- Clean up your life!
While we neither want to sound like your mother nor tell you to “clean up your room,” now is a good time to take note of your habits and eliminate some of your most unhealthy ones. Although we don’t want you to throw everything fun away, we do suggest cutting out the excesses. Maintain (or initiate) a healthy diet, try and catch some good zzzzs, and engage in exercise. Honestly, you should be doing this anyway (do we sound like your mother yet?), so why not get the process started before your plus one is present?
- Make sure you are taking a prenatal vitamin.
Whether you are pregnant, considering pregnancy, or are nowhere near wanting a baby, vitamins are a good thing. Despite our best efforts to maintain a well-balanced diet, we usually are missing something. Prenatal vitamins are chockfull of good things (for both you and your baby). Generic or prescription, brand name or basic really doesn’t matter (especially in the “trying” phase). Most have the same ingredients and are equally good at giving you what you need.
- Establish care with an OB/GYN that you gel with.
The doctor-patient relationship is an important one, no matter what body part you are taking care of. However, the OB/GYN-patient relationship is particularly unique; they will be there when you bring life into this world! They will likely be your coach and your confidant through some pretty amazing and sometimes tough times. So while they don’t have to be your BFF, they should be someone you can see yourself spending a lot of quality time with.
- Invest in reliable reading material.
You will no doubt have at least several hundred questions when the process begins. When do I have intercourse? What are signs that something is off? How will I know if the pregnancy is normal? Why do I feel like this? All are totally normal! And while your doctor is there to offer advice, sometimes those questions hit in the middle of the night. Finding a good book or seeking out a reliable online source (#truly, MD) can be a smart idea.
- Take a deep breath.
Even saying the words out loud: “We are ready to have a baby” can be overwhelming and frightening. Although it may take some years to get to this point while others reach it in a minute, vocalizing this statement is a big deal. The fact is, you are not alone. Most of us are never really ready and don’t have any idea what to expect. Just take it one day at a time. You will get through this and maybe even have some fun along the way!
A fertility work-up is no walk in the park. It requires getting poked and prodded as well as scanned and surveyed. It’s an involved process. We are not doing this to torture you or to make the experience any more exhausting than it already is. We are doing it because there are a lot of aspects to investigate when trying to see where and why the fertility puzzle pieces are not fitting together. You have ovaries, tubes, and a uterus (in addition to many other non-fertility-specific organs). While they all don’t need to be batting a hundred for pregnancy to occur, they do have to know how to swing the bat and run the bases in order for you to get that coveted home run.
Any test that can do two things at one time is an obvious grand slam. The fertility testing and subsequent treatment takes A LOT of time out of your busy lives; anything we can do to streamline it gets two big thumbs up. The hysterosalpingogram (often referred to as the HSG or that “awful tube test”) can evaluate both the tubes and the uterus at the same time. It is an X-ray that uses radiopaque dye to evaluate these structures.
Not to sound like Google Maps (take a right at the light, and go 4.4 miles), but by infusing dye through the vagina, into the cervix, and hopefully into the uterus, it will find its way out of the tubes and into the pelvis. During the dye’s travels, we can learn a lot about what’s going on inside. So while the test may not be anyone’s idea of fun, it does kill two big birds in the infertility work-up with one stone (not sure where that saying came from…who really wants to kill two birds?).
Despite the information gleaned from the test, we have a breaking news update—the HSG is not perfect. It is limited in its ability to assess function. While it is pretty darn good at telling us if things (a.k.a. the tubes and the uterus) are open, open does NOT equal functional. In other words, while the test may say the tubes are OPEN (liquid can travel through them) that doesn’t guarantee that a sperm and egg can find each other, and as a unit (aka an embryo) make their way back to the uterus. Therefore the results of the HSG should not be assessed in a vacuum–your medical and gynecologic history are important when deciding if the tubes are tunnels that can be easily traveled.
