My wife said to me: “If this were a “male thing” we would have had solutions by now.” Far be it for me to argue with her but on this occasion I didn’t think this was down to male chauvinism but more the fact that commercial companies don’t make money if there isn’t anything concrete to kill or treat.
In my eyes, infertility is also a misnomer based on a definition that you are classified as infertile if you are not pregnant after 12 months of trying. Each year around 29,000 women in the UK are estimated to get to this 12-month stage (added to the ones that are already there and continue to try beyond 12 months). If you follow this group for a further 2 years we would expect around 12,000 to get pregnant naturally during that time. So were they infertile?
What does it mean if doctors can’t find a clinical reason why pregnancy doesn’t happen? With only IVF or “keep trying” as frustrating options those women that search the internet will come across an array of alternative tips and methods that helped some women.
These tips and methods won’t be endorsed by the medical profession as they require solid clinical trials before they accept proof of effectiveness. At the same time the NICE Fertility Guidelines mention as the top bit of research required: how long should women try to get pregnant naturally before considering IVF?
We don’t have that answer yet but over time we will as a new fertility monitor (myLotus) has just been launched that allows measurement and tracking of personal hormone levels. This is important because all women are different and currently too many home tests are based on comparing yourself to the “average woman”. If you are finding that conception is taking longer than expected you could be above or below that average and the home tests may not work for you.
myLotus initially focuses on a particularly important hormone (LH) that can tell you many different things about your fertility and potential links with issues.
First: the level of LH before ovulation is important. Up to 20% of women have very low levels and a small surge that often isn’t detected by classic ovulation tests.
Other women can have very high base levels and it could look like they are constantly fertile, which is also not right. (Note: women with PCOS often have high levels of LH)
The ability to see what your personal base level is also allows you to see what your personal surge is. Typically the level of the LH hormone shoots up 24-48 Hrs before ovulation. It is sudden and rapid and is at least twice the baseline level seen in the previous days. (But it can be 10 times that level or more.)
The length of the surge is being linked to likelihood of conception. Research shows that most of the pregnancies occur in a cycle where the surge lasts for 3 days. Shorter or longer surges do link to pregnancies except less so. At this stage this bit of information does not highlight anything wrong as such but it would tell you whether or not you were in that ideal scenario.
Currently women try to identify that LH surge to see whether they are in their peak fertility stage. What many women don’t know is that you can have multiple surges. In our studies we saw that only 70% of women have a single peak. When your body thinks that the follicle that is being produced is a bit small it starts to pump out more hormones to release a second egg that it thinks might be more viable. We found 5% of women with more than 2 surges. We don’t know at that this stage which these surges would produce a viable egg but just focusing on a first surge may not be sufficient to cover all your chances.
Issues around ovulation are of course not the only potential issue. Nutrition, stress, bacterial vaginosis, chronic inflammation, lifestyle issues can all contribute to conception not happening in a particular cycle. This could be each of these on their own or in combination with others. It could also be different issues each cycle.
This somewhat explains the difficulty for the medical profession to give you a diagnosis of what is wrong and to prescribe a treatment regime. As we learn more about the body, what constitutes a balance, how that balance is disturbed and how it is restored we will be putting together a checklist of common factors where prevention may give us a better cumulative chance to bring forward the time to conception.
That knowledge is taking shape and future articles will cover the other factors mentioned above and what you can do.
With the NICE fertility guidelines quoting that 1 in 4 fertility issues link to ovulatory issues myLotus is a good place to start to really understand your cycle and to see results that are your personal hne levels. The free app makes it easy to visually see that baseline surge, see your surge length and see whether you have multiple peaks. You can also use it as a diary and store all information that, at some stage, could be useful, whether that be on food and vitamin intake, acupuncture or reflexology session, stressful events, etc. The ability to compare cycles and to find common threads could just be the lightbulb moment that leads to finding what works for you.
If myLotus could be useful to you and it does help you to speed up the time to a natural pregnancy please let me know. I would love to show my wife that I work in an industry where the satisfaction of helping people outweighs any commercial consideration.
Erik Henau works for Concepta Diagnostics Ltd, the manufacturers of myLotus.