged veins in the scrotum
Genetic disorders
Low testosterone levels
Use of anabolic steroids
Undescended testicles
History of chemotherapy
Surgical procedures to the testicles, such as a vasectomy

While most of these causes of infertility are out of a man’s control, common risk factors can predispose a male to infertility.² They include:

Advanced age
Being overweight or obese
Excessive alcohol or drug use
Exposure to excessive testosterone and radiation levels
Exposure to high temperatures, such as hot tubs
Exposure to environmental toxins such as pesticides, lead, or mercury

The first step to determine the possible cause of infertility is the same for both men and women. Your doctor will complete a medical and sexual history to understand your overall health better and determine any of your risk factors for infertility.² Your doctor may perform a scrotal exam and ultrasound to check for structural concerns. They may also run blood tests to check for hormonal imbalances. The final test is a semen analysis to look at the shape, size, number, and movement of your sperm.³ These tests will help your doctor form a picture of your infertility and point you and your partner to the correct fertility treatment options.

Regardless of the fertility treatments you and your partner may pursue, medications will likely be a part of your journey. You may be prescribed Clomid or Letrozole for fertility medications, or you may be prescribed something else. The most common medications are:²

Letrozole: This is used to help temporarily lower a woman’s progesterone levels, which tells the body to produce more follicles or mature eggs. It can also be used to cause ovulation in a woman with PCOS.
Clomid: This is used to cause ovulation in women with PCOS or those with problems with ovulation and to help women with normal ovulation produce more mature eggs.²
Hormones: Various hormones can help a woman develop more mature eggs with each cycle or help the uterus prepare for an embryo transfer.
Metformin: This is used to treat women with insulin resistance, diabetes, or PCOS. This medication helps lower the high levels of testosterone in women with PCOS. It is a common PCOS fertility treatment that can help the body ovulate.

via americanpregnancy.org

IUI, or intrauterine insemination, is a fertility treatment procedure in which sperm is directly inserted into a woman’s uterus through her vagina.² IUI is typically used as the first line of treatment for women experiencing unexplained infertility or whose male partner can produce sperm.² The success rate with IUI is similar to that of normal conception, or around 20%.⁴

Some insurance companies will cover some or all of the IUI costs, so check your fertility benefits with your carrier. If your insurance plan does not cover IUI, you can expect to pay $300-$4,000 per round of IUI, depending on the medications and testing needed.⁴

A licensed reproductive specialist at a medical center typically performs an IUI. While there are products on the market to complete artificial insemination at home, that option may not be the best or safest option. Before attempting the procedure, please speak with your doctor about the risks and benefits of at-home artificial insemination.⁴

IVF, or in vitro fertilization, is a fertility treatment procedure where the egg and sperm combine outside of the woman’s body to create an embryo through a process called egg retrieval. A woman will take different IVF injections of medicine that will help her produce mature eggs. The eggs are then retrieved from the woman’s ovaries, and fertilization with the man’s sperm is done in a laboratory setting. After three to five days, the fertilized embryo is put into the woman’s uterus. During IVF, you can freeze multiple embryos to use at a later date.²

IVF is typically used for women with fallopian tube damage or blockage, endometriosis, uterine fibroids, and ovulation disorders. IVF is also used for men who have impaired sperm function or production or for couples with unexplained infertility who do not qualify for IUI.⁵

The success rate with IVF is hard to pinpoint as it depends on many factors. These factors include:⁶

Age of the parents
Quality of the embryo
Parents medical history
Cause of infertility
Lifestyle risk factors such as smoking and drug and alcohol use

The cost of IVF can vary depending on the medications and procedures. However, some insurance carriers will cover some or all the costs, so check with your insurance carrier before starting treatment.

While most causes of infertility are due to structural abnormalities of the reproductive tract, poor sperm quality, or hormonal imbalances, there are some lifestyle changes that you can make to help increase your chances of conceiving. These changes include:⁷

Avoiding drug and tobacco use
Avoiding high temperatures for men, such as hot tubs
Exercising regularly
Limiting caffeine for women
Maintaining a healthy weight

The world of fertility treatments is large and often scary and confusing. It is important to remember that while there are many fertility treatment options, your doctor can explain the best options for treatment and help guide you through the process. Don’t be afraid to ask questions. You must feel comfortable with whatever options you and your partner pursue.

‘Geriatric Pregnancy’ Stigma: How Does It Affect Women?

Kate Sheppard — Tue, 26 Sep 2023 10:30:40 +0000

Over the past few decades, the age when women have their first child has steadily increased. In 2022, the average age hit 30 for the first time in recorded history, signaling a new era of family planning that waits for financial stability and personal maturity.¹Worldwide, the trend has been for women to delay pregnancy well into their 30s and even into their 40s.¹⁵ Some of the reasons for delaying pregnancy include; higher rates of divorce, living together before marriage, or having a second or later marriage, limited job-related policies around childcare or leave for parents, financial security and the need for two incomes, educational and career opportunities as well as improved reproductive technologies.¹⁶

Despite the rising numbers, there’s still a stigma about having children when you’re older, and the “geriatric pregnancy” negativity still exists throughout society. So, how does this affect our 30-plus new mums, and how can we beat the geriatric pregnancy stigma?

What is the ‘Geriatric Pregnancy’ Stigma?

The term “geriatric pregnancy” was once used to describe pregnancy in women older than 35 – and sometimes as young as 30. As a medical term, however, it carries many negative connotations, and many moms object to being classified as geriatric in their 30s. Now, most medical professionals use words like “advanced maternal age,” which may feel slightly less offensive to some.²

But even with the geriatric labeling a thing of the past, the stigma still exists. Women beyond their 30s having children often face negative behavior and comments, while society, in general, is still being taught that to have a child over the age of 35 is somehow wrong when it isn’t. In fact, a term was coined “Healthcare Stereotype Threat” (HCST) which explores the stereotyping and stigma older pregnant mothers face when seeking health care and medical support during pregnancy. This stigma, in some cases, may negatively influence the quality of care received by these mothers.¹⁸

Some Issues Do Increase with Age

The number of pregnancy-related issues does indeed increase with age, including:^3,17

Congenital disorders and chromosomal conditions such as Down syndrome
Miscarriage and stillbirths
Ectopic pregnancies
Placenta previa and abruption
Preeclampsia
Gestational diabetes

It can be harder to become pregnant when you’re out of your 30s and moving closer toward menopause. Research by the American College of Obstetrics and Gynecology shows that 1 in 4 healthy women in their 20s or 30s can get pregnant in any menstrual cycle, and by the age of 40, that number drops to 1 in 10 women.^4,5

However, the number of children born to women older than 35 without a problem is a testament to the fact it shouldn’t be an issue. Fertility rates in the U.S. between 1990 and 2019 for women ages 20-24 declined by 43%, while those of women ages 35-39 increased by 67% during the roughly 30-year period.⁶

Any significant problems are monitored closely, too, and modern medicine provides older moms with a wealth of tests, medical help, and post-pregnancy treatment options. Though the risks are higher, they’re still likely to be lower than stigma or misperception tells us.

The Effects of Geriatric Pregnancy Stigma

For men and women, negative connotations related to pregnancies in women over 35 can have plenty of knock-on effects when it comes to mental health. We’ve put together some of its impact to understand why it’s time to knock this stigma on its head.

Increases Anxiety in 35-Plus Pregnancies

The misguided idea that pregnancies in older women are full of risk for both the mom and the baby can drastically increase anxiety during pregnancy.⁷ Fear-mongering online, with endless articles that greatly exaggerate the safety concerns of a 35-plus pregnancy, can cause severe, chronic anxiety about something going wrong. While it’s true that high-risk pregnancies can result in fear, frustration, grief, anger, sadness, guilt, and even mental health disorders, geriatric pregnancies after 35 years of age are not always, or automatically high risk.⁵ However, the perception of them being high risk may also result in similar feelings to those who actually have high-risk pregnancies.

For some women, this perception of risk may even make them too nervous to have a child once they’re past a certain age, which is devastating when the risks are quite low.⁸

It’s important to note that increased anxiety is linked to higher levels of stress and the hormone cortisol, which can have negative impacts during pregnancy.⁹

Puts Pressure on Younger Women

Older pregnancy stigmas can put pressure on women in their 20s to have children. Calling 35-plus (and sometimes even 30-plus) pregnancies “geriatric” creates the idea that anyone who isn’t in their 20s is too old to be pregnant.

We’re all aware of the negative attention older pregnancies can attract, making it look unappealing. Unfortunately, pressure can result in women having children before they’re ready because they fear running out of time. This can lead to numerous mental health impacts, including the stress of not being psychologically ready.¹⁰

Feeling Pressure From Others

Geriatric pregnancy stigma is widespread. If you’ve ever had someone say to you, “You’ll need to start thinking about babies — the clock is ticking,” then you’ve experienced stigma.

External pressure can be just as harmful as internal pressure. Particularly in women already experiencing stress and mental health effects because of their own ideas, having outsiders comment on your “body clock” can be exhausting and lead to anxiety. Pressure from others may encourage a woman to have a child too soon, which comes with plenty of mental health concerns.

How Can We Break the Stigma?

The best way to fight back against the 35-plus geriatric pregnancy stigma is with facts. To ease your anxieties or use when anybody else brings up negative thoughts about older pregnancies, having an arsenal of readily available scientific-backed information is a great way to combat stigma in society.

It’s essential to acknowledge that getting older can increase pregnancy risks, but the chances of anything going severely wrong are still low. For example, a woman older than 40 has only a 2 in 1,000 chance of experiencing a stillbirth at 39-40 weeks, similar to women in their mid-20s at 41 weeks.¹¹

There is a slightly higher risk (1 in 100) for miscarriage and babies born with Down syndrome in older parents who conceive at age 40 (and this is something to be aware of if you’re over 40, in particular). Still, with modern medicine, these risks can be watched and monitored.¹²

You’ll find that the more problems you uncover, the more solutions you find. For example, you can prevent gestational diabetes with diet and have regular blood pressure checks to prevent preeclampsia.^13,14

If you’re anxious about waiting to have a child after your 20s, speak to your doctor. Remember, it’s your pregnancy and nobody else’s. As long as your doctor knows you’re healthy enough, nobody else gets to say when you have a child.

