Here is my guide for what to do.
Let’s get real. It sucks when we do everything we can in our power to make something happen, and it just doesn’t.
We try. We try again. And still we don’t get the result we’re hoping for.
If you’ve ever wanted to get pregnant, and have seen a negative result on the test, you know exactly what I’m talking about.
Month after month. Test after test. It doesn’t matter if it’s one month of trying or 2 years….
“Trying to get pregnant” can be painful, and the phrase itself is defeatist. The mindset it establishes is one based on fear, vs. love. I like to lead from a place of love, and encourage my patients to think positively.
For that reason, I advocate for replacing it with, “preparing for pregnancy.”
Doesn’t it just sound more peaceful, and open to the process? I think so.
Regardless if you are on board with my line of thinking, I do want to share some helpful tips and suggestions so that your path to pregnancy is as informed and efficient as possible.
Preparing for Pregnancy
Whether you’ve been preparing for pregnancy for one month, or twelve. It can be hard work and may make you feel depressed or confused. I’m here to tell you these feelings are normal, but please know that you’re not alone and there is hope. As always, talk to a fertility specialist about any concerns you have.
In the meantime, here are my top tips for preparing for pregnancy. More than tips, there are many questions I want you to ask of yourself and of the process.
My point of view is that the quality of your care can be impacted by the quality of questions you ask your doctor. Leave no stone unturned. Be an investigator of your own body!
My #1 tip for preparing for pregnancy is to NOT put blind faith in fertility apps.
Your phone doesn’t know when you’re fertile. TRUST me.
I have patients that say, “I felt like I was ovulating but the app said I wasn’t so I didn’t try.” Um, people, go with your gut! Don’t be a slave to your technology. You know your body better. You = human. Phone = not human.
Instead, I suggest listening to your body, tracking your cycle, and verifying timing through a simple ovulation predictor test. I recommend this one to my patients.
Tip #2: Develop a resilient, and positive mindset.
My personal mantra for when I see a negative or even have something that causes me to feel a little anxious in my life is the following:
Let it Go.
And then…Let’s get this party started.
And yes, I recognize these are all song titles to platinum selling songs. Thinking in songs makes this crazy life a little less stressful for me so maybe it will work for you too?!
To be clear. This mantra is not meant to be a finger pointing at you directing you to “just relax” or to “chill out”. That’s not my style. I’m in no way saying that.
Part 1 of the mantra is simply to breath. Really, that’s it! Science shows that mindful meditation and deep breathing can reduce stress levels.
Part 2: Let it Go. Just like Elsa. Don’t dwell on the past. Certainly use the past to inform your decision making process but don’t for one second go down the Debbie downer route of, “ if this didn’t work then nothing else will work… and my body is broken… and why me?” You get my point. That kind of thinking is unproductive. Just let it go.
Lastly, like PINK sings, “Let’s get this party started.” Live life to the max. No matter how you’re feeling on the inside consider actively embodying a mindset of joy, and perhaps your body will listen. Be so happy that you sparkle: make happiness sparkle. (If you’re rolling your eyes, I get it. This stuff is way easier said than done, but it’s important to be said and even more meaningful when you just do it!).
Tip #3: Make use of science (diagnostic testing) to understand what could be preventing you from getting pregnant. Oh, and ask questions. Lots of them!
This tip is relevant for those looking to get pregnant on their own or through IVF.
If you don’t already know your fertility levels or fertility diagnosis, now is a good time to find out.
Get a fertility screening exam with your local Reproductive Endocrinologist (fertility expert). You can also go to eggwhisperer.com and I can help you from there. It takes 3 things to have a baby: egg, sperm and fallopian tubes. All three need to be working. Understanding if there are any challenges in these three areas will help dissect why you may be getting a negative pregnancy test.
If you did IVF or IUI and did not get pregnant:
If you’re working with a doctor already, and are going through IVF treatments that aren’t successful, sit down with your doctor after a negative result and ask yourself:
- Why do I think I didn’t get pregnant?
Would your doctor do anything different with the dose or type of medications you were on to prep you for the cycle, during and after the cycle?
Your doctor may want to change the type of cycle she put you on and may want to increase or decrease your dose of medications. Or your doctor may want to add a medication that wasn’t used before. Asking these questions will help optimize your chances next cycle.
- Should you try testosterone priming, estrace priming, natural cycle start, birth control pill start? Are there additional supplements you should add to improve egg quality? What about HGH?
Depending on what was used to start your IVF cycle ask why that protocol was chosen and if it should be changed for next time.
Once you were in treatment:
- How many eggs were you expecting to get?
- How many eggs did you get?
- How many were mature? Mature eggs are the goal in an IVF cycle. You want as many mature eggs as possible because the mature eggs are what will get fertilized by sperm and result in embryos.
- Did your hormone levels rise during your cycle as expected?
- How many eggs were fertilized? Is this what you expected? How were your hormone levels during the cycle?
If you did not do ICSI, ask if your doc would recommend ICSI (procedure done where the sperm is injected into the egg) the next time. If you did do ICSI ask if you should still do it the next time.
- Should you consider advanced egg DNA tests or Sperm DNA tests?
- What was the quality of embryos transferred?
- What is the typical success rate given the quality of embryos you had transferred?
- Were they genetically normal or not?
- How many embryos were transferred?
- Would you transfer the same number of embryos the next cycle or increase the number of embryos transferred?
- What day were the embryos transferred on?
- Does your doctor recommend a fresh or frozen transfer next time?
It’s important that you know the answers to these questions so you feel as informed and in control in a scenario where at the end of the day, it’s all up to nature after you’ve used all the science you can.
- How did the embryo transfer go?
Or if you did IUI? How did that go?
- What was the sperm quality like?
- Was it timed perfectly?
- Should you consider a double IUI next time?
- Are you using lubricants at home that could be sperm killers?
- Was the transfer more difficult than expected?
- Was there a difficult time getting the catheter through the cervix?
- Is there anything you would do differently at the time of transfer looking back? Like abdominal ultrasound guidance, or doing the transfer under anesthesia?
- What about taking valium or doing acupuncture before and after the transfer?
Ask your doctor if you can discuss your case with the embryologist. The embryologist may have insight as to what went wrong and what could be improved upon or what was learned from the cycle. Make sure you have a copy of your embryology report and you get your questions answered.
Think about the following:
- Have my fallopian tubes been evaluated?
- Is there a chance that I have a hydrosalpinx (fluid in the tubes)?
- Has my uterine cavity been evaluated?
- Is there a chance that I have a uterine polyp in my cavity that is affecting my pregnancy chances?
- Should I do implantation testing?
If you didn’t do acupuncture, ask about what role acupuncture may play in your treatment cycle. It may help you.
Tip #4: Talk to your doctor about things you can do that are in your control like lifestyle and diet.
Should you work toward a healthier BMI?
Or are you exercising too much and should reduce the intensity and add weight (if your BMI is < 19 for example)?
Perhaps you and your partner (if you have one) should consider being sober (I often say sober is sexy) because for some people stopping all together is easier than just having a drink.
And lastly, what about your environment? Household items may have an impact on your ability to get and stay pregnant.
If you’re a patient of mine, I will review all this with you as you’re doing treatment with me. You’ll know why we’re doing what we’re doing, the pregnancy rate associated with the treatment and the expectations from each treatment cycle.
You can take these tips and questions to your next appointment and hopefully you’ll understand more about your fertility than ever before. There’s no such thing as “unexplained fertility.” Only “it hasn’t been explained to you enough!”