If you still haven’t gotten pregnant after several months of trying this strategy, you may want to modify it slightly. In other words, those who had intercourse every day should try every other day during their fertile cervical fluid. And those who had intercourse every 48 hours may want to try it every 36 hours instead.
Finally, be aware that most of the sperm is in the first spurt of ejaculate. Therefore, the man should try to penetrate deeply and remain still while ejaculating so that the majority of sperm will be deposited at the cervix, allowing easy access to the cervical opening.
A Note About the Semen Emitting Technique (Kegels)
In order to time intercourse most effectively, you should eliminate residual semen so that it won’t mask your cervical fluid in the following days. As you read in Chapter 6, this is easily done by doing Kegels about a half hour after sex. Those sperm will then have had all the time they need to swim beyond the cervix.
Why to Include the Day of the Rise in Temps for Intercourse
If you’ve been paying attention, you should be questioning why I still suggest intercourse up through the thermal shift, especially given that you have already learned it’s generally too late to conceive by then. This is because there is a small chance the egg is still viable if it was released within the prior 12 hours. In addition, a multiple ovulation may allow for another egg still being viable. While the odds are not good, it’s still worth trying, particularly if you have intercourse the morning of the rise.
IF THE MAN’S SPERM COUNT REVEALS INFERTILITY
The good news is that with today’s advanced technologies, there is still hope for a pregnancy using assisted reproductive technologies, as discussed in Chapter 15.
Sexual Frequency: Maximizing Your Odds
The number of days per cycle that you should have intercourse will be a function of your combined fertility. A woman will generally have fertile cervical fluid for several days. Depending on the man’s fertility, you should take advantage of each of those days or perhaps just every other one.
Again, the crucial point for all couples is to include the Peak Day, which is the last day of slippery eggwhite or lubricative vaginal sensation. This day is considered the most fertile because it generally occurs either on the day you ovulate or the day before. Again, if you don’t observe eggwhite, you should try for the last day of the wettest-quality cervical fluid that you do have.
What that means, practically speaking, is the following: If you see eggwhite on Monday and take advantage of it by having intercourse that day—great. But, if you still see eggwhite the following Wednesday, have intercourse again because the ovum has probably not yet been released, and you are still extremely fertile. Of course, Tuesday would have also been a good day to try, especially if your partner’s sperm count is normal.
Kimberly’s chart. Going for the gold . . . got it!
A FEW WORDS ABOUT PREGNANCY TESTS
If you can’t wait 18 days because the suspense is killing you, you could get a blood test about 10 days after your thermal shift that has a high degree of accuracy. Of course, blood tests are somewhat inconvenient and expensive. You could also do a home urine test, but they aren’t quite as accurate, and often can’t detect the presence of the pregnancy hormone (HCG) until about the time of your missed period or even later, depending on the sensitivity of the test and the amount of HCG your body produces.
Be aware that if you have been given an HCG shot to aid in ovulation induction, you may get a false positive, which of course would also be the case if a fertilized egg implanted just long enough to release a tiny amount of HCG before immediately detaching from your lining (technically called a biochemical pregnancy). Unfortunately, the deceptive presence of HCG may be triggered on rare occasion by several other factors, including certain fertility drugs, pituitary tumors, excess protein in your urine or blood, and even the onset of menopause. So, if you have a positive pregnancy test, but don’t have any signs of pregnancy within a few weeks, you should probably get tested again to confirm whether you really are pregnant.
Whether you get a blood or urine test, you may also occasionally get a false negative, meaning that you are in fact pregnant, though the test indicates that you aren’t. The most common reason for false negatives is that they are performed too early, before the egg has had a chance to implant and start producing HCG. In some cases, implantation may have occurred, but it may still be too early for HCG to be detected. Obviously, if your temps continue to remain above the coverline beyond 18 days, simply repeat the test a few days later, and it will almost certainly reflect a positive result.
