Top Reasons You Are Not Getting Pregnant (Episode 407)

Full Transcript: Episode 407

Lisa Hendrickson-Jack

Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Charting Journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works, and how artificial hormones disrupt that natural process. I teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices, and I host live coaching programs to help you achieve optimal fertility and health, because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I’m a busy girl, but I managed to fit it all in.

This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with me today.

Today, I’m sharing the second installment in this month’s conception series. And today’s episode is meant to share a few common reasons why conception may not be happening, some that you may be aware of already, especially from a fertility awareness standpoint, and others that are very, very common, but tend to be downplayed. And so with that said, let’s go ahead and jump into today’s episode, the top four reasons why you’re not conceiving.

So let’s get into today’s episode, the top four reasons why you’re not conceiving. So, you know, I want to make sure that, you know, these aren’t the only four reasons. Fertility challenges are complex. And it’s extremely important that whenever we’re talking about fertility challenges, that we do acknowledge that it is complicated. And it’s not the same for everybody. And there’s multiple things that have to take place in order for a baby to be conceived. It’s truly a miracle. The more that you understand about the science and everything that has to go just right at just the right moment for everything to come together. The more that it just seems almost like an impossibility when you think about everything that has to happen in order to conceive. And so on the most basic level, in order for conception to occur, you need healthy eggs, healthy sperm, healthy cervical mucus and a healthy body. So a place where the baby can grow and thrive. Not to make it too simplistic, but I think often we forget that that is the recipe for a baby. We need to have all of those parts and components in place. And if they’re not in place, then it can create challenges.

And so, you know, it might seem really easy. You see your friends, you know, conceiving very simply and wondering why it’s not happening for you. At the end of the day, we just never really know anyone’s personal situation. We have no idea what I have learned over the years because in my work, I get to look behind the curtain. I’m working with women. I’m working with couples who are trying to conceive. I’m seeing the numbers. I’m seeing the charts. I’m seeing when the sex is occurring. I’m seeing all of this behind the scenes information. And so it looks very different person to person. There’s a lot of different factors that come into play. But there’s a few specific things that just to get out the way right off the top of the bat. But when it comes to fertility challenges, I mean all things related to fertility, pregnancy, the menstrual cycle, etc. We have a very specific focus on the female. We’re always looking at the woman. We’re looking at her specifically, assuming most of the time right off the bat that if there is a problem, it is a problem with her and that’s something that I’ve talked about quite a bit on the podcast and it’s something that I will continue to talk about because more and more what I’m seeing when I’m working with women who are struggling to conceive is that it really is not just on her side.

And when I look back at all of the clients who I’ve worked with over the years who, and I did say all on purpose, who have been trying to see for quite some time. Often they’ve been told that the sperm quality is totally fine, but when we look at the semen analysis together, when we go over the numbers, I have yet to see a man whose sperm falls into all of the three main parameters optimally, as far as the science is concerned. So we’ve talked about it on the podcast. I talk about it quite a bit in the Fifth Vital Sign and really and truly what the World Health Organization has listed as their low bar for sperm is much, much lower than what the research would tell us is optimal for natural conception. And there’s a lot of different reasons for that. So right off the bat, right off kind of the beginning of this conversation, I really have to acknowledge that because I really haven’t worked with that many women who just didn’t think it was them and who didn’t automatically assume that there’s something wrong with them, there’s something wrong with their cycles.

And as they chart and become more confident and go through more and more cycles through fertility awareness charting, they become more adept at picking up issues with their charts. And it is important to have that sense and understanding that your menstrual cycle is a reflection of overall health and we can gather data and information from our cycles. But at the same time, we’re not robots and our cycles are never going to look air quotes perfect. I’ve never worked with a woman who had quote unquote perfect charts and I’ve said multiple times that there is no such thing as a perfect chart because we are human beings. Our charts are always in flux. Our charts are constantly reflecting back to us what’s happening in our lives health-wise, whether it’s stress, whether it’s change in diet, whether it’s a change in sleep patterns, whatever the case is, our menstrual cycles are always reflecting back to us what’s happening. And I’ve certainly noticed a tendency of women who are really into charting their cycles to really get bogged down in the details and the specifics. And, you know, oh, I saw a tiny bit of spotting on this day, you know, thinking that it must necessarily mean something very dire and very serious. And so this is just to kind of get our feet wet into this discussion, but I just really want to acknowledge that when it comes to issues related to fertility, we really do make the cultural assumption that it has to be on the women’s side. And I’ve worked with enough women over the years to know that often there is an issue with the men’s side, even if you’ve been told that everything is totally fine.