What Is a Blighted Ovum?

Kirsten White — Tue, 13 Jun 2023 10:00:26 +0000

A pregnancy loss at any point can be heartbreaking. In particular, the first trimester’s newness, excitement, and hope can be shattered instantly due to miscarriage. Maybe you walked into your first ultrasound eager to see your baby and hear its heartbeat, only to instead hear the devastating news that there is no baby. Or maybe you have experienced unexpected bleeding only to be later told you have had a blighted ovum.

While you may not be able to prevent or rescue a blighted ovum from happening to you, understanding more about what happened may help to process your grief and move forward.

A blighted ovum is a type of first-trimester miscarriage. It can also be called an “anembryonic pregnancy” because it refers to a fertilized egg that implants but never progresses to an embryo.¹

Because the fertilized egg has implanted into the uterus, the placenta begins to form, and pregnancy hormones still secrete. This may cause you to experience early pregnancy symptoms. A gestational sac forms and sometimes even a yolk sac, but the embryo ceases to develop.^1,2

It can be difficult to identify the cause of a blighted ovum because it happens so early in pregnancy. A woman may not even have received an ultrasound yet before she experiences symptoms of miscarriage. Otherwise, a blighted ovum may be found unexpectedly at a first-trimester dating ultrasound.¹

Even if you have an early pregnancy ultrasound, the products of conception may be tiny, making it difficult to obtain and test genetic material. However, experts believe chromosomal or genetic abnormalities most often cause blighted ova. These chromosomal abnormalities, such as trisomy of a particular chromosome, can cause structural issues with the embryo that prevent it from implanting or developing.¹

Structural issues within the uterus, including adhesions or an unusually shaped uterus that a woman is born with, can also affect long-term implantation and contribute to miscarriage. These uterine structural issues may be genetic or can result from scar tissue from prior uterine surgeries or infections.¹

Immune disorders in the mother can also cause her body to reject the newly implanted egg and cause it to cease growing.¹

Finally, hormonal disorders such as low progesterone or thyroid dysfunction may contribute to early pregnancy loss and blighted ovum.¹

A blighted ovum can happen to anyone, but certain risk factors make women more susceptible to them.

Women with obesity are more likely to experience miscarriage. Although most miscarriages are thought to be related to chromosomal abnormalities, obese women are more likely than women with a lower body mass index to miscarry a genetically normal embryo.³

As women age, the number of eggs remaining decreases because she is born with all the eggs she will ever have and loses some of them every month beginning at puberty. In addition to having fewer eggs, the quality of the eggs and the genetic material decreases — the remaining eggs are more likely to be chromosomally abnormal. If fertilized, these chromosomally abnormal eggs may cause structural abnormalities that prevent an embryo from implantation and development, causing a blighted ovum.⁴

Your medical provider can diagnose a blighted ovum via ultrasound. Once the gestational sac reaches a certain size, but you cannot visualize an embryo within, practitioners can feel confident the embryo will not develop from there.¹

If there is uncertainty about whether an embryo is present, your medical provider can perform a repeat ultrasound 11 to 14 days after the first. If there has been no growth of an embryo, your provider can diagnose a blighted ovum at that point.¹

A provider may suspect or diagnose a blighted ovum because of a pregnant woman’s presenting symptoms. These symptoms may include abdominal cramping and vaginal bleeding, but there also may be no symptoms. This means a blighted ovum is often not discovered until an ultrasound is performed.¹

First-trimester miscarriage happens in about 15 percent of clinically recognized pregnancies, and blighted ova cause about half of those miscarriages. Therefore, 7 to 8 percent of pregnancies may have a blighted ovum.¹

Once a provider diagnoses a blighted ovum, three primary treatment options exist.

Expectant management means watching and waiting to see if the body passes the pregnancy tissue spontaneously. You may be monitored with hCG blood draws or ultrasounds to ensure you pass all the pregnancy tissue and your pregnancy hormone levels return to baseline, but expectant management means no interventions.¹

If a miscarriage does not occur on its own, or if not all the pregnancy tissue passes, you may become at risk of infection. To help the miscarriage progress, interventions such as medication or surgery may become necessary.

Medical management means using a medication called misoprostol to induce the passing of the products of conception. Your doctor can prescribe this medication. It causes uterine cramping and vaginal bleeding as if a miscarriage were to happen independently, but you have control over where and when it occurs.¹

Surgery can remove a blighted ovum from the uterus. Typically, this is done by dilating the cervix and then using a vacuum or an instrument to empty the uterus.²

Blighted ova are usually random events due to an issue with the egg or sperm that joined at conception. They occur due to factors determined at or even before conception. Unfortunately, you cannot prevent a blighted ovum, nor can it progress to a healthy pregnancy. However, most women or couples who experience one have a successful, healthy pregnancy later.²

Regardless of whether an embryo ever fully develops, you were still pregnant. You had hopes and dreams for this pregnancy and baby. Miscarriage is no less tragic because it was early. You may have feelings of sadness, frustration, and even guilt. However, nothing you did can cause a blighted ovum, so it is not your fault. Allow yourself time to grieve and talk to your doctor if you have questions about your treatment options, what happened to you, or how to proceed.

11 Celebrity Miscarriages: Strong Women Open Up

Karen Johnson — Thu, 30 Mar 2023 10:30:07 +0000

For generations, women enduring the mental and physical pain of miscarriage suffered alone, in silence. Even though their friends, neighbors, and family members were often experiencing the same heartbreaking loss, it wasn’t discussed. And because miscarriage was kept hidden, a sense of shame surrounded it, sending the false message to mothers that somehow losing the pregnancy was their fault. Thankfully, that has changed as more women are normalizing talking about their pregnancy losses so others feel less alone, and we’re hearing more about celebrity miscarriages.

Miscarriage Rates Remain High

Despite medical advances and the development of far better prenatal care today than in the past, the chance of miscarriage remains high even today.

According to the Mayo Clinic, about 10 to 20 percent of known pregnancies end in miscarriage. However, it says the actual number is likely higher because many occur before someone might even know they’re pregnant. The March of Dimes concurs, saying research suggests more than 30 percent of pregnancies end in miscarriage, and many end before a person even knows they’re pregnant.”^1,2

That’s a lot of pregnancies and women who, rather than feeling ashamed and sitting alone in their grief, decide to be open and tell their stories. And many of those women happen to be celebrities — because, like all painful life experiences, miscarriages don’t discriminate. Pregnancy loss happens to women of all races, ethnicities, income levels, and job titles.

But reading about celebrity miscarriages of famous women we idolize — like Meghan Markle, Pink, and Beyoncé — and learning they’ve endured the same gut-wrenching grief many of us have can often help women in their healing process. And for that, we appreciate the honesty of these very strong, but also very vulnerable, celebrity women.

11 Celebrity Miscarriages

1. Chrissy Teigen

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A post shared by chrissy teigen (@chrissyteigen)

One of the most recent and heartbreaking celebrity miscarriages, we all remember the anguish on Chrissy Teigen’s and John Legend’s faces as they shared the horrific news that they’d lost baby Jack. Weeks after their loss, Teigen opened up in an emotional essay about what happened.³ She’d had a partial placenta abruption and was bleeding so severely that she’d had several blood transfusions. Doctors tried everything to save baby Jack, but at some point, she says, “My doctor told me exactly what I knew was coming — it was time to say goodbye. He just wouldn’t survive this, and if it went on any longer, I might not either.”

Tragically, at that point, Chrissy, John, and their team of doctors were forced to end the pregnancy, knowing Jack would not live and Chrissy’s life was in danger.

Despite criticisms that the couple decided to publicize such a “private” moment, they also received overwhelming love and support. “The moments of kindness have been nothing short of beautiful,” she wrote. “I went to a store where the checkout lady quietly added flowers to my cart. Sometimes people will approach me with a note. The worst part is knowing so many women won’t get these quiet moments of joy from strangers. I beg you to please share your stories and to please be kind to those pouring their hearts out. Be kind in general, as some won’t pour them out at all.”

Since Chrissy Teigen’s miscarriage, she has had another baby, a girl named Esti, who was born in January.

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2. Meghan Markle

Also among the celebrity miscarriage group, Meghan Markle shocked the world when her New York Times essay “The Losses We Share” was published in November 2020.⁵ “Losing a child means carrying an almost unbearable grief, experienced by many but talked about by few,” Markle says.

She describes the day she lost her pregnancy as “any other day” — she made breakfast, fed the dogs, and found a missing sock. She felt a sharp cramp that brought her to her knees while she held Archie, singing a lullaby to keep them both calm.

“I knew, as I clutched my firstborn child, that I was losing my second,” she adds.

Markle has also allowed the world into another struggle she had related to pregnancy — her mental health struggles. It is these life experiences — miscarriage, depression — that continue to motivate the now mother of two to tell her story and advocate for women everywhere.

Since Meghan Markle’s miscarriage, she is now the proud mom of two adorable kids — Archie and Lilibet.

3. Pink

Singer/songwriter Pink has always expressed herself through her lyrics as a songwriter, telling the world of her struggles. Whether it was her painful relationship with her father, rocky times in her marriage, or her ballad “Happy,” she sings, “Since I was 17, I’ve always hated my body / And it feels like my body’s hated me.” In a 2019 interview with USA Today, she revealed some truths behind those lyrics: The superstar celebrity had a miscarriage at 17. And she experienced several more on her journey to motherhood.⁵

“When that happens to a woman or a young girl, you feel like your body hates you and like your body is broken, and it’s not doing what it’s supposed to do,” Pink said in that 2019 interview with USA Today. “I’ve had several miscarriages since, so I think it’s important to talk about what you’re ashamed of, who you really are, and the painful (expletive). I’ve always written that way.”