Or, if all else fails, you could always utilize the foolproof method that Skip Morrow so eloquently described in his greeting card below.
“Greeting Card Pregnancy Test” reprinted with special permission of Skip Morrow.
WHEN THE LONG-AWAITED PREGNANCY OCCURS
Once your temps remain above the coverline for at least 18 days and you have not gotten your period, you are almost certainly pregnant. A rare exception is in the case of LUFS, as discussed here.
Pregnancy Symptoms
Besides the obvious 18 high temps above the coverline (or even the triphasic pattern that some women get), there are often other signs of pregnancy, including:
•implantation spotting (light bleeding about 8–10 days after ovulation)
•tender breasts or nipples
•nausea
•fatigue
•excessive urination
•creamy cervical fluid starting in the latter part of the luteal phase and continuing throughout the pregnancy
CONCLUDING REMARKS ON TRYING TO GET PREGNANT
As you’ve read, couples are usually told to consult a physician if they haven’t gotten pregnant within a year of trying. By now you should realize how unnecessary it is to wait a full year if you’ve been timing intercourse precisely. So if you have not gotten pregnant after 4 to 6 cycles of intercourse during your most fertile days, you should carefully read Chapter 15 to see what diagnostic tests and treatments to consider.
If, however, this chapter helps you to attain your dream of a healthy pregnancy, then congratulations! The joy that you’ll receive will no doubt bring you bittersweet rewards to last a lifetime. As writer Elizabeth Stone once said,
“Making the decision to have a child . . . is to decide forever to have your heart go walking around outside your body.”
SUMMARY OF WAYS TO OPTIMIZE CHANCES OF GETTING PREGNANT
1.The most important tip for getting pregnant is to have intercourse on the Peak Day, which is the last day of eggwhite, spotting, or lubricative vaginal sensation. If you don’t observe eggwhite, try for the last day of the wettest cervical fluid or vaginal sensation you have.
2.If your partner’s sperm count is normal, have intercourse every day you have fertile-quality cervical fluid. If his sperm count is low, consider having intercourse every other day that you have fertile-quality cervical fluid. Either way, ideally he should abstain from ejaculation for a couple days until your cervical fluid becomes slippery.
3.Try to have sex through to and including the first morning of your thermal shift, since it’s possible that the egg is still viable.
CHAPTER 14
Practical Tips Beyond Fertility Awareness
Please note that while the tips in this chapter are specifically written for those of you who hope to get pregnant, Chapter 9 on balancing hormones naturally deals with the broader issues of treating the most common menstrual cycle disorders that can affect all women. Many of those issues are also discussed on the following pages.
Beyond using the principles of Fertility Awareness to time intercourse most efficiently, there are a number of tricks that can help you conceive. Many are things to avoid, but there are a lot of positive things you can do, too. All of them should be considered in light of your specific situation.
HERBAL SUPPLEMENTS
As discussed in Chapter 9, there are many women who swear by t
he effectiveness of certain herbs in dealing with all varieties of cycle-related issues. Vitex in particular is considered among the most beneficial and an herb that you may want to research further.
HEALTHY DIET, WEIGHT, AND EXERCISE
You’ve heard it a zillion times before. When trying to get pregnant, your body should be as healthy as possible. As you’ve already read, this may mean limiting consumption of refined foods, excess sugar, and products with additives. (In other words, basically restricting yourself to nuts and twigs.) All of these can impede the liver’s ability to metabolize hormones, while eating a well-balanced diet of wholesome foods can eliminate such potential problems.
In order to ovulate, most women should have a BMI (body mass index) of 20 to 24, or at least 22% body fat. But just as being underweight can prevent ovulation altogether, being overweight can also alter your cycles by causing excessive production of estrogen, which interferes with the normal feedback system of the hormonal cycle. Some of the signs of excessive estrogen are prolonged phases of fertile cervical fluid buildup, delayed ovulation, and irregular cycles.