So let’s get into then the top four reasons why you’re not conceiving. So we will get back to the point about the men. Of course we will. All right. So number one, you’re not getting the timing right. Number two, you’re not focusing on your cervical mucus production. Number three, you just got off the pill. And number four, your partner’s sperm is not up to par. So I’m actually saving the sperm conversation to last, but I thought it would go through to give you a sneak peek at what we’re going to be talking about today.

So let’s jump into number one, you’re not getting the timing right. And by this, I’m fully calling out what I often refer to as rhythm method thinking. And so anyone who’s listened to the podcast for any period of time will know that, you know, that’s how I talk about it. I talk about it as rhythm method thinking, because culturally, we really do adhere to all of the myths about the menstrual cycle. So for many of you before you tuned into this podcast and started diving down the rabbit hole of fertility awareness, you still believed what we were, most of us were taught in junior high school, which is that the menstrual cycle is always 28 days and ovulation always occurs on day 14. Now there are many women who go to their doctors. I’m trying to conceive, it hasn’t happened yet. And their medical doctors, their health professionals will advise them to have sex around day 14 of their cycle or on day 14, they’ll advise them to, you know, have sex every other day, forever, or they’ll tell them, okay, make sure to have sex between days, you know, whatever it is, day eight and day, you know, 16 of your cycle or whatever the case is. But this information and advice is based on the idea that the menstrual cycle is stable. It’s always the same, that it’s always 28 days, ovulation always happens on day 14. Basically, like, as if you’re a robot and nothing ever changes, and we can actually make decisions based on this kind of hypothetical scenario.

When you’re being told to have sex on a certain day by someone who is not actually looking at your charts, if you are not actually charting your cycles, and you don’t actually know when you’ve ovulated in the cycle and you’re not actually keeping track of, you know, how long your cycles are and when ovulation is taking place in the cycle, then that information is basically the same as shooting in the dark. And what I always say, especially when I first first learned fertility awareness back in the day, and I first started teaching women many years ago, I often thought that you could only really screw it up if you were trying to avoid pregnancy. I really did. So at the beginning of my journey, when I first got into this work, I really thought, well, if you’re trying to conceive, you can’t really screw it up. Like it’s only you can only really screw it up if you’re avoiding pregnancy, because if you’re avoiding pregnancy and you’re using fertility awareness as your primary method of birth control and you don’t figure out which days are fertile, which days are not, and then you engage in quote-unquote risky behavior, otherwise known as having sex on a fertile day and then you get pregnant, well, that’s not what you wanted if you’re actively avoiding pregnancy. But when you’re trying to conceive, you can just as easily screw it up, which is really important. So if you take nothing else away from this point, you can screw it up if you time sex based on your kind of rhythm method thinking.

And so calling it out, this would be basing your actions on the idea that you are going to ovulate on a certain day. So whether you’re doing it based on day 14, because that’s what you’ve been told and that’s what all the websites say is when ovulation happens, or whether you’ve charted a couple of cycles and you notice that your ovulation happened on a certain day and you’re trying to have sex on that particular day of your cycle. However, you’re doing it or even if you have been charting for quite a while and you know that you typically ovulate around a certain time and you’re not really checking your fertile signs and you’re relying more on that idea, all of those things fall into what I call rhythm method thinking and that rhythm method territory. And when you’re doing those things, you’re not optimizing your chances of conception.

Now this is really important because the reason why it’s important to understand how your body works and how your cycle works is because the most variable part of your menstrual cycle is your follicular phase, your pre-ovulation, pre-ovulatory phase. And so the number of days before ovulation can vary widely. It can vary from typical ovulating around day 12 or day 13 to ovulating on day 21 or day 22. And in a long cycle, you could be ovulating on day 30 or day 45 if you have some irregularities happening there with your ovulation. And so even for women who have very regular cycles who typically do ovulate on a certain day of the cycle, this is still really important because, you know, I’ve seen it over and over again. It’s possible to have that one random cycle where you ovulate early, you know, where instead of whatever your typical day of ovulation is, it actually happens sooner than that. And when you’re going with this idea of, “Well, I know when I usually ovulate, so I’m just going to have sex around that time,” it’s very easy to miss time.