The best time to undergo an HSG is in the early half of your cycle—think day 5 to day 11. This is done to make sure that you are not pregnant; dye and X-rays are not baby-friendly. It’s also important that your doctor KNOWS your medical history before you go; women with a history of pelvic infections or other serious abdominal surgery or disease are in need of some pre-HSG precautionary antibiotics. Additionally, if you have an allergy to iodine, make this well known to anyone and everyone; due to the dye used, an HSG is not right for you.
We all need a complete check-up every now and again; our hearts, our heads, our intestines, our kidneys, and our bones need to be checked out before they can be checked off (at least for that year). Same thing goes for all the structures/organs involved in the reproductive system. Things aren’t always as they seem. For instance, just because you don’t ovulate doesn’t mean you can’t also have a blocked tube. Simply stated, get your tubes checked out before you check the box for what’s causing your fertility problems. Things aren’t as “simple” as they seem.
While some pathology can be what we like to call “incidentalomas” (medical way for saying we found it while looking for something else and are not sure how much meaning it has), if you see it, you should deal with it. You don’t want it to be your deal breaker once treatment starts to progress.
No one looks forward to a dental cleaning. No one looks forward to a colonoscopy, and no one looks forward to a Pap smear (we don’t either!). But they are necessary to get that clean bill of health. Think of the HSG for the tubes and the uterus in the same way; they are necessary to get your fertility clean bill of health. The good news is, if it’s normal, you can check two boxes off of your never-ending to do list. Isn’t that efficient?
Our lives are filled with stress. Busting at the seams, boiling over the top, big-time stress. Will I get there on time? How can I pay the bills? And what can I do to improve my health? It never seems to end. From the moment we open our eyes to the second our heads hit the pillow, we have found hundreds of things to stress over. We even stress over the weather!
How we deal with that stress and remain positive and productive can be difficult. Succumbing to the anxiety and negative emotions can be tempting; in many ways, it is easier than powering through, becoming stronger, and seeing the positive. Difficulty conceiving can rock the core of even the toughest individuals. Getting a negative result month after month can bring anyone to her knees. And the more negatives you get, the more stressful the situation becomes…stress on top of stress on top of stress. It would drive anyone crazy. Finding ways to relieve this stress, quell your anxiety, and cope with the situation at hand is key.
It seems pretty clear that stress plays some role in infertility. How big or how small is hard to define, as it is difficult to study the impact of stress on infertility. But there is definitive evidence that stress levels influence the outcome of fertility treatment and contribute to a patient’s decision to remain in treatment. Trying to get pregnant can be stressful; when something that you thought would just happen doesn’t, it can be incredibly difficult to deal with. And as you get deeper into the world of infertility, from Clomid to IVF to egg donation, studies show that the level of stress rises.
In a large study, more than 50% of women reported that infertility was the most upsetting experience of their lives. It was likened to a cancer diagnosis. After a failed cycle, most women reported feelings of depression, anxiety, anger, and isolation. Bottom line, it sucks. And it often sucks so bad, patients quit. They stop the race and pull off to the side of the road before hitting the finish line.
While it has always been assumed that the brake was a financial or medical reason, data shows that it is actually the emotional stress of the situation. In countries where IVF and fertility treatment are paid for by the government, patients still veer off the road (and not for a pit stop, but for a total stop) before using up all of their free cycles.
What is even more of a bummer is that, for most women, the longer you stay in the game, the better your chances are of scoring; the chance of success (having a baby) increases over time (more treatment cycles). This is not the place to quit while you are ahead. Rather, don’t quit until you have succeeded. The exception is when your doctor has deemed it medically unadvisable, given a poor prognosis.
One of the most common questions we are asked is “Is my stress causing my infertility?” The answer is flat out, without a doubt, no. Your stress, your eating habits, and your activity level are not causing your infertility (extreme situations aside!). You are not the culprit. You did not cause this. You did not make this happen, so stop blaming yourself. Don’t forget about self-compassion. You have compassion for your partner, your friends, and your co-workers, but not enough compassion for yourself. You beat yourself up for every failure, every loss, every bad event; doing this won’t change the situation.
