Hello! My name is Sarah, and I’m a specialist here at Fairhaven Health. From here on out, I’ll be writing the Fairhaven Blog! Some of you may already know me from the OvaCue Blog where I chart my  OvaCue Fertility Monitor data and offer insight by interpreting those readings. For those of you that don’t follow me there…Nice to meet you! I have the honor of talking with many wonderful women about their trying-to-conceive journeys and feel fortunate that we’re able to provide them support and assistance. Of course, I’m very familiar with the Fairhaven Health product line (I track my ovulation every day! ) and look forward to sharing advice and information relevant to trying-to-conceive couples. Which brings us to my first topic….

What is a hysterosalpingogram?

Try saying that five times fast! Recently, I’ve had quite a few women call, explaining that they recently had an HSG (hysterosalpingogram) test. While familiar with the term HSG, I’ll admit to not having a detailed understanding of what takes place procedurally in an HSG test. This became very clear when women began calling to discuss changes they were seeing in their OvaCue readings…and I then began digging a bit deeper into this procedure. Little did I know, that a saline solution is used often during the procedure, which can alter your electrolyte levels and, thereby, impact OvaCue readings.

An HSG, simply stated, is an X-ray examination of a woman’s uterus and Fallopian tubes. Women that have been trying-to-conceive for some time often undergo this test to determine if a Fallopian tube is blocked, or to find problems in the uterus (such as, abnormal shape or structure, fibroids, polyps, etc). This information can help to eliminate or diagnose an issue that may be impacting a woman’s ability to conceive.

The procedure is often performed just after menstruation, but before ovulation – to ensure that you are not pregnant at the time of the exam. A thin tube is inserted through the vagina and cervix, and finally into the uterus. A contrast dye (which is visible in an X-ray) is then added into the tube and projects into the Fallopian tubes and uterus. As the dye flows through the female reproductive tract, X-ray pictures reveal any blockages or abnormalities. The dye is then absorbed naturally into the body. If a blockage is discovered, certain dyes may be used to remove the blockage.

Many benefits can come from this procedure. It is a short, minimally invasive procedure that can provide valuable information about structural problems that can impact fertility. Another added benefit may be that if a blockage is found during the exam, the dye can potentially unblock and open the Fallopian tube. Risks include exposure to radiation, though minimal. If there is a chance you are pregnant or have an untreated sexually transmitted disease, it is important to discuss these issues with your physician prior to the procedure.

One thing I’ve discovered from discussions with ladies that have undergone this exam is that they experienced some cycle irregularity that first cycle or two after the exam. Some women skipped a period entirely. Interestingly, I wasn’t able to find this “risk” anywhere online. So, please take it with a grain of salt, but it may be something to consider.

Well, there you have it! Now, if you ever hear the term HSG mentioned or if your doctor discusses this as an option for you – at least you have some understanding of what goes into an HSG examination.

Unfortunately, when trying to get pregnant many couples encounter difficulties and visiting a fertility specialist becomes necessary. This is not just for the ladies…men may be asked to have a semen analysis done as inadequate sperm count, motility, and/or morphology affects more than 30% of couples facing infertility. A semen analysis measures the amount and quality of semen in the sample to determine if there is infertility issue.

The preparation for a semen analysis is actually quite simple. He may be asked to abstain from any sexual activity 2-4 days before the analysis. It is also recommend to not avoid sexual activity for the 1-2 weeks before the analysis, because sexual inactivity can hinder the results. At the appointment, he is asked to masturbate into a clean, wide mouthed bottle. This bottle is then delivered to the laboratory for testing. Men that are concerned with the process of masturbating in the doctor’s office should ask for alternate ways to provide the sample.

Approximately 30 minutes after the sample is taken (allowing the semen to liquefy), multiple tests are performed:

Semen Volume: 2-6 ml is a normal volume of ejaculate in a healthy man. An especially high or low volume can signify an issue that may need to be investigated.

Semen Viscosity: Semen should liquefy in about 30 minutes. If it doesn’t liquefy, this likely indicates an infection of the seminal vesicles and prostate.

Semen pH: The alkaline pH protects the sperm from the acidity of vaginal fluids.

Presence of fructose: Fructose provides energy for sperm motility – an absence of fructose may indicate a block in the mail reproductive tract.

Sperm Count: Sperm count is measured by an examination under the microscope. If the sample is less than 20 million per sperm per ml, this is considered low sperm count.