Pink and her husband, Carey Hart, are now busy parents to two kids growing up fast — Willow and Jameson.

4. Beyoncé

Powerhouse couple Beyoncé and Jay-Z and their three beautiful children, Blue Ivy, Rumi, and Sir, seem to have it all. But like any other family, they have had their fair share of heartbreak. A 2013 documentary discusses Beyonce’s miscarriage, and she said the loss was “the saddest thing I’ve ever been through.”⁶

And her story is a lot like that of her fans — one day, there’s a heartbeat, and the next, there’s not.

“I was pregnant for the first time,” Beyoncé explains. “And I heard the heartbeat, which was the most beautiful music I ever heard in my life… Being pregnant was very much like falling in love. You are so open. You are so overjoyed. There’s no words that can express having a baby growing inside of you, so, of course, you want to scream it out and tell everyone.”

But sadly, she did not get to share the news with everyone as she’d hoped. “I flew back to New York to get my check-up – and no heartbeat. Literally, the week before I went to the doctor, everything was fine, but there was no heartbeat,” she said.

Her husband Jay-Z alludes to other challenges in starting a family with his lyrics to “Glory,” released right after Blue Ivy was born. “Last time the miscarriage was so tragic / We was afraid you disappeared but nah baby, you magic.” And the song also includes this line: “False alarms and false starts / All made better by the sound of your heart / All the pain of the last time / I prayed so hard it was the last time,” sharing with the world that this famous couple’s path to parenthood was not an easy one.

5. Michelle Obama

Another powerful, leading woman, Michelle Obama, opened up in her book “Becoming” about her and former President Obama’s fertility struggles and how the process often left her feeling alone and hopeless.⁷

“We were trying to get pregnant and it wasn’t going well,” the former first lady writes. “We had one pregnancy test come back positive, which caused us both to forget every worry and swoon with joy, but a couple of weeks later I had a miscarriage, which left me physically uncomfortable and cratered any optimism we felt.”

She goes on to explain that, in her mid-30s, she felt the familiar pressure of that “biological clock ticking” and turned to fertility treatments, a journey she took on mainly on her own. Giving herself hormone shots while her husband worked long hours at the state legislature meant Michelle was “largely on my own to manipulate my reproductive system into peak efficiency.”

We know that after Michelle Obama’s miscarriage, the couple eventually had two beautiful daughters, despite their challenging road to parenthood.

6. Lily Allen

Singer-songwriter Lily Allen has shared that she’ll probably never fully recover from losing her child in 2010.⁸ Her pregnancy tragically ended at six months with a stillbirth, leading to severe depression.

“It’s not something that you get over. I held my child and it was really horrific and painful—one of the hardest things that can happen to a person,” Allen said in an interview.

However, the rainbow came after the storm, and Lily and her husband, Sam Cooper, welcomed their first child after losing their son in 2010. “I just think that he’s a part of my eldest, really,” she explains. “If he hadn’t died, it wouldn’t have physically been possible for our eldest to be alive because I got pregnant with her so quickly. We’ve got a little stone in our garden with his name on it. And lots of different things that I do, rituals, I have him in my mind. My husband and I shared this horrible thing together but it kind of brought us closer.”

7. Gabrielle Union

In her book, “We’re Going to Need More Wine,” actress Gabrielle Union shares, “I’ve had eight or nine miscarriages. … For three years, my body has been a prisoner of trying to get pregnant — I’ve either been about to go into an IVF cycle, in the middle of an IVF cycle, or coming out of an IVF cycle.”⁹

Although Union did eventually become a mom to daughter Kaavia via surrogacy, her journey with miscarriage and infertility was a long one riddled with heartache. And it is because of these challenges that Union tries to dissuade people from asking about another woman’s journey to motherhood, as they may not know what she’s going through.

For many women, not just women in the spotlight, people feel entitled to know, “‘Do you want kids?'” she explains. “A lot of people, especially people that have fertility issues, just say ‘no’ because that’s a lot easier than being honest about whatever is actually going on. People mean so well, but they have no idea the harm or frustration it can cause.”¹⁰

8. Nicole Kidman

Nicole Kidman has also been open about her miscarriage, like many other celebrity miscarriages, and an ectopic pregnancy while she was married to Tom Cruise.

“I know the yearning. That yearning. It’s a huge, aching yearning. And the loss! The loss of a miscarriage is not talked about enough,” Nicole said in an interview, as reported by Women’s Health. “That’s massive grief to certain women.”¹¹

In a Marie Claire interview, she also said, “It was incredibly traumatic for me. Sometimes you share your grief.”¹²

The actress eventually became a mom, however, adopting Isabella and Connor while married to now former husband Tom Cruise and having both Sunday Rose and Faith (via surrogacy) with husband Keith Urban.

9. Halsey

Singer-songwriter Halsey shared on an episode of “The Doctors” that they found out they were pregnant on one of their tours but soon lost the pregnancy.¹³

“Before I could really figure out what that meant to me and what that meant for my future… the next thing I knew, I was on stage miscarrying in the middle of my concert,” Halsey describes.

Beyond Halsey’s miscarriage, the singer also has been open about their struggles with endometriosis and how she finally sought treatment for the disease. “The sensation of looking a couple hundred teenagers in the face while you’re bleeding through your clothes and still having to do the show, and realizing in that moment… I never want to make that choice ever again of doing what I love or not being able to because of this disease,” Halsey says. Halsey is now a doting mom, having welcomed their baby Ender with boyfriend Alev Aydin in the summer of 2021.

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10. Jana Kramer

Another celebrity miscarriage announcement that broke hearts was country singer Jana Kramer telling the world in 2017 that she had suffered a miscarriage. Sadly, it wasn’t her first. And the singer wanted to share her story rather than suffer in silence as women did for so long.¹⁴

“1-3,” Kramer writes. “Today I am 1-3. I don’t want I’m sorry or sympathy. I just don’t want to feel alone. And I know I’m not. This, unfortunately, isn’t my first loss. When I first found out I was pregnant, I wanted to shout it from the rooftop, but I know for reasons like this we have to wait. So because we don’t tell many, we have to suffer silently…and suffering silently was my thing in the past, but it’s not now.”

Two years later, she penned another poignant post on IG, this one, however, with news of a rainbow after the rain.¹⁵

“A year ago today, I got the news that I had yet again another miscarriage. It was after an IVF cycle. The embryo was a boy and it was the last embryo we had,” Kramer says.

“I was devastated. I felt like I failed as a woman, and as a wife. IVF wasn’t an option again because it’s too expensive, so I felt defeated.”

But she eventually went on to have baby Jace, to whom the post is dedicated, adding, “So I prayed. Boy did I pray for you.” And Kramer also explained why she has chosen to share her journey with the world — to make other women know they aren’t alone. “I know nothing I say will make the yearning or pain any better, but if anything, know you’re not alone and that I was in the same spot a year ago,” she says.

11. Shawn Johnson

Gymnast Shawn Johnson admits that, like many women, she blamed herself after losing her pregnancy in 2017.¹⁶

“I had struggled so long with eating disorders, I had taken excessive amounts of Adderall and I had taken weight loss pills,” Johnson explains. “I had abused my body for so long that my worst fear going through all of that back then was, ‘Am I going to do permanent damage to my body?’ And I didn’t have a period for years and I had truly done harm.”

Women’s Health also reports that despite her doctor telling her the miscarriage wasn’t her fault, Johnson said to herself, “It probably is.” And those intrusive thoughts of self-blame, that mindset, is something many women can relate to.

“If I could go back to that doctor’s office, I was trying so hard to keep it together but I was breaking inside because in my mind, just as a mom, you have all of these guilts and these fears,” she says. “I was like, ‘Is my body not made to have children? Did I abuse it so much that it can’t carry a child? Is this God’s way of telling me I’m not meant to be a mom?'”

Shawn eventually went on to have two babies, a daughter, Drew, and a son, Jett.

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Women Are No Longer Alone

These 11 celebrity miscarriages are vastly different stories — some pregnancies were unexpected, some planned. Some celebrity miscarriages came as a shock. Others came with fair warning due to health issues. But they all chose to share their stories so other women — rich and famous or not —would know they aren’t alone in their pain. Miscarriage is no longer something women must suffer in silence. Today, we tell our stories because in helping others, we help ourselves heal.

And that is the village all mothers need.

When is the Best Time to Take a Pregnancy Test?

Kirsten White — Tue, 07 Feb 2023 11:00:31 +0000

Whether you have been trying for a baby for a while or have a sneaking suspicion you might be pregnant, waiting to take a pregnancy test can be agonizing. However, pregnancy tests can be expensive, and you want to ensure accurate results. Taking a test too soon can be inconclusive, give you a false negative, or force you to continue testing for a precise result.

You want to know if you are pregnant as soon as possible, but you do not want to risk getting a false negative. You might wonder when is the best time to take a pregnancy test. Should you wait for symptoms or a particular day? Are at-home tests accurate, and how do they even work?

Home pregnancy tests detect human chorionic gonadotropin (hCG) in your urine. A fertilized egg releases hCG after it implants into the uterine lining. So, to get a positive pregnancy test, sperm not only must fertilize an egg, but the egg must also implant into the uterus.

When an embryo begins releasing hCG, it first shows up in the mother’s bloodstream and then in her urine. Home pregnancy tests detect the hCG hormone in urine. To use a pregnancy test at home, a woman may either collect her urine in a cup, dip a test strip into it, or pee directly on the test. Two lines appear if the test is positive, whereas only the control line will appear if the test is negative. Any line, no matter how faint, indicates a positive pregnancy test.

Digital home pregnancy tests use the same method and technology, but they read the lines for you and give you a definitive result of “pregnant” or “not pregnant” instead of you having to interpret the line or lines.