Finally, folic acid is one of the most important vitamins you should take when preparing for conception. By taking 800 to 1,000 mcg of folic acid per day in the first trimester, you can dramatically decrease your baby’s risk of neural tube defect, brain and spinal cord defects, and spina bifida. Since this vitamin has been shown to be so beneficial, you should begin taking it well before you even start trying to conceive, to be sure it is in your system from the day of fertilization onward.
CAFFEINE, NICOTINE, DRUGS, AND ALCOHOL
You and your partner should both consider reducing or even eliminating caffeine, nicotine, drugs, and alcohol from your diet. In women, tobacco may decrease fertility, and caffeine seems to affect the ability both to conceive and to nurture an embryo. Marijuana has been shown to disrupt a woman’s ovulatory cycle. And, as you saw Click here, antihistamines can dry up cervical fluid and thus interfere with sperm survival.
Finally, alcohol can alter estrogen and progesterone levels and has been associated with anovulation, luteal phase dysfunction, and impaired implantation and blastocyst development. And if that isn’t enough to concern you, it’s notorious for potentially causing fetal alcohol syndrome in the offspring of mothers who drink while pregnant, especially during the first trimester.
In men, the following substances may suppress sperm production: marijuana, tobacco, alcohol, antimalarial drugs, steroids, and ulcer medications.
DOUCHES, VAGINAL SPRAYS, AND SCENTED TAMPONS
Vaginal sprays and scented tampons can cause a pH imbalance as well as an allergic reaction to the chemicals used in the products. As you would expect, the resulting imbalance can impede sperm survival. And, as you’ve read in previous pages, douching alters the normal acidity of the vagina and is not necessary for most women.
Douching can adversely change your normal pH balance, which can ironically lead to vaginal infections and pelvic inflammatory disease (PID). It can also alter the vaginal environment to such an extent that sperm can’t survive. And finally, it may wash away the very cervical fluid that sperm need to swim through the cervix to the egg. Other than that, hey, douching’s no problem!
ANTIBIOTICS AND YEAST INFECTIONS
If you’ve ever had to take antibiotics for an extended period of time, you may remember having to battle yeast infections—one of the real drags of an antibiotic regimen. So the lovely aroma of baking bread wafting from an oven while there’s a fire crackling in the fireplace is a beautiful thing. But that smell emanating from your vagina? Not so much.
These drugs are notorious for killing the good bacteria along with the bad, often producing an overgrowth of candida, a yeast that renders the vaginal environment inhospitable to sperm. Study results are mixed, but several claim that one of the ways to counter the effects of antibiotics is to eat yogurt with probiotics or to ingest probiotic tablets, because probiotics replace the good bacteria killed by the antibiotics. It also appears that lactobacillus probiotics are beneficial for bacterial vaginosis, but not for candidiasis or UTIs.
LUBRICANTS
Virtually all artificial lubricants, as well as vegetable oils, glycerin, petroleum jelly, and even saliva, can kill sperm. And though there have been studies that show canola oil and baby oil have minimal impact on sperm, you should avoid them, because oil-based lubricants can increase the risk of vaginal infections.
Luckily, there is a vaginal moisturizer that is specifically designed to mimic natural body secretions and provide an optimal environment for sperm. It’s called Pre-Seed, and it works by delivering a pH-balanced semen-like fluid. You can learn more about it at www.preseed.com.
POSITIONS DURING INTERCOURSE
Although no definitive studies appear to have been done, there is considerable speculation that if the man has a marginal sperm count, the best position for intercourse is the traditional missionary position. This allows for the deepest penetration, and will thus deposit the sperm closest to the cervix.
Some clinicians also believe that if your cervical fluid is not the most fertile type, or the sperm quality is marginal, it may be advantageous for you to remain lying down for up to half an hour in the basic position in which you had intercourse. The theory is that this will help maximize the time the sperm has to travel up (so probably another reason to save the downward-facing-dog yoga position for when you are outside of your fertile phase!).