Sperm Motility: Sperm motility is the ability of the sperm to move. For fertility purposes, it’s important to remember that only the sperm that move forward fast are able to fertilize the egg. Motility is graded from A to D;

A – sperm swim forward fast in a straight line

B – sperm swim forward, but in a curved or crooked line, or slowly

C – sperm move their tails, but do not move forward

D – sperm do not move at all

Grade C and D are of concern when testing for fertility.

Sperm Morphology: Sperm should have a regular oval head, with a connecting mid-piece and a long straight tail. Abnormal sperm is distorted in shape (round heads, large heads, double heads, absent tails, etc). A normal sample should have at least 15% with normal form.

Sperm Clumping: Sperm clumping (or agglutination) means sperm stick together. This impairs motility.

Pus Cells: Some white blood cells in the semen is normal – however, many pus cells suggest the presence of an infection.

For couples that are trying-to-conceive, if the semen analysis is abnormal, it will likely be repeated 3-4 times over a period of a couple months. This will help to confirm if there is indeed an abnormality present. If so, you can then work to treat that specific issue.

Not sure if you need a semen analysis? The SpermCheck fertility test is a convenient and affordable way to measure for normal count. You can test in the privacy of your own home, if the result shows low sperm count it would be a good indicator that thorough analysis is warranted.

There also are herbal supplements available on the market to help address issues with sperm count, motility, and morphology. FertilAid for Men works to promote the healthy production of sperm and has been shown to have a positive effect on all three of those parameters. For men diagnosed with low sperm count (under 20 million per ml), CountBoost can be taken in conjunction with FerilAid for Men to specifically address a low sperm count. For men diagnosed with low motility (grade c or d), MotilityBoost can be taken in conjunction with FertilAid for Men to specifically address poor motility.

Clomid (Clomiphene citrate) is a fertility drug commonly prescribed to women that are trying-to-conceive to induce ovulation. Clomid is often prescribed to women with irregular cycles that either experience irregular ovulation or don’t ovulate at all. If you aren’t sure whether you are ovulating, you can determine this by tracking your menstrual cycles with ovulation predictor kits, fertility monitors, or even monitoring your body’s natural signs – the consistency of your cervical mucus and tracking your basal body temperature.

In order to understand how Clomid works, it is important to understand what is happening in your body as you approach ovulation. In the beginning of your cycle, estrogen levels are low which signal your body to produce FSH (follicle stimulating hormone). Estrogen levels begin to increase which triggers LH (Luteinizing Hormone). This surge is what releases the mature egg from the follicle. For ovulation to occur, enough LH and FSH must be produced to release the egg. Clomid is used to help your body produce enough LH and FSH. It tricks the body into thinking that there is not enough estrogen – which increases the production of LH and FSH, causing your body to ovulate. Generally, it is not recommend to take Clomid for more than six cycles, so if pregnancy is not achieved, a different treatment plan should be discussed.

While taking Clomid, it is common to experience a decrease in fertile-quality cervical mucus. It is extremely important to have a healthy environment to transport and protect the sperm when trying-to-conceive. Supplements, such as FertileCM can help increase the quantity and quality of fertile-quality cervical mucus and is safe to take along with Clomid.

I never cease to be amazed by the number of times I run into people who tell me that they have been trying to get pregnant for nearly a year, but have never been taught the most basic information about their bodies.  If only people were routinely taught the fundamentals of human reproduction in school, scores of couples would not be erroneously led to believe they have an infertility problem. This is where the Fertility Awareness Method (FAM) comes in.

The Fertility Awareness Method is an easy but scientific means of charting the woman’s menstrual cycle on a daily basis. It involves observing the two primary fertility signs: waking temperature and cervical fluid, and the optional third sign: cervical changes.

It is the most practical way that a woman can tell on a day to day basis what is going on in her body. Not only can she use it for pregnancy achievement or natural birth control, but it can alert her to numerous potential gynecological issues.

The hallmark of a healthy cycle is ovulation, and more specifically, when it occurs in the cycle. Charting easily allows women to know if and when they are ovulating. If a woman isn’t ovulating, it can be indicative of many possible causes which would need to be rectified if a woman wants to become pregnant.

But a doctor is only as good as the data he/she has to work with. So if a patient comes in with nothing to provide her physician, her doctor will have to start at Square One and conduct all sorts of potentially invasive and expensive diagnostic tests, many of which would be totally unnecessary if the woman were charting her cycles.

FAM allows women and their health practitioners to determine many potential problems relating to their cycle, including:
• not ovulating
• delayed ovulation
• luteal phase defects
• unsuitable cervical fluid production
• hormonal imbalances
• insufficient progesterone levels
• miscarriages

The Fertility Awareness Method is incredibly simple. When the alarm rings, you simply slip the digital thermometer in your mouth until it beeps, about a minute. Then whenever you use the bathroom, observe what it feels like when you wipe herself (always from front to back!) Does it feel dry? Creamy? Slippery? Then in the evening, record it. That’s it!