Remember that implantation must occur before the pregnancy hormone hCG is secreted, and hCG is what triggers a positive pregnancy test. Implantation occurs between six to eight days after ovulation and fertilization of an egg.¹

It can take three to four additional days for hCG to rise high enough and for the levels to be detectable in blood and urine. So, the earliest you can potentially get a positive pregnancy test is about nine days after ovulation.¹

Suppose fertilization or implantation occurs on the later side of these windows. In that case, it is possible to be pregnant but not get a positive pregnancy test until much closer to your missed period or 12 to 14 days after ovulation. You can take a pregnancy test earlier than that, but if you test too early, a negative pregnancy test may not be accurate.

If you were not tracking ovulation, a good rule of thumb is to take a pregnancy test once your period is late or missed. If a woman is indeed pregnant, 98 percent of pregnancy tests will be positive by the day of her missed period.¹

Taking a pregnancy test first thing in the morning with your first void of the day is best. This is when your urine is the most concentrated since you likely have not been drinking and peeing as frequently throughout the night. More concentrated urine means that hCG will be less diluted by water, and the test may pick up a positive result sooner.

You can take a pregnancy test later in the day, especially if you are closer to or past your missed period when hCG should be high enough, no matter your urine’s dilution or time of day. However, taking a pregnancy test just nine days after ovulation in the middle of the afternoon will probably not result in a positive, even if you are pregnant.

If you do not want to wait to test until the following day, make sure not to drink large amounts of liquid in the hours before testing, which can dilute your urine sample and give you a false negative.²

Many early pregnancy symptoms are caused by the hormone progesterone, which rises in the second half of your cycle after ovulation, regardless of whether you are pregnant. This explains why many women complain that their premenstrual symptoms (PMS) match their pregnancy symptoms in the early days.³

If your pregnancy hormones are high enough to cause symptoms, they should be high enough to register a positive home pregnancy test. Suppose you are experiencing pregnancy symptoms such as breast tenderness, bloating, nausea, and frequent urination, and your period is nearly due or past due. In this case, a pregnancy test would likely be accurate by this time.

Some women like to take pregnancy tests daily, starting around nine days post-ovulation. This may provide a better idea of when implantation occurred based on when you get your first positive result. In some cases, this can help with pregnancy dating and due-date calculations.

Serial pregnancy testing like this also provides some women comfort—they like to see their pregnancy test lines darken daily as their hCG rises. However, it is important to note that home pregnancy tests only measure whether hCG is present, not how much hCG is present. Although it can be reassuring to see home pregnancy test lines darken, these are unreliable measures of your hormones rising.²

For other women, taking multiple tests causes additional anxiety, and they prefer to wait until their missed period and rely on the results of just one or two tests. After all, if you are not pregnant, you will eventually get your period.

Pregnancy tests today are sensitive and accurate, so if you wait until your missed period to take a test, there is little need to take multiple tests. False positive pregnancy tests are rare, but if you receive a positive test, you should reach out to your provider, who may do another test in their office to confirm.¹

If you receive a negative test and you still do not get your period, it is a good idea to take another test a few days to a week later.²

In most cases, a blood pregnancy test is not necessary because home tests are sensitive and accurate. However, there are a few circumstances when your provider may think it is a good idea to check your blood for pregnancy hormones.

If your period is over a week late and you are getting negative home tests, it may be a good idea to follow up with a blood test. Your doctor may also want to look at other things in your blood for the causes of your delayed period.

If you are going through fertility treatments, your doctor may monitor hCG levels in your blood because many fertility medications and shots contain hCG, and they can cause a false positive home pregnancy test. However, if your hCG levels continue to rise, you are likely pregnant!

Another reason to get a blood pregnancy test is if you or your provider would like to trend your hormone values instead of saying a simple “yes” or “no” to whether you’re pregnant. Urine pregnancy tests detect whether hCG is present but not how much. If your provider suspects your hCG is not rising as it should, they may want to draw serial blood pregnancy tests to trend numerical values. Unfortunately, this may be the case with ectopic pregnancy or miscarriage.

It can take a lot of willpower to wait for a pregnancy test when you might be pregnant. If seeing an early negative is not going to break your heart, there is no harm aside from cost and disappointment in testing early. However, your results may not be accurate until 12 to 14 days after ovulation or the day of your missed period.

While home pregnancy tests are accurate when taken at the right time, reaching out to your provider is always a good idea if you are unsure whether you are pregnant. In the meantime, try to find some patience (easier said than done!), and rest assured that you will know soon enough whether you have a little one on the way!

Here’s What to Try If You Want to Get Pregnant With Twins

Kirsten White — Mon, 23 Jan 2023 11:30:47 +0000

Although twin pregnancies are higher risk than singletons, there are undeniable perks to having twins. Some moms see twins as an opportunity to get two babies from just one pregnancy, while others may crave twins for the special lifelong bond they may form from sharing the womb.

Regardless of your reasons for having twins, there is much to know about conceiving them. Of course, whether you get pregnant with twins is up to fate, but some factors might increase your odds. So how are twins conceived, how common are they, and how can you increase your chances of getting pregnant with twins both naturally and with medical treatments? Here’s what you need to know.

Types of Twins and How It Works

Essentially there are two types of twins. You have probably heard the terms “identical” and “fraternal.” Fraternal twins are also called “dizygotic” twins, which originate from two separate eggs, sperm, and embryos. This means a woman must ovulate two eggs, and they must both get fertilized in one cycle. Genetically, the two babies that result from fraternal twins can be as similar or different as any other siblings from two separate pregnancies. Fraternal twins share about half their DNA, like other sets of siblings, and they can be same-sex or opposite-sex.¹

Identical or “monozygotic” twins came from one zygote or fertilized egg. This already-fertilized egg, or embryo, divides into two babies in the early stages of cell division and development. We know much less about the mechanics of identical twins, but they have identical DNA and are always the same sex.¹

How Common are Twins?

Twinning rates have fluctuated throughout history and vary by region, country, and racial and ethnic groups.

The rate of identical twins is relatively constant at about four sets of twins per 1,000 pregnancies throughout history and demographics. The changes in twin popularity depend primarily on fluctuations in the prevalence of fraternal twins.¹

In the United States, twin births had been on a steady incline from 1980 until their peak in 2014, then began to decline. In 2018, 32.6 of every 1,000 babies born was a twin. This includes both identical and fraternal twins.²

How to Conceive Twins Naturally

The current understanding of identical twins is that they occur randomly. There have been no identified maternal, genetic, or environmental contributing factors in conceiving identical twins. If you hope to conceive identical twins, the best you can do is cross your fingers and pray!¹

There are, however, several factors that may increase a woman’s chances of conceiving fraternal twins. Some of these you can control, while others are unchangeable.

Increasing Maternal Age

A woman is born with all the eggs she will ever have, but they are immature. At puberty, these eggs begin to ripen in batches each cycle, though typically only one reaches full maturity, is ovulated, and can be fertilized.

Follicle-stimulating hormone, or FSH, recruits a new group of eggs to mature each cycle. As a woman ages, her reserve of eggs decreases because she loses batches each month. As the egg reserve decreases, you may need higher levels of FSH to recruit new eggs for development. Higher FSH levels increase the chances that more than one egg will reach full maturity and be ovulated in one cycle. This may be how older moms are more likely than younger moms to have twins.¹

Increased Parity

Parity refers to the number of babies born to a mother. Mothers who already have babies are more likely to have twins. While moms with more children are likelier to be older than first-time moms, we can correlate increased parity with twin pregnancies, even independent of maternal age. It is not understood why having previous pregnancies and births increases chances for twins, but what this means is if you keep having babies, you are more likely to have twins eventually!¹

Genetics

The most recent studies suggest a woman can inherit a tendency toward fraternal twins from either of her parents. However, you can only choose your partner, not your parents, and your male partner’s family history of twins does not impact your likelihood of conceiving twins.¹

Sperm Quality

A woman can ovulate two eggs, but both must be fertilized to conceive fraternal twins. Eggs are more likely to be fertilized if the quality of a man’s sperm is high.

If you are hoping to conceive twins (or conceive at all), optimizing the sperm health of your partner is a top priority. Interventions such as maintaining a healthy weight, diet, and exercise routine, managing stress, limiting alcohol and other drugs, and keeping the testicles cool can all improve male fertility.³

Maternal Size

Taller moms and moms with a body mass index of over 30 have a higher likelihood of getting pregnant with twins.¹

Conceive During Summer or Fall

Some studies have shown an increased chance of conceiving twins during the summer and fall seasons. Food and nutrition availability may contribute to this trend and the effect of daylight hours on hormone concentrations.¹

Folic Acid Consumption

Some studies have shown an association between folic acid consumption around the time of conception with getting pregnant with twins. Perhaps this is due to a higher likelihood of implantation of both fertilized eggs if a mother’s folic acid concentrations are adequate.¹

Recent Discontinuation of Hormonal Birth Control

After a woman stops taking birth control pills or another form of hormonal birth control, her body takes time to re-regulate her hormones. This may cause a temporary increase in FSH and raise her chances of conceiving twins.¹

Dairy Consumption

One study shows that women who ate dairy compared with women who did not were five times more likely to conceive twins. This may be due to a hormone released from an animal’s liver that makes the ovaries more sensitive to FSH.⁴

Breastfeeding

Women who are breastfeeding when they conceive a new pregnancy are also nine times more likely to become pregnant with twins.⁴

How to Conceive Twins with Medical Treatment

While all these factors can increase your odds of getting pregnant with twins, there are no guarantees. There are also ways to conceive twins with medications and other medical interventions.

Ovulation Induction

Women who do not ovulate regularly on their own often take fertility drugs to encourage their bodies to mature and release an egg for fertilization. Some of these medications, such as clomiphene citrate or follicle-stimulating hormone, can cause a woman to ovulate multiple eggs in one cycle, increasing her risk for a multiples pregnancy.