Developing the skills to accept the situation, to stop fighting the outcome, and to move forward can often be the difference between success and failure. How this is accomplished can be different for different people. While we all have the image of the therapist on a couch, there are many different forms of counseling and types of psychological interventions. Use whatever works for you because if it works in not getting you worked up, it will likely have a positive effect on your treatment outcome and even improve your chance of pregnancy.
Do what relaxes you. Whether that be running, reading, or riding, if it relaxes you, it is good for you. Don’t sit around stressing about your stress…if you stress about stress, then you will just have more stress! We all find our inner peace and meditate in different ways. Not all of us do this on a couch. For some, it’s out on the track; for others, it’s in a house of worship. For many of us, it’s toasting with good friends. But what makes you Zen is what makes you stronger, calmer, and more skilled to cope with what lies ahead.
The road may be long and filled with lots of ups and downs. Developing the tools to navigate this unpaved path will not only allow you to stay on the road but also may make for a more positive outcome. Finding the right tools can be challenging, but the options are limitless. Explore meditation, yoga, exercise, acupuncture, support groups, cognitive behavioral therapy, and in some cases medications. Something is bound to fit.
Unfortunately, there will always be things to worry about, from the banal (Will I make the next train?) to the critical (Will my loved one survive this deadly disease?). Some will turn out good, and some will turn out bad. Learning to accept the unknown and recognizing that you have done all that you can will help alleviate a great deal of stress. Remember, you can’t live life in reverse. If you knew what was going to happen tomorrow, you would probably live your life differently today.
We are certainly not here to echo the words of your friends and family who say “If you just relax, it will happen,” because in all honesty, it might not. And your stress is likely not the reason you haven’t gotten pregnant. But it will make the situation worse and possibly have a negative impact on your fertility treatment. Take a deep breath, let it out, and do it again. You can get through this, and you will get through this. Turn your stress into something positive, and kick infertility’s behind!
Disclaimer: We do not endorse any one method or brand. We will attempt to remain as impartial as possible and give you the many ways mamas to be can make sure they are ovulating.
- Symptoms: Straight-up symptoms such as breast tenderness, bloating, and one-sided abdominal cramping mid-cycle (a.k.a. Mittelschmerz) are some of the simplest ways to predict if ovulation is occurring. That feeling that you get before you get your period but after you ovulate is due to the progesterone! If you feel this, you are likely ovulating and making progesterone.
- Regular Menses: If your period is more on time than planes landing at O’Hare, you are almost for sure ovulating. The cadence and regularity of the menstrual cycle is set by ovulation—the signals sent from the brain to the ovaries ultimately make their way to the uterus. In response to these signals, the lining of the uterus is shed in a predictable pattern. By association, you can see that, if the ovaries are doing their job and ovulating, then your periods will be regular.
- Basal Body Temperature (BBT) Charting: Your temperature charting looks like a convicted felon’s polygraph test. If there are pretty predictable highs and lows, you are likely ovulating. Progesterone is a “hot” hormone. Therefore, after you ovulate, your temperature will rise. It will remain elevated as long as progesterone is on board. If pregnancy is not achieved, the corpus luteum will break down, and with it, a drop in progesterone and your temperature!
- Cervical mucus changes: Although most of us have not paid any attention to what our cervix is producing before we cared about progesterone and pregnancy, cervical mucus changes are a pretty good way to predict ovulation. The cervical mucus changes throughout the cycle ultimately become a more hospitable and welcoming place for sperm (after ovulation, it goes back to being uninviting once again). The changes are not only evident to the sperm but also evident to you (if you track it from the beginning to the middle to the end of your cycle), if you pay close attention.
- Ovulation Prediction Kits (OPK): It’s hard to walk into a drugstore without seeing an OPK. They seem to hang out next to the pregnancy tests—and as you can imagine, this can be sort of frustrating. Their popularity comes from their ability to predict ovulation and help couples time intercourse. By measuring the LH level in the urine (LH is the hormone that leads to ovulation), you can pretty reliably predict when or if you are going to ovulate. Although a small percentage of women (about 7%) will get a false positive—the test says you’re ovulating but you’re not—for most women, it is a pretty reliable way to predict ovulation.