Yet it’s amazing how many women are initially put off by the thought of “so much work.” But do you begrudge brushing your teeth every day? FAM doesn’t take anymore time to chart your two fertility signs each day! And scores of women have the same reaction to learning how to chart: initially, they are incredibly excited about the sense of control they finally feel over their bodies.

But that excitement often evolves into anger when they realize all of the years that they thought they were infertile, only to discover that they simply needed to understand their particular cycles. Or when they realize all the side effects and physical ramifications they endured over the years with most methods of birth control. Or they feel humiliated when they remember all the times they ran off to the gynecologist, seemingly every month, for what turned out to be absolutely normal and healthy cyclical cervical fluid.

So what is the most practical take-home message I could give you when trying to get pregnant? Learn the empowering benefits of charting your cycle! Then have sex on those few days each cycle when you have slippery cervical fluid at your vaginal opening. And keep in mind that it won’t necessarily be Day 14, since women may ovulate earlier or later in the cycle than that day.

Good luck!

By Toni Weschler, Fairhaven Health guest contributor

Toni Weschler is the author of “Taking Charge of Your Fertility”, a national bestseller widely regarded as the preeminent guide to helping women conceive naturally. For over 20 years she has been a committed educator having started “Fertility Awareness Counseling and Training Seminars (FACTS) back in 1986. She recently completed another book, “Cycle Savvy: The Smart Teen’s Guide to the Mysteries of Her Body” which helps teenage girls to better understand their bodies on a day-to-day basis.

Knowing what you should and shouldn’t be doing when trying-to-conceive can greatly improve your odds of getting pregnant. First things first, it is important that you are having sex at the right time of the month. Timing intercourse during your “fertile window”, the days leading up to ovulation, will dramatically increase your odd of conceiving. See Am I Ovulating, to learn when you ovulate.

If you are having a hard time predicting your ovulation due to an irregular cycle, natural fertility enhancing supplements can help to regulate your cycle and boost your fertility. FertilAid for Women, promotes hormonal balance, which helps to regulate ovulation and improve overall reproductive wellness. FertilAid for Men is designed to increase sperm count and motility by supporting the healthy formation of sperm. When you are trying-to-conceive, make sure you are taking your prenatal vitamins – including folic acid,  as it can help to reduce the chances of neural tube defects.

Now for a couple things to steer away from…no smoking or drinking when trying-to-conceive. It is a good idea to decrease your caffeine intake as well. Also, something you may not have thought of – if you are taking any prescription medications, talk with your doctor to make sure you are not negatively impacting your chances of conceiving.

The simple answer is….Yes!  Not only is it safe to combine the two supplements as they were formulated to be taken together but it is highly recommended for women to use both to maximize conception efforts.  FertilAid for Women is a supplement designed to regulate your ovulation and correct any hormonal imbalances that might be present, which in turn should help to normalize your cycle over time. Additionally, it is a complete prenatal supplement providing the maximum recommended amount for women that are trying-to-conceive. The fertility enhancing herbs as well as the prenatal vitamins provide the best nutrition when trying-to-conceive. FertileCM promotes the production of fertile-quality cervical mucus.  It has also been shown to strengthen the uterine lining and support female arousal and sexual sensitivity. Fertile-quality cervical mucus is essential when trying-to-conceive, as it needs to nourish and protect the sperm while in transit. FertileCM helps to ensure that your cervical mucus is the appropriate pH balance conducive to conception. As you can see, the combination of the two supplements helps to maximize your conception efforts in many ways. You can begin taking both supplements (3 times a day) at any point in your cycle and are to be taken throughout your entire cycle.

First things first, what exactly is ovulation? Ovulation is the release of a mature egg from the ovarian follicle into the fallopian tube. Inside the fallopian tube is where the egg will be fertilized. If the egg is fertilized, it must implant successfully on your uterine lining, which typically takes place 6-12 days after ovulation. If fertilization doesn’t take place within the 12-24 hours, the egg disintegrates and is absorbed into the uterine lining, which is then shed at the time of menstruation.

There are many ways to help you determine not only if you are ovulating but also when you are ovulating; increased levels of luteinizing hormone (LH) and estrogen, and changes in your basal body temperature and cervical mucus.