Clomiphene citrate increases a woman’s chance of conceiving twins from less than 1 percent to 5-8 percent.^5,6

Doctors will combine ovulation induction medications with timed intercourse, telling you when to have sex to optimize your chances of conception. Sometimes ovulation induction medications are combined with intrauterine insemination (IUI) when sperm is injected directly into a woman’s uterus at the time of her ovulation.⁶

If you take ovulation induction medications, you will likely be closely monitored for the number of mature follicles in your ovaries before ovulation. If you appear to ovulate more than two eggs, your doctor may instruct you to abstain from intercourse, or your insemination might be canceled for that cycle. You do not want to risk conceiving higher-order multiples such as quadruplets because of the risks it places on a pregnancy.

In Vitro Fertilization

In vitro fertilization (IVF) refers to harvesting a woman’s eggs and fertilizing them with sperm in a laboratory. If fertilization occurs, a doctor can transfer the resulting embryos into the uterus in hopes of implanting and beginning a pregnancy. If they transfer multiple embryos and both implant, fraternal twins will occur.⁷

Even when the doctor transfers only one embryo, IVF pregnancies are more likely to result in twins because the embryos are more likely to divide and cause identical twins. However, there is no clear understanding or scientific consensus as to why.⁸

You probably will not go through fertility treatments to have twins, but it could be a nice bonus if you have always wanted to have two babies at once. If you are not eligible for ovulation induction, IUI, or IVF, you may have to rely on the old-fashioned way of getting pregnant, whether with twins or just one baby.

While many factors that influence getting pregnant with twins are out of your control, some interventions are relatively harmless to try. Always talk to your doctor before changing your diet, medications, or supplements, but upping your dairy intake and starting a folic acid supplement could be good places to start. And even if you do not end up pregnant with twins, these changes could still help you conceive a singleton baby, which you would likely still be thrilled about.

Best Ovulation Tests & Different Methods to Track Ovulation

Kirsten White — Fri, 13 Jan 2023 11:00:07 +0000

Many women transition off hormonal birth control, hoping to become pregnant or searching for natural methods to avoid pregnancy. As a result, many ovulation trackers and tests have become available. From strips and devices to tracker apps, the market has many options for identifying ovulation and finding your fertile window.

Ovulation is the “main event” of your menstrual cycle. But how is it tracked? Here we will discuss ways to track ovulation and choose the best ovulation test for you and your family planning goals.

Ovulation happens once per menstrual cycle, roughly halfway between the start of one period and the start of the next. Many period tracking calculators or phone applications use this guess to identify your day of ovulation based on your cycle history. However, the actual day of ovulation varies from woman to woman and cycle to cycle. There are much more precise ways to identify when ovulation occurs for each woman and cycle. This knowledge can help time intercourse to avoid or achieve pregnancy.^2,3,4

Ovulation is a response to fluctuations of a few female hormones. When these hormone levels rise, they are detectable in a woman’s blood and urine. A woman can collect her urine sample at home, dip an ovulation test in it to measure one or more of the hormones and get a reading within a few minutes. This information helps to predict that ovulation might be coming. Some ovulation tests can also confirm that ovulation has already happened for a cycle.⁵

Although the purpose of ovulation tests is pretty much the same—to predict and confirm the timing of ovulation—they vary in accuracy, warning time, readability, and cost.

Some ovulation tests only look for luteinizing hormone (LH), which surges about 24 hours before ovulation. If you want to time sex to get pregnant, waiting for a positive LH test gives you a good shot. That way, sperm are waiting for an egg when it is released.

If you want to know that ovulation is approaching in the next few days, other, more comprehensive ovulation tests look for estrogen and LH. Estrogen rises a few days before the LH surge and gives a more advanced warning that ovulation is coming.

Some ovulation tests also look for progesterone, which rises after ovulation. A positive progesterone test confirms you have already ovulated, and the window to get pregnant is closed until the next cycle.

Some ovulation tests require that you compare and interpret the darkness of a test line versus a control line on the ovulation strip. Some ovulation tests come with access to a free smartphone application to help read the sometimes-ambiguous results. Other ovulation trackers use a monitor that reads the results for you and gives a black-and-white reading of low, high, or peak fertility. You do not even have to look at the test sticks.

Some women like to see the progression of their ovulation test lines go from light to dark, while others prefer the objectivity of a digital monitor reading.

Typically, ovulation tests that you read yourself will be less expensive than tests that interpret the results for you. Some digital tests also require you to purchase a separate monitor. This can cost close to $100 but is a one-time expense that you can continue to use as you purchase new boxes of test sticks. Ovulation tests that read multiple hormones also cost more than those that measure only one.

Depending on the cycle detail and price point you are looking for, several digital tests may be a good fit for you. Here is a breakdown of the three top digital ovulation tests available:

Buy Here

The monitor for Inito costs $100 and has 15 test sticks per cycle with a $3.33 per-stick cost. The Inito device tests estrogen, LH, and progesterone levels and predicts and confirms ovulation. You can sync the monitor to your smartphone. The report from the test comes within about five minutes, and measures high, peak, or ovulation confirmed using numerical values on a graph.

Buy Here

The monitor for Clearblue costs $118, and each test stick costs about $1.40 with 10-20 sticks per cycle. It tests for estrogen and LH levels and predicts ovulation but doesn’t confirm ovulation. When testing, the report readability is low, high, or peak fertility, with results in about five minutes.

Buy Here

Mira costs $199 and uses 10-20 sticks per cycle at between $2 and $4.50 per stick. The device measures estrogen, LH, progesterone, and FSH, and predicts and confirms ovulation. The monitor can also sync to your smartphone. The reading time takes much longer than the other two tests—about 21 minutes—and you get a fertility score from 1-10 with numerical values on a graph.

Digital tests are easier to read, provide more comprehensive insight into your cycle, and are slightly more sensitive, but they are also more expensive than generic ovulation tests.⁵

At just $0.30-$0.40 per test, some inexpensive and easy-to-source analog ovulation tests include Wondfo, Easy@Home, and Pregmate. Although these do not come with monitors or analyzers like their digital counterparts, women can use a smartphone app called PreMom to upload photos of their ovulation strips for assistance with interpretation. PreMom is for the Easy@Home tests, but you can use any generic ovulation test stick.

Proov is a fertility monitor that tracks your entire cycle through the use of an app on your mobile device instead of using an external device to read the test strips. Proov also makes LH strips that function similarly to the other analog LH ovulation tests.

If you are new to the ovulation and fertility world and all of this is overwhelming, then simple LH strips might be a good place to start. However, if you have been tracking your cycle for a while, are looking for additional ovulation insight, and are ready to invest a bit more money into the process, you might be ready to try a digital ovulation tracker. If you suspect you are not ovulating, look for a digital or analog progesterone test to help confirm or alleviate your suspicions.

If the thought of at-home urine testing seems too much, but you would like to know when you are ovulating, there are biological ovulation signs and symptoms and markers you can also observe, some just by paying attention to your body!

For a general idea of when you ovulate, you can start by paying attention to your cervical mucus. As ovulation approaches, your cervical mucus becomes “fertile,” meaning it creates a suitable environment for sperm to survive and swim to meet an egg at ovulation.

Fertile cervical mucus is clear, stretchy, slippery, wet, and abundant, like a raw egg white. If you notice this normal discharge in your underwear or when you wipe after going to the bathroom, ovulation is likely very near.⁶

A woman’s body temperature rises after ovulation for the second part of her cycle from ovulation until the start of her next period. This happens in response to the hormone progesterone. If you do not want to test your urine or blood directly for progesterone, you can take your basal body temperature daily first thing in the morning before getting out of bed. When you notice a sustained rise in your temperature, you likely have high progesterone levels in your system, which can help confirm you have ovulated.⁷

This does not help predict that ovulation is coming, so it cannot help you know when to have sex if you are trying to conceive. It can, however, help to ensure you are ovulating normally or identify if there is an ovulation issue.

If you are ready to start tracking your cycle and ovulation, a few things will make it easier.

Pay Attention to Your Body

As mentioned, your body gives you biological signs of where you are in your cycle, even without tracking. If you notice these signs, they can indicate when it could be a good idea to take an ovulation test.

If you are committed to daily testing and tracking for ovulation, you must not miss a day to have a complete picture without any missing data. Whether you need to set a daily alarm or recruit your partner to remind you, get in the habit of ovulation testing every day during your potential fertile window.

There is no point in collecting all this ovulation information if you will not remember it! You can log your ovulation tests on a paper chart or a phone app or rely on one of the digital devices to store it for you. No matter how you maintain your data, make sure you record it all somewhere consistent so that you can look at your cycle history. This information can be helpful for pregnancy dating, infertility workups, and more.

With so many ovulation testing and tracking options, it can be overwhelming to decide which tests to use and when to use them. Whether you are looking for in-depth cycle detail or cheap simplicity, the good news is that the right fit is for you. Consider your goals, budget, and dedication, then use the information in this article to make the right investment for your cycle health. There is a learning curve to using ovulation tests, but if you commit to learning a method, you will quickly pick up on your cycle trends and tracking habits. Happy testing!

Ovulation Symptoms and Signs: What to Look for and Know

Kirsten White — Mon, 31 Oct 2022 10:30:33 +0000

Many women grow up thinking they will get pregnant if they have sex. It is not until a woman is trying to conceive that she finds it may or may not be that easy. After all, there are only a few days per month that intercourse can result in pregnancy; this window ultimately depends on when a woman ovulates, so it’s essential to know the signs and symptoms of ovulation.

Without ovulation, a naturally conceived pregnancy is impossible. Whether you are looking to conceive or avoid a pregnancy, knowing about your cycle and ovulation signs can provide important insight into your overall health. Here we take a closer look at what ovulation is, what causes it, symptoms, and when and how to predict and confirm ovulation.