CONDITIONS THAT MAY BE AMENABLE TO NONINVASIVE REMEDIES
Irregular Menstrual Cycles
In case you skipped Chapters 7 through 9, there I discussed potential causes of irregular menstrual cycles and the numerous things that you could do to try to regulate them. At a minimum, I would encourage you to be examined for PCOS, a serious medical condition for which irregular cycles are one of the primary symptoms. It’s discussed more fully in Chapter 8.
Thyroid Issues
If you’re one of those women who suffer from unusually long cycles in which you have extended phases of less-than-fertile-quality cervical fluid, you should also observe whether you have low basal body temps. This is because the combination of these three symptoms often indicates hypothyroidism, a condition that you may be able to treat by simple nutritional supplements, as discussed in Chapter 9.
Limited Fertile-Quality Cervical Fluid
My professional experience is that one of the most commonly overlooked causes of subfertility is the lack of lubricative cervical fluid produced during a woman’s cycle. Of course, the more days you produce it the more likely you’ll be able to get pregnant. Women coming off the pill or approaching menopause are particularly susceptible to this problem, as are women who have had cone biopsies performed on their cervix.
If charting has confirmed that your cervical fluid doesn’t seem wet enough, or isn’t wet for at least two days, it may be a reflection of other reproductive problems. Still, there may be a simple solution available. Before resorting to more involved medical therapies, I would encourage you to review Chapter 9. You might also want to try any of the following recommendations:
•Avoid drugs that may dry up cervical fluid, such as antihistamines, atropine, belladonna, cough mixtures containing antihistamines, dicyclomine, progesterone, propantheline, or tamoxifen. If you must take Clomid, combining it with oral estrogen may compensate for its drying effects. However, estrogen should never be taken without fertility drugs, since, paradoxically, that could actually inhibit ovulation.
•Drink lots of water!
•Evening primrose oil is a supplement that may have beneficial effects on your cervical fluid. It has a high content of the omega-6 essential fatty acids, linoleic acid, and gamma linolenic acid.
•A supplement such as FertileCM is designed to help women develop the clear and lubricative cervical fluid that is ideal for conception (available at fairhavenhealth.com).
•Mucinex Expectorant or Guaifenesin Extended-Release 600 mg tablets, as directed on the box, star
ting about 4 days before you would expect your Peak Day and continuing until a day after your thermal shift. Along with helping to liquefy mucus in the lungs, it also has the added benefit of making your cervical fluid wetter or more slippery. So if you don’t produce eggwhite, you could try this.
•PLAIN Robitussin expectorant (with no letters behind it, or it can actually dry up your cervical fluid, and absolutely not with dextro-methorphan!). You can also take a generic version of it, with the sole ingredient being guaifenesin. Take 2 teaspoons 3 times a day starting about 4 days before you would expect your Peak Day and continuing until a day after your thermal shift. It works similar to Mucinex above.
Luteal Phase Insufficiencies
As you know by now, the reason it’s so important to have a luteal phase of at least 10 days is so that the fertilized egg has sufficient time to implant before menstruation begins. There are three basic types of luteal phase issues, but all of them are usually a reflection of an ovulatory dysfunction.
•Type 1: The luteal phase is too short, and so a fertilized egg would have no chance to implant in the uterine lining. This condition is the easiest to detect through charting. Anything under 10 days would be considered a problem, but for some women, even 10 or 11 days may be considered borderline.
•Type 2: The luteal phase appears to be a normal length, but the amount of progesterone is not optimal to produce an ideal uterine environment for implantation. This is often reflected in temps that hover around the coverline.
•Type 3: The luteal phase appears normal, but the progesterone starts to drop dramatically just a week or so after ovulation, often causing premenstrual spotting. Again, this usually means that progesterone is not high enough to produce an ideal uterine environment for implantation.
Taking Charge of Your Fertility Page 21