Just prior to ovulation, your body experiences a rise in estrogen, which in turn stimulates a surge in LH. You can detect your estrogen surge with saliva fertility monitors and your Lh surge can be detected in your urine using ovulation predictor kits. Electronic monitors, such as the OvaCue, are very easy to use and can help predict your fertile window with even more accuracy – using your saliva to detect ovulation as well as an optional vaginal sensor to confirm ovulation.

After ovulation, progesterone levels rise (could be a little as four tenths of a degree). You can detect this rise if you are charting your basal body temperature. Another sign to look for is the consistency of your cervical mucus. As you approach ovulation your cervical mucus should become clear and slippery, also known as ‘fertile-quality’ cervical mucus. Keeping track of all of these ovulation signs can help determine if and when you are ovulating and are most fertile.

The benefits of herbal supplementation to enhance fertility are unfortunately often overlooked. One of the most recognized and recommended herbs used in fertility enhancement is Chasteberry, or Vitex (vitex agnus-castus). Vitex is a fertility-promoting herb that has been used as far back as ancient Greece. Vitex was and still is recognized for its medicinal properties, which are used for a number of ailments. For centuries, women have used vitex to increase their odds of conceiving a baby, as well as to treat symptoms associated with hormonal imbalance and PMS.

Recently, Vitex has been shown in several clinical studies to help stimulate and stabilize the reproductive hormones involved in ovulation, cycle balance, and menstrual regularity. These studies also document a statistically-significant increase in fertility among women using vitex, with more pregnancies than in control groups using a placebo. Vitex is an important ingredient in both FertilAid and FertiliTea which contain a number of other fertility enhancing and nutritive herbs such as Red Raspberry Leaf, Green Tea, Ladies Mantle and Nettle Leaf.

Couples who are trying to conceive are now, more than ever, turning to more natural ways of addressing infertility. Scientifically validated ingredients found in fertility supplements may lead to increased conception rates and provide a healthful alternative to conventional treatments such as prescription drugs or other invasive treatment options.

It is true that FertilAid may help to normalize an irregular cycle, and as such, it is often used by women with cycle irregularity issues such as Polycystic Ovary Syndrome (PCOS), however most of the women who take FertilAid already have regular cycles. This is because cycle regularity represents just one small facet of what FertilAid is designed to provide. FertilAid is designed to improve a woman’s overall reproductive health. Not only does it provide all of your preconception vitamin and mineral needs, but it also contains key herbal ingredients that have been found to benefit reproductive rates. If you have a regular cycle, you may experience a bit of irregularity initially as your body adjusts, but typically regularity is re-established fairly quickly. For more information about FertilAid, visit www.fairhavenhealth.com.

Dating back thousands of years in China, acupuncture is increasingly becoming a respected form of treatment in Western medicine for many ailments and conditions, including infertility. Yoga is also increasingly viewed as a legitimate alternative fertility treatment. Traditionally Indian, meaning “union” in Sanskrit, yoga is a series of physical postures and poses designed to create union between the mind, body and spirit. Combined with proper supplementation, yoga and acupuncture may help you increase your fertility odds, and is a great alternative to harsh and expensive fertility treatments!

Acupuncture

In acupuncture, based on the problem you’re experiencing, different ‘points’ are stimulated using long, thin acupuncture needles. These long, thin needles vary in length according to which point it is to be inserted into. The idea is that by stimulating these points, energy flow is rebalanced and the body can then begin to heal itself. While Western practitioners admit that they are unsure of the connection between acupuncture and fertility, many recommend it as a way of regulating ovulation and menstruation for women trying to conceive, as well as decreasing stress levels, opening blocked sperm ducts in men, and increasing blood flow to the reproductive organs. Acupuncture has been recommended by fertility specialists and naturopaths and homeopathic specialists for both diagnosed and non-diagnosed couples with fertility problems. It has also become widely recommended to women undergoing In vitro Fertilization (IVF) and other fertility treatments. In fact, A German study in 2002 found that performing acupuncture about 25 minutes before and 25 minutes after an embryo transfer increases pregnancy rates to 42.5 percent, compared to about 26 percent without acupuncture! *

Yoga

While gaining popularity by many Westerners as great exercise and an alternative to the gym, like Acupuncture, yoga has also become a recommended alternative to infertility treatments such as In vitro Fertilization and Clomid. Yoga and specific yoga poses recommended for fertility, help to balance hormones while others increase the amount of blood flow to your organs, thereby stimulating and strengthening them. Meditation can also be a part of yoga, which can be a great stress management technique. Check out PhD, RYT, scientist and yoga instructor Anna Davis’s Bend, Breathe & Conceive for a respected fertility yoga DVD that receives incredibly good feedback and reviews!

* http://www.alpineacupuncture.com/Infertility.htm