A woman is born with all the immature eggs she will ever have, approximately 1-2 million, in her ovaries. Until puberty, these eggs remain immature. At puberty, a thousand or more eggs per cycle begin to mature in the ovaries. Typically, one egg on only one side will reach full maturity and release. It is thought that the right and left ovaries alternate each month,¹ but that eggs ovulated from the right side are more likely to result in pregnancy.² Another study shows that ovaries do not necessarily take turns, and each month’s dominant ovary is predominantly random.³

One ovary releases an egg from the dominant egg follicle into the fallopian tube each cycle. There, it has the potential to become fertilized.¹ The egg lives only 12-24 hours after ovulation, whereas sperm can live up to five days. Therefore, the best chance of pregnancy is when the sperm is waiting for the egg. The highest likelihood of pregnancy occurs when a sperm fertilizes an egg within 4-6 hours after ovulation.⁴

If fertilized by a sperm, the egg, now called an embryo, continues its journey down the fallopian tube to the uterus for implantation and pregnancy. If the egg is not fertilized, it is reabsorbed.

A new batch of eggs begins ripening each month in response to a hormone called follicle-stimulating hormone. As the egg follicles grow and ripen, they release increasing amounts of estrogen. When estrogen reaches exceptionally high levels, it causes the brain to release a surge of luteinizing hormone.¹ Luteinizing hormone then causes an egg to be released from the ripest egg follicle within 24 hours of its peak level.⁵

A woman’s new cycle begins on the first day of her period. At this point, the uterine lining sheds, and a new batch of eggs begin to ripen. The time between her period and ovulation is called the follicular phase, during which egg follicles develop and mature. The average length of the follicular phase is between 14-21 days. Still, the follicular phase length can vary significantly from woman to woman and from cycle to cycle, making predicting ovulation difficult.⁶

The post-ovulatory phase, named the luteal phase, lasts from ovulation until the start of the next period. The luteal phase is much more consistent in length—it is almost always 14 days.⁷ This means that you ovulate 14 days before your next period.

If you have predictable and regular cycle lengths, you can use the estimated date of your next period and subtract two weeks to calculate when ovulation will occur. However, due to the potential variability of the follicular phase, this is not the most accurate or reliable way to predict ovulation.

The female body shows that ovulation is approaching, which can be more reliable than guessing and math based on previous cycles. These ovulation signs include cervical mucus and hormonal changes observed and tracked at home.

The cervix, which acts as a passage from the vagina to the uterus, releases a fluid that changes in quality and quantity throughout the menstrual cycle. These changes in texture and volume occur in response to hormones. This mucus is secreted by the cervix but makes its way out through the vagina, making it relatively easy to observe and identify changes throughout the cycle once you know what you are looking for. You may notice this mucus in your underwear or toilet paper when you wipe.

After your period but before ovulation, your mucus may be nonexistent or scant, tacky, thick, and cloudy. As ovulation approaches, mucus becomes clearer, more stretchy, slippery, wet, and abundant. The most fertile-type cervical mucus is highly correlated with ovulation. Fertile cervical mucus is also a perfect environment for sperm cells, helping them to stay alive and directing them to the egg.

By paying attention to the changes in your cervical mucus throughout your cycle, you will begin to recognize what fertile mucus looks like. Then, you can predict your ovulation by noticing when you start to observe fertile cervical mucus. Ovulation typically occurs on the last day of peak or fertile cervical mucus.⁸

Ovulation occurs in response to the rise in two hormones: estrogen and luteinizing hormone, or LH. Estrogen rises throughout the follicular phase, which causes cervical mucus to become fertile. Some commercially available digital ovulation tests and monitors measure estrogen in your urine. Most of these tests require you to test your urine daily. When they detect a rise in estrogen, ovulation is likely approaching.

When estrogen reaches peak levels, this causes a brief but very high spike in a woman’s luteinizing hormone levels. The luteinizing hormone surge causes the most mature egg follicle to rupture or ovulate. Ovulation typically occurs 24-36 hours after the start of the LH surge and 10-12 hours after LH reaches its peak levels.⁹

The term “ovulation test” typically refers to a luteinizing hormone test. There are both analog and digital at-home LH tests. Digital ovulation tests require no interpretation and provide you with a “peak” reading when they detect an LH surge. Analog LH tests require some interpretation—the line that detects luteinizing hormone levels must be present and darker than the control line to indicate an LH surge. Many analog LH tests come with access to a smartphone app that will help read the tests for you if you upload a photo.

Digital ovulation tests typically test for estrogen and luteinizing hormone, compared to analog tests that only measure LH. Digital tests are easier to read, slightly more sensitive, and expensive.¹⁰

Some digital ovulation tests available include the Touchscreen Clearblue Fertility Monitor, Clearblue Advanced Ovulation Test, Inito Track & Confirm Ovulation & Fertility Monitor, and the Mira Fertility Plus Tracking Monitor Kit. These measure estrogen and LH, giving you the best estimate of when ovulation is approaching.

Some good, readily available analog ovulation tests include Wondfo, Easy@Home, and Pregmate.

In addition to fertile cervical mucus and positive ovulation tests, some women experience other signs and symptoms associated with ovulation. These symptoms can help predict ovulation timing in people who have them.

One sign of ovulation is single-sided lower abdominal pain. This pain is called mittelschmerz, meaning “middle pain.” This pain can be sharp, sudden, dull, or achy but typically lasts only a few minutes to a few hours. The one-sided pain indicates which ovary, right or left, you are ovulating from. This may alternate month to month or occur on the same side for many months. If you experience this pain and the timing and other symptoms line up with ovulation, you are likely experiencing mittelschmerz.¹¹

Women may experience a higher libido during ovulation, especially in committed, long-term relationships.¹² This increased sex drive is related to high estrogen levels. These high estrogen levels also cause increased vaginal lubrication, increasing libido.

There are many ways to predict ovulation, but you can only know for sure that it happened if you confirm it after the fact. Some methods of confirmation require a doctor’s intervention, while others can be done at home.

A transvaginal ultrasound is the best way to confirm that ovulation has occurred. This closely looks at the ovaries, searching for a recently ruptured egg follicle called the corpus luteum.¹⁴ If a corpus luteum is seen, that means that ovulation occurred. Ultrasounds for ovulation confirmation are not routinely completed because they are expensive, inconvenient, and invasive. They are typically only ordered during artificial reproductive interventions.¹³

The ruptured egg follicle or corpus luteum releases a specific hormone, progesterone, only after ovulation. If this hormone is present in a woman’s blood or urine, she can be confident that she recently ovulated. You can request a progesterone blood draw from your doctor or measure progesterone metabolites in your urine at home.¹³ Some of the digital ovulation tests mentioned above also test for progesterone—specifically, Inito and Mira. There are also analog at-home progesterone tests. One brand is called Proov (we got to chat with one of its founders). A positive on any of these tests indicate the presence of progesterone, meaning ovulation has occurred.

Basal Body Temperature

After ovulation has occurred, progesterone causes a rise in body temperature. A woman can measure her body temperature immediately upon waking each day and document these values. When she notices a pattern of higher temperatures after a series of lower ones, ovulation can be confirmed. However, other factors such as illness, sleep schedule, alcohol consumption, stress, and medication can influence body temperature, making it difficult to interpret and trust.¹³

Ovulation is a complex process requiring the cooperation of multiple hormones and circumstances each month. The first step in many natural family planning or fertility awareness methods is understanding ovulation and its signs and symptoms. Many women are turning to natural family planning because ovulation and menstruation provide valuable insight into your overall health. Whether you are trying to conceive or avoid pregnancy, knowing your ovulation status can help you time intercourse accordingly to meet your goals. Ovulation awareness can also help you recognize when it may be time to seek help for irregular cycles or difficulty conceiving.

What to Do When One Partner Wants a Baby and the Other Doesn’t

Kirsten White — Tue, 12 Jul 2022 10:00:53 +0000

Marital and family conflicts are unavoidable. Although you have committed to a partnership, you are still two individuals with different and sometimes incompatible needs, desires, and interests. Since you live together and are building a life and family together, these conflicts can be challenging to escape from, even temporarily.¹ When it comes to major life decisions like the number of children or family size, a disagreement can feel agonizing if one partner wants a baby and the other doesn’t.

A common conflict in a marriage or life partnership is whether or not to have another child. Not only is it a huge decision, but there is also no obvious compromise. If one partner wants one child and the other wants three, you can compromise or meet in the middle with two. But if one wants two and the other wants three, you cannot have half a child! A new baby is an all-or-nothing commitment.

To Have a Baby or Not . . . That is the Question

More than eighty percent of couples agree on whether to have a child or another child. This means that between ten and twenty percent of couples disagree on having another child, making the number of children a common debate within marriages.^2,3 Couples are pretty evenly split on whether the male or the female partner in a heterosexual relationship wants another child.³ Although a disagreement is rarely desirable, if handled positively, conflict can strengthen a marriage.¹ This is true regardless of whether one partner or the other gets their way or the two come to a consensus.

Who gets to decide?

There are many theories regarding which partner has the decision-making power concerning childrearing. Some of these views on which partner often has more influence are outlined below. Remember that these are societal observations and not a commentary on who should get to decide.

1. Matriarchal View

Historically, traditional gender ideology classifies childbearing and childrearing as primarily the woman’s responsibility. One model of thinking, called the sphere of interest, deems that because traditionally, the woman bears more of the day-to-day work of raising children, the decision on whether to have another child lies within her domain. This relates to the matriarchal view of society, which states that women always have a more decisive say in family matters.

It is also similar to the joint utility model, which believes that whichever partner takes on most childrearing responsibilities will have more say in family size decisions. In couples deciding whether to have a second or subsequent child (but not first children), one study showed that women’s intentions are more predictive and decisive than men’s in a gender-equal society.²

2. Patriarchal View

An alternate view of fertility decision-making puts the choice in the hands of the one with the most socioeconomic resources. Historically this has meant the male partner has the most significant influence in decisions regarding children. This is similar to the patriarchal view, in which men always decide.²

3. Societal View

Every society has norms regarding childbearing and family size. In the United States, in 2020, women had an average of 1.6 total births. However, this number can vary between states and towns or cities.⁶ When couples disagree on the number of children to have, the partner on the side of a societal norm usually “wins.” Either partner has veto power when considering having more children than the average in their community. One study states, “conflict resolution tends to favor the less radical partner.”⁵ In other words, if it is rare or unusual in your society to have only one child, the partner who wants a second child often ends up getting their way.