- Ultrasound measurements: Serial ultrasounds done from pre- to post-ovulation are another way to confirm ovulation. The presence of a large follicle followed by the absence and then the presence of a corpus luteum lets you know ovulation has occurred.
- Progesterone level: The queen of ovulation confirmation is checking a serum (blood) progesterone level. Anything greater than 3 ng/mL (nanograms per milliliter for the science buffs!) in the mid-luteal phase is a positive. Note the boldfaced mid-luteal; timing is important when checking your progesterone. Day 21 is not day 21 for all of us! Make sure to mention how long your cycles are to your doctor before getting your blood drawn. And although we all obsess over what the level is and how high is too high and how low is too low, all we are looking for is a positive result to confirm ovulation.
So you see, there are really plenty of ways to know if your body is producing progesterone. Some are costlier than others, some are more labor intensive than others, and some are more accurate than others. But whatever you choose to check the ovulation box, it’s important that you do something to cross it off the list.
Confirming ovulation is an essential part of any fertility work-up. It may seem basic, but without an egg, there can be no embryo! Good news is that, when women have ovulatory issues, they usually have a ton of healthy eggs just hanging out waiting to be released, and we have lots of ways to persuade those eggs to come out! We just have to see why they are being so shy and what we can do to coax them out of their shell!
Finding out that you have infertility is no piece of cake. It can knock you, shock you, and rock you in a way nothing else can. Why me? What did I do? How did this happen? The questions are endless. And while we may not be able to give you individual answers (at least not right now!), we can tell you what is most likely (in percentages and rates) to be hampering your efforts.
Infertility and its various causes (e.g., low ovarian reserve, ovulatory dysfunction, tubal damage, uterine issues, sperm abnormalities) are often depicted in the medical literature and medical textbooks as a pie chart. And a pie chart for all of you who have been away from math and statistics for some time is a circular statistical graph that is divided into slices. Each slice represents a different piece of the overall pie (a.k.a. the problem you are analyzing). Therefore, the bigger the piece, the bigger its contribution to the issue at hand.
Whether you prefer apple, blueberry, or peach, close your eyes, and picture a pie. Now substitute infertility for whatever fruit you are envisioning, and let’s cut it up.
~ 35% of infertility is “female related.”
~ 25% of infertility is “male related.”
~ 10% of infertility is unexplained.
~30% of infertility is due to both female and male issues (a.k.a. combined).
Keep in mind that percentages are like pieces of pie; cutting is not an exact science. Depending on the study or the reporting agency, numbers can be slightly higher or lower.
Now it’s pretty rare that you go to a party and there is only one dessert (or pie) option. How can you leave the blueberry crumble behind when walking away with that peach cobbler! The same goes for infertility pie graphs—there is usually one that represents the percentages for all causes of infertility, one that represents the percentages for all female causes of infertility and one that represents the percentages for all male causes of infertility. Take a bite out of these numbers.
For causes of female infertility, the numbers are as follows:
~ 40% of female infertility is due to ovulatory disorder (includes ovulatory dysfunction and diminished ovarian reserve/failure).
~ 30% of female infertility is due to tubal/peritoneal disease.
~ 15% of female infertility is due to endometriosis.
~ 10% of female infertility is unexplained.
~ 5% of female infertility is due to uterine disease/cervical disease.
For causes of male infertility, the numbers are as follows:
~ 35% of male infertility is unexplained.
~ 15% of male infertility is due to varicocele (s).
~ 10% of male infertility is due to hypogonadism (low testosterone).
~ 10% of male infertility is due to urogenital infection.
~ 8% of male infertility is due to an undescended testis.
~ 5% of male infertility is due to sexual dysfunction.
~ 15% of male infertility is due to other causes (immune and systemic diseases).
However, just as there is variability in pie size (give or take a few slivers!) for the percentages of overall infertility diagnosis, the same can be said for female and male causes of infertility. Cutting is most certainly not an exact science!
