Top 5 tips for Christmas when trying to conceive

Dec 10, 2015 - 4:56pm

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To help you through the busy upcoming Christmas period, here are our top tips on how you can prepare your body for conception.

 

1. Take a prenatal vitamin

It is advisable to start taking a prenatal vitamin three months before trying to conceive. This is to make sure the woman’s folic acid, iron and vitamin D stores are topped up in order to prevent birth defects.

We recommend:

Elevit pre-natal supplement, 30 tablets $27.95

2. Immunisation

When planning pregnancy, ask your GP to run a blood test to check your immunity status to Rubella. Rubella infection during pregnancy can cause birth defects such as deafness, heart problems and intellectual disability. If you are not immune, arrange for an immunisation. You will then need to wait a month after your injection before trying to conceive.

3. Healthy eating and optimum body weight

It’s common to break your normal eating habits around Christmas, although try to remember it’s best to maintain a balanced diet. Foods rich in calcium, iron and folate, such as dairy foods, fruit and vegetables, cereals, wholegrain breads, beans and lentils are vital. Being underweight or overweight can reduce the woman’s odds of conceiving, as it makes regular ovulation less likely. Strive for a healthy body weight (BMI 20-25).

4. Exercise

During the festive season exercise may be the last thing on your to do list, but it is very beneficial to your overall health, as well as preparing your body for pregnancy. Create an exercise plan that you can follow into your pregnancy.

5. Reduce alcohol and give up smoking

If you are trying to get pregnant it’s best to reduce or avoid alcohol in order to prepare your body for pregnancy. Additionally, there is no better time to stop smoking then when you are trying to get pregnant. Smoking and even passive smoking may affect a woman’s chances of getting pregnant.

Credit image: onedollarphoto.com

Happy Christmas shopping from Fertility Pharmacy!

The Egg Reserve (Anti Mullarian Hormone) Test

Nov 11, 2015 - 3:06pm

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You are a successful female professional in your 30s. However, you still haven’t met the right partner to start a family. You wish to explore your options to increase the chances of having children in the future.

Unlike something apparent such as fitness level, fertility is hard to pin down. Most women do not think about their reproductive capacity until they hit thirties or start ‘trying’ for a baby.

In contrast to men, who produce sperm throughout their adult life, women are born with their lifetime supply of oocytes (immature eggs). Each monthly ovulation cycle produces a mature egg that is released into the fallopian tube, which has a chance to be fertilised by sperm. The eggs that have been released but not fertilised, will die via a process called apoptosis.

As the woman gets older, her ovarian reserve will continue to decline, as well as increased risk of the eggs produced being chromosomally abnormal. Whilst there are no tests to tell us the quality of the eggs we can have some idea of how many are in storage.

What does the AMH test tell me?

Anti-Mullerian Hormone (AMH) is a hormone secreted by the ovarian cells in developing egg sacs (follicles). The level of AMH in a woman’s blood reflects her egg reserve in the ovary. In other words, an AMH test gives us some insight into the fertility status of a woman.

Am I a suitable candidate to have an AMH test?

The AMH test is recommended:

• If you are of a fertile age and have been unsuccessful at conceiving after 6 month or more.

• If you are considering to undergo a fertility or an IVF process.

• If you have had a procedure that could have affected your egg storage capacity such as chemotherapy.

• If you are in your 30s and would like to conceive in the future, but not in the relationship at the moment. This test can help to understand where you are in relation to your reproductive life.

How do I organise an AMH test?

You will need to organize a referral from you GP to a fertility specialist who will organise an AMH test for you as well as provide you with the interpretation of the results.

What is the cost of an AMH test?

The AMH test is not covered by Medicare and costs $75. 

A word of caution …

It is important to understand that AMH test only tests ovarian reserve, but not the egg quality and is only one of the tools to help us assess a woman’s fertility.

Credit image: dollarphotoclub.com

Has AMH test help your decision making regarding your reproductive life?

Common contraception myths addressed

Jul 3, 2015 - 5:50am

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Currently, many birth control options are available to women, however there is some misinformation. This article will tackle the most common contraception misconceptions.

 

• You have to take a pill during the same time every day:
  Whilst having a daily routine of taking the pill at the same time every day is a good practice it is still effective if it is taken within a certain period window. For example, a Combined pill (estrogen and progesterone) can be taken within the window of 12 hours, whilst a Progesterone-Only pill has a window of 3 hours.
  