Conversely, suppose you already have two children and are considering whether to have a third. In that case, you will likely end up without a third child if families in your society typically have only two children. In an Italian study, couples demonstrated compromise when deciding whether to have a first or second child. Still, couples usually stopped at two if there was disagreement over whether to have a third.⁵ This may be because the Italian birthrate is 1.2 births per woman, so having three children goes against the societal norm.⁶

4. Veto Rule

The veto rule favors the partner that does not want anything to change. Essentially both individuals in a partnership must agree before acting on the desire to have more children. This is similar to the “golden mean,” which asserts that if partners disagree, nothing happens; whoever does not want the situation to change decides the outcome. Studies have shown that “negative childbearing intentions are more predictive than positive ones” and that it is most common to have another child only when both partners agree to do so.² Because welcoming new children into the family is a lifetime commitment for both parents, neither parent is willing to pursue more babies without their partner’s agreement.⁵

Ultimately the decision to have a child should not be a unilateral one. It should come from careful contemplation of a combination of factors: financial matters, childrearing responsibilities, family and societal considerations, and both partners’ individual wants and desires.

More important than which partner makes the decision or who “wins” is how you reach that conclusion and that you ultimately agree on the decision. Not only can productive conflict resolution strengthen marriage and prevent resentment, but it also produces healthier offspring. In one U.S. study, when a pregnancy was intended and desired by one parent but not the other, the infant was at an elevated risk of adverse health events. Unintended fertility was associated with delayed prenatal care and reduced breastfeeding compared to intended siblings from the same family.⁴

Tips for What to Do When One Partner Wants a Baby

So what does a couple do when one partner wants a baby, and the other doesn’t? Of course, there is no correct answer regarding whether you should have another baby. But there are steps you can take to resolve conflict, share how you are feeling, see your partner’s point of view, and hopefully come to a conclusion you both feel comfortable with.

1. Attack the problem together.

A disagreement over adding another child to your family is one in which you and your partner probably both feel strongly and passionately. You likely each have very valid reasons for your opinion. In the heat of the moment, it can be difficult not to take your partner’s differing opinions personally. But try to keep in mind that you are not rivals. Your partner is not trying to hurt or spite you by thinking differently than you, and they are probably equally distressed over this disagreement.

Direct your frustration at the situation in that you two disagree. Instead of arguing against your partner, try to unite with your partner in battling together against the issue and finding common ground. This can be difficult at first, but with practice, it can help not to see the partner as the enemy. If the two of you are having trouble achieving this mindset, a good couple’s counselor can help you feel like you are attacking the difference of opinion together.

2. Fight fair.

Remember that your partner is allowed to disagree with you, which does not make them bad. There are certain types of communication in a partnership that can negatively affect the quality of the relationship. Avoid belittling their confidence or encouraging feelings of anxiety and discomfort. Set aside selfishness, pursue only your interests, and foster teamwork and mutual positive regard. Although challenging, try to cooperate in addressing the interests of your partner. Recall all the reasons you love them, and find things to appreciate about their ways of thinking. Try to respect the emotional needs of the other; they need to feel love, care, attention, and understanding, even during an argument.¹

3. Assess the situation.

Hopefully, with this shift in mindset, you and your partner can come together calmly and with level heads. If possible, find the root of the issue. Why does one partner need to add another baby to the family? Does the family feel incomplete? Have you always dreamed of a large family? Do you want siblings for your current children? And conversely, why doesn’t the other partner want a baby? Are there financial constraints at play? Societal pressures? Would you outgrow your house? Do you have the support system you need around you to help with the emotional and logistical burden of a new baby? And does that partner never want another baby, or just not right now? If they are just not ready right now, perhaps you come to some compromise on timing or when they might feel comfortable reassessing the situation or revisiting the conversation.

4. Consider your partner’s perspective.

Now that you have assessed the root of the disagreement try to appreciate where your partner is coming from. You both have each other’s best interest and your family’s best interest at heart. As your partner expresses their point of view, aim to listen to understand, not to respond. You do not have to counter them with your opposing viewpoint immediately. Allow your partner to explain how they feel so thoroughly that you can accurately repeat it. Likewise, when it is your turn, explain your side to help your partner understand where you are coming from. Try not to set out to convince them to change their mind, as this can fuel the rivalry. Instead, evaluate how you feel to share that with your partner accurately.

Once you have their perspective and they have yours, are you able to find common ground? Perhaps you can now empathize with their stress and pressure of financial implications or the household workload of another child, for instance. Maybe you both agree that you would love to give your current child a sibling, but one party is not ready for all else that entails. Identify where each of your desires to have or not have a baby are coming from, and try to relate or find mutual understanding, even if you disagree.

5. Give it time.

In most cases, this decision does not have to be made overnight. Adding a baby to your family is too big of a deal to coerce your partner into it or have them halfheartedly agree, only to resent you later. If you reach a point where you are talking in circles and making no progress, or the topic feels too raw, it may be time to take a break. Get comfortable living in the limbo of the unknown. It is okay not to know immediately whether your family is complete. In the meantime, do not make any permanent fertility decisions and remain open to reconsidering another baby. You can revisit the conversation in a few months when both of you have had time to process the other’s viewpoint and see your family’s progress in that time.

It can feel like an impossible obstacle when one partner wants a baby, and the other doesn’t. Although no one can decide your family size except for you and your partner, there are steps you can take to understand each other and hopefully reach an agreement. Find solace in the fact that this is a relatively common issue in marriages, and you will ultimately settle on a solution. Consider what is most important to each of you, communicate your desires and fears clearly, and give each other time to process. Continue loving one another and focusing on your partnership and family in the meantime, and hope that with the passing of time, the path forward will become clearer to both of you.

Secondary Infertility: What It Is and Its Causes

Kirsten White — Wed, 22 Jun 2022 10:00:21 +0000

If you have been pregnant or given birth before, you might assume your experience trying to conceive a subsequent time will be similar to the first. For some women, this is the case. However, many couples experience difficulty becoming pregnant when they are ready to try again. This is called secondary infertility.

Secondary infertility can be a confusing and frustrating experience, especially if you expect pregnancy to happen naturally or easily. You may have envisioned a specific age gap between your last baby and your future baby. Or perhaps you planned a hopeful pregnancy around certain life events that have now long passed. Maybe you are getting questions about growing your family, adding pressure to an already stressful situation. Or perhaps just the opposite: you are receiving a lack of empathy from family and friends telling you that you should just be thankful for the child or children you already have. Many do not realize that you can be grateful for your children and still have the longing for another baby.

No matter the scenario, there is a lot of emotion surrounding secondary infertility for those going through it. There is also much to know about secondary infertility: its definition, frequency, causes, and treatments. This knowledge can give you the confidence to reach out to your doctor about what you may be experiencing and seek help.

What is secondary infertility?

Infertility refers to the inability to conceive or carry a pregnancy to term. Most providers diagnose infertility after one year of unprotected, frequent, and random acts of intercourse.^1,3,28 However, some professional reproductive organizations will not diagnose infertility until it has been two years of trying.^2,28 Other providers may diagnose infertility after only six months, especially if the woman is over 35 years old or she has a known physical complication or medical history.¹⁴

Secondary infertility is specific to the inability to conceive or carry a pregnancy to term after already having given birth at least once. This differs from primary infertility because those with primary infertility have never been pregnant or carried a pregnancy to term. The number of children a woman or couple already has is irrelevant to the diagnosis of secondary infertility.^{5, 28} For instance, you could even have three or more children and struggle to conceive again, which would be considered secondary infertility.

How common is secondary infertility?

Approximately 8-12% of reproductive-aged couples worldwide experience infertility, and secondary infertility is the most common form of female infertility.³ Secondary infertility accounts for about half of all infertility cases, and it is the most common form of female infertility worldwide.³

While it may feel like your peers are popping out second, third, and more babies left and right, it is important and reassuring to note that you are not alone. After all, one study showed over 10% of women with one baby have trouble getting pregnant again, and the CDC reports that 11% of American couples who have already had at least one child go on to experience secondary infertility.^6,²⁶ The good news is that if you have already had a child, you are more likely to have a successful second pregnancy.⁹

Although a high rate of infertility is not the best news for society, it does mean that a lot of research is being done on the topic. Research has been able to identify causes and create interventions that prevent and treat infertility and secondary infertility.

Causes of Secondary Infertility

The causes of secondary infertility are often the same as the causes of primary infertility. They can present even after the birth of any child. Secondary infertility can be caused by the male partner, the female partner, or both.¹² Below are some of the causes of male and female factor infertility.

Female Factor Infertility

One of the leading causes of female infertility is a failure to ovulate (anovulation). This contributes to nearly one-third of all infertility cases.¹² Symptoms of ovulatory dysfunction include amenorrhea (lack of a menstrual period) or oligomenorrhea (fewer than six to eight menstrual periods in a year).¹⁵ There are also physical or anatomical causes of female infertility that can usually be diagnosed and treated via imaging and sometimes surgery.² Some of the specific female infertility causes are explained here.