And I think a lot of us just are a little bit overconfident when it comes to charting, because it’s something that’s happening in our bodies where women, “How complicated could it be? This is my cycle. How could I not understand it.” I think that there’s a certain degree of just when we are thinking about our cycles, I think we tend to oversimplify it a little bit because we want it to be easy. We want to just be able to kind of set it and forget it. Okay, usually I ovulate around day 15 and then just go about our lives. But when you’re trying to conceive or when you’re trying to avoid, it’s really important to get the timing right because just that simple act of believing that everything’s always going to be the same can actually lose your chance.

I saw a woman post in my Facebook group yesterday something about, you know, I, my cycles are a little bit on the long side. And I recognize that that means that I have fewer chances to try each year. So for example, if your cycles are not, you know, 35 days typically, then that means yeah, you have fewer cycles in a year. And yeah, you technically do have fewer chances at ovulation in the year, because you’re ovulating fewer times in the year. So with that in mind if you are, you know, mistiming or if you accidentally miss that window. So let’s say that one cycle you actually do ovulate earlier, which you would not be advised of in advance. If you’re paying attention to your cervical fluid, which we’ll talk a bit more about, you would see that cervical fluid showing up earlier if you’re paying attention to it. But if you’re not paying attention to it, then that ovulation could just happen earlier. So you could end up ovulating on day 12 or day 13. And then if you were waiting for day 14 to start having sex, well, then you inadvertently use the method for birth control that cycle and missed that chance.

And what I’ve seen is that even if you did not actually have sex during your fertile window that cycle, you still think that you tried. And when the period comes, you’re still devastated. I’ve seen this time and time again. I’ve had a number of conversations with clients over the years and I’m looking at their charts and I’ll ask all the questions, you know, are you marking sex when you have it on the chart? Yes, I am. You realize that you didn’t have sex on any of your fertile days the cycle. Yes, I do. My partner and I were fighting this month or my partner was out of town or whatever the case is, right. And so even though there was no sex during the time, meaning that pregnancy is not possible, really, it’s not. If you didn’t have sex at any point during your fertile window, pregnancy is actually not possible. You’re still just as devastated.

And when you think about okay I’ve been trying for x number of months or x number of years, you’re adding those all up as if they’re consecutive, as if every single cycle was a try, even if it wasn’t. So this is why timing is really important. Now with that said it’s a double-edged sword because many of you listening do fall into that category of you know a little bit on the type A side. I’m not, I feel like I can gently say that because I’m also a bit on the type A side. I mean I think it’s pretty obvious. And so when we’re a little bit on the type A side, we really want to get everything right, and we can get really consumed with this charting. Charting in that way, it’s actually not for everyone’s personality because some women find it to be so stressful, the constant checking and charting and looking, and it feels all consuming so that it can actually turn into a negative and become a stressor as opposed to something helpful.

I try to keep it as simple as possible because really what we’re trying to do from a scientific perspective is we’re trying to identify the five days prior to ovulation, you know, the five days. From a scientific standpoint, you are fertile the five days prior to ovulation and ovulation day because your cervical fluid can keep sperm alive for up to five days. And if you determine how to identify your fertile window and identify which days are fertile, it can take the stress off if you’re able to kind of just do that and take it for what it is and then move off for the rest of your cycle. If you can get your head around the fact that there’s really only a short window, then if you have the ability to kind of let go of some of that stress and let go of some of that control for the remainder of the cycle, then you can actually use it to your advantage. But if you find yourself constantly stressing and constantly looking at all of the details and really feeling overwhelmed, then that’s the double-edged sword part. That’s the part that can be really challenging.