Additionally, just as no two pies are baked exactly the same, geography matters big time in the pie percentages—it can seriously flavor how big each slice is. For example, in large metropolitan cities where women delay childbirth, you are going to see a much bigger percentage of women experiencing ovarian dysfunction rather than tubal disease. So while percentages and pie slices are helpful, take it with a grain of sugar.
We as fertility specialists have always likened ourselves to the dentist. (No, your eyes are not deceiving you; we did say “dentist”!) This is not because we know anything about teeth or work even remotely around the same part of the body, but because seeing a fertility specialist like the dentist is usually something most people dread, delay, and don’t really want to do. Who likes going to the dentist? (Sorry to all of you dentists out there. It’s not personal; we just have very bad teeth!) What will they say, what does it mean, and what will it cost? The anxiety of “could be” can paralyze you and keep you from simply making, let alone keeping, an appointment until you are way past due. But just like that hot/cold sensation you have ignored, unprotected intercourse without a pregnancy for months, maybe even years, means something is not right. Cue the fertility specialist.
Whether the pain will wind up being a simple cavity, a root canal, or an extraction, you won’t know until you come in. But unlike those yearly “time for a cleaning” reminders your dentist sends, you won’t hear from us unless you come here to see us. The onus is on you. And knowing when to call it quits with the natural way can be confusing. To alleviate some of that anxiety you feel when putting us in your Google calendar, let us prepare you for what to expect when you finally sit in the chair.
First and most importantly, by admitting that there might be something wrong and making and keeping the appointment, you have already made some serious progress. You should stop, take a deep breath, and pat yourself (and your partner on the back) just for walking through those doors. It takes a lot of courage. In many ways, the first meeting may be like pulling teeth: talking about sex, timing, frequency, pelvic pain, periods, bleeding, and erections can be hard (to say the least).
And in order to have a good idea about what may be causing the fertility problems, we need to hear it all. Although we won’t fill your mouth with cotton and wax and then ask you questions (why do dentists do that?), the conversation can be somewhat difficult. Couples often feel shame, anxiety, and embarrassment when dealing with infertility. But you need to let these emotions go (admittedly easier said than done!). They will only hinder your ability to find out what’s going on and to treat it.
One of the most crucial parts of this first meeting is to make sure you feel comfortable with the doctor you have chosen. If it feels off, then you should probably go elsewhere. This relationship can be a long and winding road. Make sure you are comfortable with those driving the car. After we chat, we will usually start the checking process. In most fertility clinics, the doctor will do an ultrasound to look at your ovaries and your uterus. They are checking for things like antral follicle count, ovarian cysts, uterine fibroids, endometrial polyps, and what we like to call “other intruders.” The “other” category consists of abnormal things (fallopian tube dilation, pelvic fluid, masses) that shouldn’t be there. While many of these abnormalities are common and nothing to go crazy over, they can impact your fertility. Identifying them early in the game can limit the amount of time we are playing this problem out.
Following the ultrasound and physical exam, we will recommend a slew of blood tests (close your eyes, needle-phobes!). These will allow us to have a better understanding of things like ovarian reserve (how many eggs are remaining in the ovaries), ovulation, and thyroid function. Think FSH, Estradiol, AMH, TSH, prolactin, and progesterone. In our attack plan, these are like pieces of intelligence that shed light on where the enemy is hiding. They are essential to completing the full fertility evaluation. Rome was not built in a day. Similarly, the fertility work-up can take about one month to complete. Many of the tests (blood and other) must be done on a specific day of the menstrual cycle. Your time and our time may not be fully in sync when we first meet, and as a result, it can add a few weeks to the evaluation process.