1. Hypothalamic Amenorrhea

Hypothalamic anovulation or amenorrhea can be caused by restrictive diets, eating disorders, low body weight, and intense and frequent exercise. If you burn more calories than you consume daily, amenorrhea can develop. Recent weight loss is often seen in women with hypothalamic amenorrhea. Often, this condition can be reversed by increasing calorie intake and decreasing the frequency and intensity of exercise. Intense emotional stress can also cause hypothalamic amenorrhea.¹⁵

2. Obesity

Although the relationship between obesity and infertility is still being investigated, high body mass index is associated with menstrual dysfunction and anovulation. Weight loss in overweight and obese women trying to conceive has demonstrated improved reproductive outcomes.¹⁶

3. Hypothyroidism

Low levels of certain thyroid hormones can interfere with your ovaries’ ability to release an egg. Hypothyroidism can also cause hyperprolactinemia, sex hormone imbalance, and luteal phase defects. There are medications that can often easily treat hypothyroidism.¹⁷

4. Hyperprolactinemia

Prolactin is a hormone released from the pituitary gland that aids in breastfeeding. During pregnancy, prolactin prepares the breasts for breastfeeding. After giving birth, prolactin stimulates milk production. Prolactin levels can remain elevated as long as a woman breastfeeds, sometimes over a year or more. One effect of prolactin is that it suppresses ovulation, which is why many women do not get their periods while breastfeeding. This is called “lactational amenorrhea” and is normal.¹³ Some people call prolactin “natural birth control.” ¹¹ Prolactin’s suppression of ovulation can contribute to secondary infertility if you have been trying to conceive with no luck while still breastfeeding. This can usually be treated.¹³

If you are not breastfeeding but have high prolactin, this can signal a problem such as a pituitary tumor. You can be suspicious of this if you are experiencing milk leakage from your nipples while you are not breastfeeding, low libido, and painful intercourse, in addition to infertility.¹³

5. Polycystic Ovary Syndrome (PCOS)

In PCOS, high levels of circulating testosterone and estrogen can inhibit ovulation.¹⁰ If you are not ovulating, there will not be an egg to fertilize. You may think that you do not have PCOS because you have already had a child. However, PCOS can be diagnosed at any age after puberty, including after pregnancy. You can request a workup from your provider for PCOS if you are experiencing symptoms such as long cycles, irregular or very light periods, excessive body hair, weight gain, acne, or cysts on your ovaries. There are treatments available for PCOS that will help your body ovulate and help you conceive.¹⁸

6. Age

A woman is born with all the eggs she will ever have, and egg number and quality decrease over time. Female fertility peaks between a woman’s late teenage years through her late twenties. By 30, a woman’s ability to get pregnant starts to decline. This decline accelerates around age 35.^7,8 While you may have conceived earlier pregnancies easily, you were younger then. The natural decline in fertility may be contributing to secondary infertility.

7. Luteal Phase Defect

The luteal phase refers to the period of time between ovulation and your next period and should last between 12 and 14 days. During this time, the uterine lining is sustained by a hormone called progesterone secreted by the corpus luteum in the ovaries after ovulation. If progesterone is insufficient, the endometrium cannot sustain itself or support embryo implantation. Symptoms of luteal phase defect include spotting and a short luteal phase/early period.¹⁹ Tracking your cycle with natural family planning or fertility awareness methods can help to identify whether your luteal phase is of sufficient length to sustain a pregnancy. Progesterone supplementation and other medications can help lengthen the luteal phase for women trying to conceive. Luteal phase defect accounts for 3-4% of infertility cases.¹

8. Pelvic inflammatory disease (PID)

Pelvic inflammatory disease, which can result from sexually transmitted infections like gonorrhea or chlamydia, can cause scarring to the female reproductive tract, preventing or blocking the egg from being able to be released, fertilized, or carried to the uterus.²⁰

9. Scarring

Previous abdominal or pelvic surgery can cause scarring in the uterine cavity or reproductive tract. Surgeries, including cesarean section, dilation and curettage, and even appendectomy, can cause scarring and adhesions in the abdomen and uterus. If the adhesions are extensive, they can cause a thin uterine lining that would not support the implantation of an embryo.^12,21 These surgeries can also increase the risk of ectopic pregnancy.²¹ A symptom of this condition to look out for is reduced or absent menstrual blood flow. Adhesions or fibroids can also physically occlude the fallopian tubes or prevent implantation.¹⁵

10. Endometriosis

Endometriosis is a condition in which the lining of the uterus grows on the outside of the uterus or the surface of other abdominal organs.¹² It can cause painful periods, painful intercourse, chronic pain, and infertility. Endometriosis can also cause uterine scarring that contributes to infertility. It is thought that endometriosis contributes to 5% of infertility cases. It can be treated with surgery, and many women with endometriosis can get pregnant.¹

Male Factor Infertility

Male factor infertility accounts for about one-third of secondary infertility cases.¹² There is a misconception that infertility is a women’s issue, but male or combined factor infertility is just as likely. Some of the causes of male secondary infertility are described below.

1. Age

Women are not the only ones whose fertility is impacted by age. Male partners can also see a decline in fertility with age, but this usually does not happen until a man’s mid to late forties. Changes in a man’s sperm may cause issues with fertility and chromosomal conditions. If your partner is nearing this age, his sperm quality could be contributing to secondary infertility, even if you did not have difficulty conceiving in the past with the same partner.⁸

2. Varicocele

A varicocele is a cluster of enlarged veins in the testes that adversely affect sperm production. 15% of men have varicoceles, which are thought to be the most common cause of male infertility. About 35% of infertile males and nearly 70% of men with secondary infertility were found to have varicoceles.²² Varicocele prevalence increases over time, which may explain why more men with secondary infertility have them—because they are older than they were when they conceived their first babies.²³ There are several different methods of surgical varicocele repair, and many are successful in restoring adequate sperm quality for fertility.²²

3. Increased Scrotal Temperature

One theory on how varicocele affects male fertility is that a varicocele raises scrotal temperature, making the testes too warm to produce sperm.²⁴ External factors can also affect scrotal temperature, such as wearing briefs instead of boxers, using a laptop on your lap, or sitting for long periods, especially in a car. Luckily if your male factor infertility is caused by increased scrotal temperature, there are easy fixes to lower that temperature and make a difference in semen quality and quantity within a few months.²⁵

4. Unexplained Infertility

While one-third of secondary infertility is caused by the male partner and another third is caused by the female partner, combined or unknown causes cause the remaining third. Secondary infertility can be diagnosed as unexplained in about 20% of secondary infertility cases.⁵ Unexplained secondary infertility can bring with it its own frustrations when you are looking for answers and a potential treatment or path forward.

The good news is that since you were able to carry a first pregnancy, your odds of conceiving another child are 1.8 times greater than a couple experiencing primary infertility.²⁷ This is true even without being able to identify the cause of your secondary infertility. Many couples experiencing secondary infertility are successful in conceiving again if they keep trying. In fact, 95% of couples successfully conceive by the two-year mark of trying.²⁷ Despite the term “infertility,” this is not necessarily a permanent condition and does not always mean that you will never get pregnant again. Some medical literature refers to it as “secondary subfertility,” reflecting that although conception is taking longer than you would like, it is certainly not impossible.²⁷

Managing Your Emotions

Regardless of the statistics and the hope that exists for couples experiencing secondary infertility, your emotions, fears, frustrations, and anxiety are valid—just as valid as a couple with primary infertility. These emotions can cause a strain on your relationship and even cause sexual difficulties. Some find it embarrassing or stressful to disclose this situation, which prevents them from seeking medical or therapeutic help.⁴ However, there is nothing to be ashamed of if you are facing secondary infertility, and there are promising remedies to address many of the underlying causes.

If you are experiencing emotional distress related to secondary infertility, there are options to help. You could try support groups, individual and group therapy, confiding in a close, trusted family member or friend, or having candid conversations with your partner. There is hope in diagnosing and resolving the causes of your secondary infertility, but it is important to take care of yourself and your family in the meantime. Give yourself grace and empathy during this time. Secondary infertility is considered a medical disease that can be just as distressing as a cancer diagnosis. Do not be afraid to seek help if you feel defeated or feel that something is wrong.

TTC Archives - Baby Chick

Fertility Treatments: Options and What Is Involved

What Can Cause Female Infertility?

Fertility Tests for Women

What Can Cause Male Infertility?

Fertility Tests for Men

What Fertility Medications Are There?

What Is IUI?

What Is IVF?

Are There Any Natural Fertility Treatments?

‘Geriatric Pregnancy’ Stigma: How Does It Affect Women?

What is the ‘Geriatric Pregnancy’ Stigma?

Some Issues Do Increase with Age

The Effects of Geriatric Pregnancy Stigma

Increases Anxiety in 35-Plus Pregnancies

Puts Pressure on Younger Women

Feeling Pressure From Others

How Can We Break the Stigma?

What Is a Blighted Ovum?

What is a Blighted Ovum?

What Causes a Blighted Ovum?

Risk Factors for a Blighted Ovum

Obesity

Advanced Maternal Age

How is a Blighted Ovum Diagnosed?

What are the Symptoms of a Blighted Ovum?

How Common is a Blighted Ovum?

How Do You Treat a Blighted Ovum?

Expectant Management

Medical Management

Surgical Management

Future Pregnancies Can Be Healthy

11 Celebrity Miscarriages: Strong Women Open Up

Miscarriage Rates Remain High

11 Celebrity Miscarriages

1. Chrissy Teigen

2. Meghan Markle

3. Pink

4. Beyoncé

5. Michelle Obama

6. Lily Allen

7. Gabrielle Union

8. Nicole Kidman

9. Halsey

10. Jana Kramer

11. Shawn Johnson

Women Are No Longer Alone

When is the Best Time to Take a Pregnancy Test?

How Pregnancy Tests Work

How Early Can You Take a Pregnancy Test?

What Time of Day Should You Take a Pregnancy Test?

Taking a Pregnancy Test Because of Symptoms

Early Testing and Multiple Tests

When to Get a Blood Pregnancy Test

Late Period and Negative Tests

Fertility Treatments

Trend Hormone Values

Here’s What to Try If You Want to Get Pregnant With Twins

Types of Twins and How It Works

How Common are Twins?

How to Conceive Twins Naturally

Increasing Maternal Age

Increased Parity

Genetics

Sperm Quality

Maternal Size

Conceive During Summer or Fall

Folic Acid Consumption

Recent Discontinuation of Hormonal Birth Control

Dairy Consumption

Breastfeeding

How to Conceive Twins with Medical Treatment

Ovulation Induction

In Vitro Fertilization

Best Ovulation Tests & Different Methods to Track Ovulation

When Does Ovulation Happen?

What Do Ovulation Tests Do?

What to Consider When Choosing an Ovulation Test

What Hormones It Tests

Test Readability