But with that said, if you can get your head around the charting aspect of it and really start to move away from the rhythm method thinking and move towards the just the idea that your menstrual cycle fluctuates, that you can identify which parts of your cycle are fertile and which aren’t, but you can’t predict ovulation in advance and you start to just resonate, let that kind of resonate, let that simmer, then you can really get the timing right. And for some women, that’s enough. Obviously, for many women and couples, it’s not just the timing, but the timing is still crucial, you know, even if there are other issues at play, which there often are. If you’re not getting the timing right, then everything in the world can’t help if there’s no sperm meeting with the egg. So the timing is really, really important. And I would just encourage you to kind of stray away from the idea of having ovulation at a certain time and really focusing on the day and instead focusing on your cervical mucus observations because that is really the key.

And so that leads us into the second point, the number two, which is you’re not focusing on your CM production. Now when you’re trying to conceive this goes hand in hand with point number one regarding the timing, but it’s just really important to understand the important role that cervical mucus plays in our fertility. And one of the things that I’ve heard so much from all of the women who’ve read the Fifth Vital Sign and who have, you know, loved it and especially health professionals as well. I’ve had a number of conversations with naturopathic doctors and medical doctors, is what they’re always talking about chapter three, the cervical mucus chapter and telling me that it’s just mind-blowing how much information and detail and science there is behind the role of cervical mucus and also like how is it that this isn’t something that we’re taught about.

So in order to appreciate why we should be focusing on cervical mucus production specifically when you’re trying to conceive is because cervical mucus is what keeps the sperm alive for up to five days and that plays a crucial role in filtering out defective sperm and also shuttling the sperm to where it needs to go when you are in the midst of trying to conceive. And we’re often told this story about the valiant sperm and how they swim fearlessly through, you know, wherever it is to get to where they’re going. And it’s really sperm focused as if sperm is the hero of the story. But it turns out that our cervical mucus is the hero of the story because it’s our cervical mucus that keeps the sperm alive for up to five days. It’s our cervical mucus that actively, rapidly transports sperm into our cervical crypts and into our uterus and our fallopian tubes where it then waits to meet the egg. It’s our cervical fluid that actively captures sperm that are abnormal, sperm that are not able to swim properly, sperm that are deformed. Those types of sperm are not able to make it through our cervical fluid.

And a lot of women don’t realize that even the healthiest man alive, the vast majority of his sperm are abnormal. So mother nature knew that. And you can look at the science and all the information about that, if that’s new information for you. But the vast majority of sperm that men produce are abnormal. And when I say abnormal, I just want to be clear that we’re talking about serious malformations, like a misshapen head, no head, a misshapen tail, no tail, two heads, two tails. The abnormal sperm are incapable of fertilizing an egg. And the vast majority of sperm that men produce are abnormal, even the healthiest men.

And so our cervical fluid is incredible. It’s specifically designed to capture the sperm that are not able to swim properly, so the sperm that don’t have normal motility. And it’s also designed to actively screen out the sperm that have these abnormalities, so that only the normal sperm that have normal shapes and are able to swim are able to get through. And with that in mind, it just gives you a taste of the crucial, crucial role that our cervical mucus plays in natural conception, because without the cervical fluid creating the perfect environment for sperm, the perfect pH level, and also for screening out the bad sperm, and also cervical mucus plays a crucial role in preparing the sperm for fertilization. Did you know that before the sperm actually actively swim through our cervical fluid, they’re not even able to fertilize an egg. There’s a chemical process that they go through called capacitation that actively prepares them for being able to fertilize an egg. So just a multitude of very specific things that cervical fluid does in order to optimize our chances of conception, and it plays a very crucial role in that.

So with that in mind, when you are trying to conceive, you’re wanting to pay attention to your mucus first, and everything else second. And so for those of you who haven’t tuned into the archives by now, back in episode 149, it’s an episode that I refer to a lot if you’re part of my Facebook group, you’ve probably seen me post about episode 149. But episode 149 is an episode I did specifically about ovulation predictor kits, what they actually teach us, what they actually tell us, what ovulation predictor kits are actually measuring, and how you can use them effectively because it’s possible to use ovulation predictor kits and actually inadvertently reduce your chances of conception.