In addition to talking and checking blood levels, we are also going to want to check your fallopian tubes and uterine cavity (test: hysterosalpingogram) as well as your partner’s sperm (test: semen analysis). While in certain circumstances, the diagnosis is clear after our first discussion (e.g., female age, no periods, or no male partner), completing the whole fertility work-up up front is really the most efficient, most effective way to go about it. Just because you don’t get regular periods does not also mean that your fallopian tubes can’t be blocked. It’s better to know all the demons you are dealing with before deciding on a treatment option. While your doctor should be in touch as the “deets” come back, you should plan to sit down for a debrief once the work up is complete.
Unlike dentists, there is not much we can do on a daily basis to prevent future fertility problems. There is no fertility equivalent to flossing, brushing, and whitening—daily maintenance will likely not change what happens in the future. While healthy living, eating, and exercise is good for all parts of the body, they may not protect your reproductive organs. However, knowing that things can decay and need attention is half the battle. If pregnancy has not happened after six to twelve months of trying (depending on age and other medical factors), it’s time to schedule that cleaning. And if you have certain risk factors for infertility (endometriosis, family history of early menopause, irregular periods), you should go even sooner. While we may find nothing other than 32 pearly whites (or the equivalent in the fertility world), it’s important to have an evaluation, at the very least. Early attention can prevent cavities from becoming root canals! Let us take a look and see what’s going on.
Caffeine is key; ask any woman what moves her from bed to car/subway, office to a workout, and shower to dinner, and most will say coffee. Hot, iced, sugared, and frothed, it can motivate even the most sluggish of us to complete and power through our daily tasks. And more than the much-needed jolt that joe gives, it’s the warmth of the cup, the smell of the beans, and the smile from your corner barista that makes the morning routine one of our favorite parts of the day.
Questions about caffeine from bleary-eyed women who have been incorrectly instructed to quit flood our desks on a daily basis. But start brewing your beans, because we are here to say caffeine is not the culprit. While a cup a day may not keep the doctor away, it will likely keep you sane, keep you awake, and keep you functioning!
While caffeine has been deemed the devil in many pop culture forums for women struggling with fertility, there is only modest medical data to support this notion. Again, that age-old adage, “Anything in moderation,” is the key. Moderate caffeine consumption, defined by the American Society of Reproductive Medicine (the Holy Grail of most fertility doctors) as one to two cups a day (or the equivalent of about 100 to 200 mg per day), does not appear to increase a woman’s risk of infertility or poor pregnancy outcome. Now, to put this in perspective, when the street vendor on the corner serves you a medium cup, this is about 100 mg. Starbucks is a whole different story. Because we, too, are crazy caffeine addicts, this is one myth that we have already decoded. So here’s the skinny on Starbucks (and all other spots to fuel up!):
Espresso shots (think Americano, cappuccino, latte) have about 75 mg of caffeine. So if you go for a tall cappuccino, you will be having one shot, a.k.a. 75 mg of caffeine (totally acceptable). Even if you bump it up to a grande (two shots), you are still within the acceptable range (150 mg). Now, this may come as a surprise (it did to us), but the brewed coffee carries a much heavier caffeine load. A tall hot coffee has approximately 260 mg of caffeine! Size that up to a venti hot coffee, and we are talking 410 mg of caffeine. If you are more of an iced kind of a girl, size seems to matter less. A tall iced coffee will run you about 120 mg, while the venti has 235. So here, double the size does not double your caffeine load.
Although the medical data are limited, women who consumed high levels of caffeine (defined as greater than 500 mg a day or five cups/day) appeared to have a higher risk of infertility. There is also a concern that the babies exposed to these higher levels of caffeine will be delivered earlier and will be on the smaller side. This is not true when you stay under the two cups per day level (unless those two cups are venti coffees!).
How you get your caffeine is something to consider. While coffee and tea have not been clearly linked to infertility or miscarriage, sodas (both diet and regular) are not our faves! Yes, although we too break and grab a diet soda every now and again, the other chemicals fizzling in that carbonated beverage may not be what you need to quench your reproductive system with. But the long and “breve” of it is that caffeine is not the enemy and probably not the cause of your fertility struggles. While you may want to rethink that extra shot, your morning cup can continue to be consumed when you’re trying to conceive. (Try saying that seven times fast. It definitely can’t be done without caffeine!)