  
• Intra-Uterine Devices (IUD) are only used in women who had children:
  An IUD is a small device that is inserted into the uterus providing an extremely effective, long-term contraceptive method. In Australia, they are available in two types: hormonal based (Mirena®) and non-hormonal (Multiload-Cu375®).
  
  Post-birth, the cervix and the uterus are slightly larger, making the insertion of an IUD easier, as well as reducing its risk of expulsion. Nevertheless, it is frequently recommended to women who have not had children, due to the many benefits it provides. For example, Mirena may help with heavy painful periods in a young woman. Furthermore, IUDs are highly effective since there is no reliance on a woman remembering to take something every day. Another benefit is that once an IUD is removed a woman can fall pregnant straight away. Finally, IUDs are an extremely cost-effective method since the device may stay in for up to 5 years.
  
  
• Using contraception for a long-time will make it harder to get pregnant later:
  Most of the modern contraceptive methods are reversible. However, the time for the ovulation to resume depends on the product used. Let’s take a look at specific examples: 1) Progesterone depot (DepoProvera®) – this is an oily Intra-Muscular injection that slowly releases the hormone into the woman’s body. It may take 6-9 month for the hormone to exit before the woman’s fertility is restored. 2) Combined Oral Contraceptive Pill – After ceasing the pill ovulation resumes within 3 month. 3) Intra-Uterine Device (Mirena®, Multiload-Cu375®)– once the device is removed fertility return is immediate.
  
  
• The pill makes you gain weight:
  Unfortunately, most contraceptive pills have the potential for weight gain. Nevertheless, this effect varies from woman-to-woman and also depends on the type of the pill. For example, the newer combined pills containing progesterone drospirenone (Yasmin®, Yas®) have minimal weight gain and may even contribute to the weight reduction by assisting with fluid retention.
  
  
• New generation pills are more harmful then the older brands:
  Recently in the media there’s been a negative coverage of the never pills, Yasmin® and Yaz®, and the risk of stroke. Whilst some studies have shown a slightly higher risk of blood clots in women taking these birth control pills, this risk is still very low and much lower than the risk of developing a blood clot during pregnancy. Your prescribing doctor will make a detailed assessment of your individual risk and advice on the best option.
  
  
• It is not healthy to skip your period on a pill:
  Cycle control of the Combined Contraceptive pill is one of its many advantages. This means you can safely manipulate and even skip your withdrawal bleed. Just be aware that there is a chance of breakthrough bleeding or spotting when delaying your period by a month or two.
  
  
• During breastfeeding you can’t get pregnant:
  Whilst breastfeeding tends to suppress ovulation, particularly in the first 6 month post-partum, it is not a guarantee. Doctors recommend a back up contraceptive method during this time. One of the popular options is Progesterone-Only pill (Microlut®), which does not affect the flow of the milk.
  
  
• Morning after pill can only be taken 3 times in your life:
  If there are no contraindications to taking the emergency pill there are no limitations to how many times a woman can use it in her life-time. However, frequent use highlights a lack of effective contraceptive cover and it is best to speak to your doctor about suitable options for you.
  
  
• Herbal teas can stop the pill working:
  Generally, herbal teas do not interact with the pill’s contraceptive effect. Recently in the media there has been coverage of a slimming herbal infusion - Bootea, causing failures of the pill. This particular product has got senna in the night time formulation, which causes a laxative effect in the morning. In general, any laxative effect around pill-taking-time, may affect its absorption and therefore reduce the contraceptive cover.

Image credit: bigstock.com

What birth control method do you find most convenient? Have you got a question about contraception that we have not addressed in this article?

 

Polycystic ovaries or PCOS – What’s the difference?

Jun 27, 2015 - 7:46am

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A common confusion among women, is understanding the difference between having polycystic ovaries (PCO) and having been diagnosed with a Polycystic Ovarian Syndrome (PCOS).

PCO refers to an ultrasound scan image of the ovaries that appear to be polycystic (ovaries containing high density of partially mature follicles).

PCOS is a metabolic condition that may or may not come with having polycystic ovaries.In fact, to be diagnosed with PCOS a woman needs to have 2 of the following: 1) Polycystic ovaries appear on ultrasound. 2) Irregular periods. 3) Increased male hormone in the blood test or associated symptoms such as extra hair growth or acne. So if a woman has irregular periods and an increased male hormone she could have PCOS without her ovaries being polycystic. However, other conditions such as thyroid or pituitary dysfunction need to be excluded before PCOS diagnosis is made.