And so in that episode and in whenever you hear me talking about cervical fluid and the role in conception is that we really want to, when we’re looking at how are we going to time sex, how are we going to optimize our chances of conceiving, we really have to look at cervical fluid first. So our cervical mucus, and you’ll notice I use those words interchangeably, cervical mucus and cervical fluid, but cervical mucus is primary. It is what we need to pay attention to the most. And so the first thing is cervical mucus and then everything else comes secondary to that.

So needless to say then, the best days to have sex when you’re trying to conceive are your days of cervical mucus. So when you’re charting your cycle, there’s different ways to check for cervical mucus. I recommend that my clients check externally, so using toilet paper to wipe throughout the day and to see if you’re observing anything. And typically cervical mucus will present in one of three ways. So you’ll either see like a creamy kind of like hand lotion, like creamy white hand lotion type of consistency, or you’ll see like a clear stretchy as if you are looking at raw egg whites, or you’ll just notice that at some points in your cycle, you’re wiping and it feels really lubricative, really slippery. So when you’re seeing any of those three variations of cervical mucus prior to ovulation, then that is an indication that you are fertile.

And one of the examples that I’ve been using quite a bit to describe this to my clients is that often one of the biggest myths around trying to conceive is that the goal is to have sex on ovulation days. So then all of the technology and all of the products are geared to identifying ovulation days so that we can have sex on that day. But that is misguided and it’s not actually the best, and the best way to optimize your chances is not to focus all your efforts on having sex on ovulation day. So the way that Mother Nature designed it is that we actually produce cervical fluid as we approach ovulation. The cervical fluid keeps the sperm alive for up to five days. So you could have sex on Monday when you have cervical fluid and your partner could go away somewhere and then you could ovulate on Friday and you could actually get pregnant on Friday. And that is the difference between the myths around ovulation and fertility and optimizing our chances versus the actual science and how our bodies actually work.

So, you know, Mother Nature stepped in to make sure we couldn’t screw it up so that we are actually fertile on the days leading up to ovulation when we’re producing our cervical fluid. So if you’re not focusing on your cervical mucus and instead you’re looking at ovulation predictor kits, you’re focusing on your temperatures, you’re focusing on the date, you’re just randomly having sex every other day, all of those things could potentially lower your chances of conception because then you’re actively kind of timing things based on these arbitrary factors that don’t improve your chances of conception.

So for the ovulation predictor kits, I won’t go into a ton of detail because I’ll refer you to episode 149, so fertilityfriday.com/149 when you’re done listening to this one. What happens with ovulation predictor kits is that it turns positive about 24 to 36 hours prior to ovulation. When you get a positive OPK, it doesn’t mean that you are going to ovulate 100% of the time because it’s not testing for ovulation, it’s testing for your luteinizing hormone LH surge. So it’s possible that if you are waiting for the kit to turn positive, you’re missing out on several days of good cervical fluid. It’s possible that you can time it based on the ovulation predictor kit, but something can happen and it can delay your ovulation and you can end up missing your window.

And so the LH kits are helpful and I certainly work with clients, and there are times when I recommend them just to have another piece of data to get as close to ovulation as possible. But they always come secondary to your mucus observations. So that’s really important. With the temperature, because I mentioned the temperature — temperatures do not predict ovulation. So I hope that that myth is not still alive and well. But if you’re listening to this and you’ve been waiting for your temperature to rise to have sex, that’s too late. Absolutely not. You know, stop that right now. The temperature goes up after ovulation. The temperature doesn’t help you to predict it. If you’re looking for even like a dip before ovulation, that is not consistent. That is not something that all women experience. And to be honest with you, thousands of charts I’ve seen and I have never seen a consistent pattern of a dip before ovulation. So that’s not something that you can rely on. So temperature has no predictive value, but what it is helpful for is helping you to confirm ovulation in retrospect. So after the temperature rises, you can actually look back and see, hey, did I time it properly? Did I actually have sex in my fertile window, which would be five days prior to ovulation on the days of cervical fluid that you observed.

