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Navigating Your Fertility Journey

When people have trouble conceiving, they may feel overwhelmed. They have to sort out a lot of medical advice and scientific information, and they also may be uncertain about next steps. They understandably might feel sad and alone. But the truth is an estimated one in eight couples have difficulty conceiving, and a variety of fertility services and support groups are available.

When considering infertility treatment, you can take steps beforehand to make the infertility journey smoother and help you find the best treatment for your own situation.

1. Build family goals

Joseph Letourneau, MD, a fertility specialist at University of Utah Health, believes the number one thing for people to think about are their goals for building a family and what types of treatment options they might want to consider.

The importance of these discussions has been the subject of recent research, such as a 2017 research study published in Reproductive Health, where men and women ranked family building priorities a bit differently. These priorities weren’t often shared until fertility treatment was sought. Topics for discussion include:

  • Importance of passing on the genes of either parent
  • Timing of starting a family
  • Maintaining a close relationship with each other
  • Side effects of infertility treatments
  • Financial concerns and goals
  • Balancing priorities while seeking treatment.

2. Know your menstrual cycle

Understanding your menstrual cycle is key to identifying ovulation and the best chance for conception. Letourneau cautions about the ovulation predictor kits that are on the market.

“One thing to be aware of is that an ovulation kit will only identify two out of three women who are ovulating,” he explains. “It's actually a predictor kit, so it's going to predict that ovulation is coming the next day in general. But many women still ovulate and don't get a positive result.”

The kits can also give false positives for women with PCOS (polycystic ovary syndrome), women with very low egg counts, and women who are taking medication to help them ovulate. Letourneau believes that using such predictor kits can sometimes be stressful.

He explains that typical cycles are 24 to 35 days in length, with ovulation occurring about 14 days before the onset of your next period. Eggs live for 12 to 24 hours, while sperm can live for two to five days in the reproductive tract. “It’s okay to get the sperm to the fallopian tube early,” he says. “And it’s possible to get pregnant the day after ovulation.”

He suggests that couples identify what day is likely 14 days before the beginning of the next period and have intercourse on days 10-15. Because of the length of time the sperm can survive, intercourse every other day is considered sufficient.

“If having intercourse regularly around ovulation time for a year does not result in pregnancy, then maybe it’s time to see a fertility doctor,” Letourneau says. “That is considered the rule of thumb at least for those under age 35.”

He suggests, however, that people seek treatment right away if:

  • A couple has knowledge about the male partner having a low sperm count
  • Either partner has gotten cancer treatment
  • The female partner has irregular periods and may be ovulating infrequently
  • There is indication that the female partner has blocked fallopian tubes.

Between ages 35 and 40, Letourneau suggests you seek help if you have had unprotected intercourse for six months and have not conceived. For those 40 and older, he suggests you see a fertility specialist even as you are beginning to try to conceive. Fertility doctors also provide treatment to same-sex couples and single men and women who want to build families.

3. Do your own research

Before seeking treatment, research the different types of infertility treatments available and the biology behind conception and infertility. It can also be helpful to see what kind of infertility-related coverage your health insurance provides. Twenty states now have mandated insurance coverage for fertility treatment, but states vary in what must be covered, the type and number of treatments covered, how long a couple has been infertile, and whether same-sex couples or single individuals are covered.

Don’t believe everything you read on the internet or hear from others. Seeking advice from “Dr. Google” has become a national pastime when health conditions are a concern. Letourneau advises those trying to conceive to not take every bit of advice to heart. Some articles and online posts have suggested everything from taking a baby aspirin daily to ingesting safe amounts of cough syrup to thin the cervical mucus. Others focus on exercise or special diets. While exercising more and eating fewer refined carbohydrates certainly won’t hurt and can lead to a healthier lifestyle, they haven’t been scientifically proven to make a difference in conceiving a child.

4. Find your own support group

Not being able to conceive can be extremely stressful, especially if there is a clear infertility diagnosis, which research shows can be as stressful as a cancer diagnosis. Like miscarriage, infertility is considered a silent disease—people often don’t talk about it.

Letourneau suggests talking to family or friends, finding a more anonymous support group, or seeing a counselor who specializes in fertility issues. This type of counseling and support doesn’t necessarily lead to getting pregnant but provides resilience tools to help people proceed through fertility treatment or continue trying to conceive.

Letourneau remains optimistic about helping patients build the families they desire. “For most people who are able to keep trying, we are able to help them find a way to build a family,” he says.