Although there may be some similarities in the names, the risks and medical treatments are very different for these 2 situations. PCO is a normal variant of a woman’s ovary, whereas PCOS is a diagnosed condition with short and long-term consequences. This article will outline the major differences between the two.

• PCO is more common than PCOS:
  PCO is more prevalent with up to a third of women of childbearing age having polycystic ovaries on ultrasound and no other symptoms. PCOS, on the other hand, affects 12-18% of women of reproductive age, with 70% of these cases remain undiagnosed in the community. (Statistics from: www.betterhealth.vic.gov.au)
• PCO is not a disease, whilst PCOS is a metabolic condition:
  PCO is a variant of normal ovaries, whilst PCOS is a metabolic disorder associated with an unbalanced hormone levels released by the woman’s ovaries.
• Women with PCOS are at risk of developing the associated short and long-term effects, whereas women with PCO are not:
  Women with PCOS should be aware of the associated risk which may include: diabetes, pregnancy complications (ie. gestational diabetes), cardio-vascular disease, obesity and endometrial cancer. Women with PCO do not have the same risk profile.
• PCOS has symptoms and is evident early in life whilst PCO has no symptoms and often discovered by chance:
  Whilst both PCO and PCOS have a genetic component, PCOS often start showing symptoms (acne, excess hair growth etc.) in teen years, due to the associated metabolic disturbance. PCO may also be present early in life, but since there are no symptoms, it is discovered incidentally during other health checks when the woman is older.
• Emergence of cysts in PCO may be caused by a variety of reasons as opposed to PCOS where is it linked to a hormonal disorder:
  Women with PCO may still posses the hormonal balance and continue to ovulate regularly. Whilst in PCOS, the hormonal balance is distorted which interferes with ovulation. In a large proportion of these women the mechanism is linked to high insulin release that stimulates the production of androgens from the ovary disturbing ovulation.
• Women with PCO can still get pregnant, whilst those with PCOS may struggle with infertility:
  Conception with PCO may not be difficult, however women with PCOS may have problems getting pregnant. In addition, women with PCOS have a higher miscarriage rates.
  
  Image credit: Bigstock.com
  
  Have you been told that you have Polycystic Ovaries? Has this article helped you to understand the difference between PCO and PCOS? We would love to hear your stories.

Polycystic Ovarian Syndrome and Fertility

Jun 24, 2015 - 12:24pm

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Polycystic ovarian syndrome (PCOS) is a common hormonal condition that affects about 10% of women of childbearing age. It is referred to as ‘syndrome’ because it has a wide range of symptoms and signs. It is one of the leading causes of impaired ovarian function and infertility.

 

What happens to ovaries in PCOS?

Normally, a number of follicles start to mature during each menstrual cycle and at least one follicle releases a mature egg at ovulation.

In a polycystic ovary more follicles are recruited and partially mature, but there is no release of  the egg. This means ovulation does not take place, as a result, a woman cannot get pregnant.

What are the symptoms of PCOS?

These dense number of immature follicles in the polycystic ovaries not only cause irregular periods and absence of ovulation, but the whole hormonal system gets out of balance producing other symptoms of PCOS.

Ovaries, normally, produce a small amount of male sex hormones called androgens. In PCOS, ovaries produce more androgens, which may cause acne, development of facial hair and mood swings.

In addition, PCOS is linked to a metabolic problem called insulin resistance, where the body is not able to use insulin well. As a result, more insulin is produced to regulate blood glucose levels derived from foods. These high levels of insulin further stimulate androgen production from the ovaries. 

What causes PCOS?

The exact cause of PCOS is unknown, but there is a genetic factor since it tends to run in families.

How is PCOS diagnosed?

PCOS can be difficult to diagnose since group of symptoms may vary from woman to woman. Firstly, the doctor needs to exclude all the other causes of your symptoms (ie. Thyroid problems).

Other investigations may include:

• Menstrual cycle history.
• Blood tests: hormone levels.
• Vaginal Ultrasound: check of the shape of your ovaries.

 

What lifestyle and dietary measures I could try for PCOS?

PCOS cannot be cured but certain steps can be taken to improve its symptoms. The aim of treatments is to restore regular menstruation and achieve pregnancy if desired. Healthy diet and exercise are the pillars of PCOS management, particularly if you are overweight. Being within a healthy BMI (Body Mass Index) 18.5-24.9 can help to balance the hormone levels and improve your symptoms. These positive changes work by stabilising the blood glucose levels and improve the body’s ability to use insulin.

Even a 10% body weight loss can restore regular periods.