And the timing thing we’ve already talked about. So yeah, so those are the first two points. The third point, you just got off the pill. Now, this is kind of a broad point. I could probably, I’m sure I have, but I could do an entire episode on birth control and the effect that it has on fertility. But I think it’s really just important to again break some of the myths around the pill and how it impacts fertility. Many women are to this day told by their doctors that the pill has no effect on fertility. And there’s a lot of research studies that look at certain things. But I’ve talked about this before on the podcast. When you look at the research studies that are showing what happens and how long it takes for women to get pregnant when they come off the pill, these studies exclude any women who had pre-existing issues with their cycles. Any woman who previously, if she was having irregular cycles, if she wasn’t sure when she was going to ovulate next, if she had some serious cycle issues that were interfering with her cycle in general, then she’s going to be excluded from those studies because it’s well established in the research that women who have a pre-existing issue, whether that is irregular ovulation, irregular periods, painful periods, whatever the case is, the pill is not a cure and it doesn’t actually fix it or treat it or cure it. What the pill does is it masks the symptoms by preventing you from ovulating and having a menstrual cycle. And it gives you a regular withdrawal bleed, which makes it look like everything’s fine.

So it’s like you have a big hole in your wall, and you tape up a piece of paper or something, and then you paint over it. And like, you just act like the hole isn’t there. But when you eventually take off the piece of paper with the tape, the hole is still there. And that’s basically the analogy that I just made up on the spot to describe what is happening with the pill. So whenever I talk about this, I get a lot of women who get super defensive, women who have painful periods and different issues that they’ve been facing, and the pill is the only thing that they’ve found so far that gives them relief. So I just want to acknowledge that. Like I hear you, I see you. I also had really painful periods. And I’m not joking around, like it was completely ridiculous. Anyone who’s heard me talk about it, the way I describe it, actually, if you want the specifics, is it felt like someone reached up my butt and squeezed as hard as possible all day. So I’ve experienced really horrible pain with periods. So when I say that the pill doesn’t treat or cure it, I’m just saying that it’s a temporary thing. It’s like putting a band-aid on, but it doesn’t actually address the underlying reasons why it’s there.

And there’s with the way that our medical system looks at health and illness, we’re not always looking at the cause. We’re often just looking at, okay, there’s pain, we’re just gonna solve it, okay, there’s an irregular cycle, we’re just gonna use the pill to force a bleed every 28 days, but we’re not actually looking at the solution. And so when you come off the pill then, if you did have a pre-existing issue, if you did go on the pill because you had really irregular cycles, you’re at a greater risk of not getting your period back right away and having a delay in the return of your periods at all. So when you’re looking at the research, that’s kind of the first thing, because any woman who did have issues with her period, she should know that, and she should just know, like if you did have issues with your period before and you weren’t sure when you were ovulating, or you weren’t ovulating at all, or you know you stopped ovulating on the pill, or stopped bleeding at all, even having a withdrawal bleed on the pill, then it’s really important to just look at those factors and to consider coming off earlier.

Now, another thing about the research studies is that they tend to minimize the temporary delay in the return of fertility. So when it comes to the pill, there’s no evidence to suggest that it’s a permanent thing. There’s no evidence to suggest that the pill causes any permanent impacts on fertility. I haven’t seen that, and I’ve looked at tons of research papers. And ultimately, when you look at the effect that the pill has on fertility, it’s well established in the literature: hormonal birth control has a temporary effect. So it causes a temporary delay in the return of your fertility. And what that means is if you’re on the pill, it’ll take about twice as long from a statistical standpoint for conception to occur. So on average, a healthy couple, no issues — on average, it’ll take about four cycles for conception to occur. When a woman comes off the pill, on average, it takes about eight cycles. That’s twice as long. Now, of course, this is an average. So some women come off the pill, and they get pregnant right off the bat. Some women get pregnant four months, six months, eight months. But some women are on the other side of that, and they’re getting pregnant 12 months, 14 months, 16 months later, whatever the case may be.

And so I think, first of all, that’s a really important piece of information. When you look at the way that the research talks about it, because it’s reversible and because the effect is temporary, the researchers tend to minimize that delay. And so they tend to conclude that it’s really not that big of a deal, because ultimately it does go back to normal. But I think that you and I both know that it is a really big deal, because as women, we have spent most of us, many of us, a lot of us have spent years of our life being very responsible, getting our decks in a row, getting our careers organized, our relationships organized, our homes organized, so that we’re finally at the stage where we can actually have children, support children, and feel comfortable, safe and supported doing so. So after you’ve spent years of your life getting everything in line and everything organized for this baby, to come off the pill and to not know that there’s this delay and to not know that it could take you twice as long and to not know that on average it takes nine to twelve cycles, which is on average twelve to eighteen months, for cycles to fully normalize post-pill — that’s a huge, huge problem.