Alcohol has been lauded and lambasted when it comes to health issues. The tide can turn so fast on spirits that it’s difficult to know whether that glass of red wine is going to make you live forever or take a few years off your life. However, while the medical benefits of daily consumption are still murky, what’s on the minds of many reproductive-age women is: does a glass a day really keep the baby away? The answer is, unless you have a really heavy hand, probably not.
While alcohol in excess is a no-no for a pregnant woman, there is not much out there on what it does (if anything) to one’s fertility. It has not been shown to decrease egg quantity or quality. Additionally, it has no impact on a woman’s ability to ovulate, the function of her fallopian tubes, or your partner’s sperm. In moderation, it has not clearly been linked to infertility or miscarriage. In fact, some studies have shown that women who drank wine conceived at a faster rate than those that didn’t!
But this is where who’s pouring is important. Moderate alcohol use is defined as less than two drinks a day. In most studies, one drink is equal to 10 grams of ethanol. But (as many of us have found out the hard way) not all drinks are created equal, and therefore, who’s mixing your cocktails matters.
Here’s a cheat sheet…In the United States, a standard drink (12-ounce beer, 5-ounce glass of wine, 1.5 ounces of distilled spirits) has about 14 grams of pure alcohol. Bottom line, before you go bottoms up, be aware of what you are imbibing.
Too much of anything is not a good thing. And while a big night out once in a while is not the end of the world (let’s face it, this is probably the cause of many unintended pregnancies!), limiting alcohol consumption is a good idea. Although you certainly don’t need to put away those wine glasses when trying to conceive, be smart about how much and how frequently you imbibe (and don’t forget, there is no safe amount of alcohol consumption in pregnancy). But if the bubbly is what keeps you bubbly, that’s ok; it’s not blocking you from having a baby. This fertility journey can be long and rocky; a few drinks along the way will most certainly not derail you.
- You get your period as often as the White Sox win the World Series (meaning about once a century).
Irregular menstrual cycles (medically termed oligo-menorrhea) are a hallmark of PCOS. In fact, they are usually the main reason women with PCOS come to visit their GYN in the first place. Why, you may ask, are the cycles so off? The reason is, simply, wiring…in women with PCOS, the signals being sent from the brain to the ovaries are off. Without clear instructions from their boss, the ovaries are sort of lost. They don’t know how or when to produce an egg, and they certainly can’t figure out how or when to release one. Irregular or complete lack of ovulation (medically termed oligo– or anovulation) leads to wacky and infrequent menstrual cycles.
- You see your waxing lady more than your best friend.
Elevated androgen levels (think male hormones) are very common in women with PCOS. Elevated androgens = elevated hair content (and not on top of your head!). More hair in not the most fun of places (lip, chin, sideburns, chest, and stomach, to name a few) means more visits to either the threading, waxing, or laser place. Unfortunately, most of these treatments are temporary, and unless you can lower the androgen levels in the blood, you will find yourself lying on that table forever.
- You have sampled every over-the-counter and prescription skin care product out there, and you still find yourself lathering cover-up on pimples.
Fun fact: androgens not only cause abnormal hair growth, but they also cause acne. Oh, what a joy! The same culprit that caused you to fight facial hair is also public enemy no. 1 when it comes to pimples.
- You look at a sugary snack and gain five pounds.
PCOS not only involves crossed signals from the brain to the ovary but also with insulin resistance and glucose metabolism. With insulin resistance comes high glucose and straight-up sugar intolerance. Problems with glucose metabolism leads to diabetes and obesity—not a sweet situation!
- You have taken so many ovulation prediction kits without ever once seeing a positive that you should own stock in the company.
If you have PCOS, ovulation predictions kits are not your friend. They are pretty poor in interpreting the message your ovaries are sending out and will likely do nothing more than drive you crazy—and into poverty. They simply don’t work. And why they don’t is not because the tests don’t work but because the ovaries are not working and not ovulating. So do yourself a favor, and don’t waste your hard-earned cash on these kits!