 

What further treatment options are available from my fertility specialist?

If you are trying to conceive you may be offered the following treatments:

• Clomiphene – tablet form; stimulates ovulation.
• Gonadotrophins – injection; stimulates ovulation.
• Metformin – tablet form; increases your body’s sensitivity to insulin and helps to resume ovulation.
• Laparoscopic Ovarian Drilling (LOD) – this surgical technique works by destroying small amount of ovarian tissue that is producing adrogens and may resume ovulation short-term.

 

Monitoring by the specialist

Every woman has an individual response to a treatment and your doctor will be doing regular monitoring to check your response. Some of these checks may include:

• Ultrasound of the ovaries
• Ultrasound of the uterus lining thickness
• Hormone level blood tests

Final word …

Finding the best treatment suited to you can be a lengthy process.  If you are overweight, losing weight may assist your treatment outcome. 

Next time …

Stay tuned for my ebook coming up - Dietary strategies for PCOS symptoms and weight loss.

Image credit: bigstock.com

What PCOS symptoms do you suffer from? What measures have you found the most useful?

Should I bother charting my temperature changes in the cycle?

May 25, 2015 - 9:24am

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Some lucky women may conceive almost as soon as they start trying, whilst for others it may take longer. One way to increase the probability of pregnancy is to track your fertility cycle covered in one of my previous blogs. An additional method is to chart temperature changes during the month using Basal Body Temperature.

 

What is Basal Body Temperature (BBT)?

BBT is your lowest body temperature, which occurs before you get out of bed. A woman’s temperature fluctuates with the onset of ovulation and there is a spike before ovulation.

How do I measure BBT?

BBT is best measured with a digital basal thermometer first thing in the morning. A basal thermometer records temperatures in smaller degree increment changes verses fever thermometers. Methods to measure BBT include: vaginal, rectal or oral route.

Basal thermometer we recommend:

Surgipack 6335 Ovulation Digital Thermometer

How are temperature changes linked to my ovulation?

Before ovulation, a woman’s BBT is usually in the range of 97.2 to 97.7 degrees Fahrenheit or 36.2 – 36.5 degrees Celsius. Following ovulation, BBT increases by about half a degree in almost all women. Woman’s hormonal changes, post-ovulation, trigger an increase in BBT, which lasts until the next period. If a woman becomes pregnant, her temperature will stay elevated into the first trimester.

It is important to note that once the temperature rise happens post-ovulation, you have already missed your chance to become pregnant.

By recording your temperature every day over several cycles, a pattern should form similar to the chart below, narrowing down your ‘fertile window’.

How do I do it?

- Begin taking your temperature on the first day of your period.
- Take it at about the same time every day.
- Don’t do anything before you measure your temperature – move around, eat, drink.
- You can measure your temperature various ways, but oral measurements are the most convenient.
- Your measuring method and thermometer device needs to be the same throughout the cycle.
- Record your temperature everyday. Fertility apps are great for that - you just plug in the number and it charts it for you.

Chart from our recommended app - Monthly cycles:

Final word of advice …

Whilst BBT charting is a useful technique to boost the chances of conceiving, it not 100 percent accurate. Some women may struggle seeing the pattern in their recorded temperatures.

Furthermore, this technique may not be suitable for some women.

If ovulation occurs at different times in your cycle from one month to the next, the BBT chart may not be an effective way at predicting when you’ll ovulate.

Nevertheless, it is a cheap and a non-invasive method. So if you are willing to put in a little effort why not give it a go!

Let us now if you have tried using BBT charting.  Did you find it useful?

Our pick - free Ovulation Calendar App

May 18, 2015 - 2:51pm

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Tracking your menstruation cycle is important to get pregnant or avoid getting pregnant. There are just few days in each cycle that a woman can get pregnant - ‘the fertile window’. The most likely days to conceive are the two days before ovulation and the day of ovulation.

 

Why should I track my period cycle?

This fertility pattern is unique to every woman. Many women do not have the ‘perfect’ 28-day cycle with 7-day menstruation. Periods for most women last 3-7 days and the cycle can be as short as 21 days or as long as 35 days. Some women are lucky and get predictable menstruation length cycle every month, but most it is less regular.

If a woman wishes to get pregnant her ovulation window may vary and that’s when a period app is very useful. Ovulation apps estimate the date of your next period, based on the average number of days in your cycle. This way you have can estimate when your most fertile window is.

We have picked one free ovulation calendar app for the iPhone and iPad – Monthly Cycles.

Why do we love it?