And so what it means is that if you just came off the pill and you had no idea that it could take your body some time to normalize, then that could be one of the reasons why you’re not conceiving. And in the moments, it feels horrible because it’s just cycle after cycle of not conceiving. But if you are aware of it and as difficult as it is, if you can just recognize that it takes some time post-pill for your cycles to normalize, for your ovaries to resume their normal hormone production, for your progesterone and estrogen production to go back to normal, there’s a lot of things you can do to support your body during this period of transition. But it doesn’t mean that your body won’t go through a period of transition. You can know all of the things, you can do everything right, but at the end of the day, your body will still have to actually go through the transition phase. And so that’s just something that’s really important to know. And again, one of the issues is that we’re not being taught and told about this information, even though it’s right there in the scientific literature.

So for those of you who are listening and you are in the preconception phase, so you’re not actively trying to conceive, but you know that you’re planning to have a baby within a year or two or maybe several years into the future, this is something you can keep in mind. If you’re on the pill or you’ve used the pill or whatever the case is, you’re taking a hormonal method, then knowing this just empowers you. You’re able to then decide when you’re going to come off of it with this in mind. So many women knowing that there’s a delay in the return of normal fertility will then consider coming off earlier. So at least I recommend two years, but bare minimum at least one year. And during that year, you’re actively avoiding pregnancy because you’re not ready to get pregnant yet. So I’m suggesting that you come off of it before you’re ready to have a baby and you find other ways to manage your fertility during that time so that you can give your body the chance to normalize. Because when your body can just normalize and your cycles can just get back to normal without the pressure of actively trying to conceive at the same time, it’s a completely different experience than actively trying to conceive while your body is normalizing.

There’s no right or wrong way, but I just feel like information and knowledge is power. And when you know that, it’s just a completely different experience. So I’ve supported women in both scenarios. I’ve supported women who’ve come off the pill a year or two before they’re even trying, so they’re actively avoiding, terrified of getting pregnant, coming to me to make sure that they know all the rules and they can feel really comfortable using fertility awareness while they’re also working on improving their cycles. And I’ve also worked with women who have come off the pill and they are right into trying to conceive and we are doing everything at the same time. We are actively trying to conceive while monitoring the cycle, watching the cycles normalize and doing everything we can to support hormonal health. So like I said, there’s no wrong answer. And if you are in the midst of trying to conceive and you didn’t know this, that’s fine. We can of course meet you where you’re at and do everything we can to support the hormones. But it’s just important to know, it can take a bit longer. Okay, so that’s point number three.

Now, point number four is what we touched on at the beginning, which is your partner’s sperm is not up to par. So it’s really what I would suggest for those of you who are really interested in this topic, who’ve heard about it, if you have already grabbed your copy of the Fifth Vital Sign, go to chapter 17 and read the section about improving sperm quality. I know some of you are reading it like front to back in order, but it’s okay. You can skip around and I kind of designed the book that way as well. For those of you who haven’t bought the book, I would suggest for you to consider, especially if you’re really interested in it. And also this particular topic, all of the information that we’ve spoken about today is covered in the Fifth Vital Sign in a ton of detail. So fertilityfriday.com/vitalsign. And also for those of you who are into audiobooks, you can listen to the Fifth Vital Sign for free with your trial of Audible, fertilityfriday.com/audible.

Okay, but let’s get back to the sperm. Now, one of the things that’s really important to know is that this is a problem that’s kind of bigger than you. It’s bigger than your partner and it’s bigger than your relationship. So often there’s kind of this idea that it’s an individual man’s problem, like, oh, this is Tom and Tom has poor sperm quality. But it’s really not like that. So when you get into the research, you start to see the trends and the trends are staggering. So I’ve said this on the podcast before, I’m sure. But your average man in the 1940s had a sperm concentration of about 113 million sperm per milliliter. But the average man today has an average sperm concentration of anywhere from 40 to 50 million sperm per milliliter. Now that’s anywhere from 60 to 70 percent or more drop in the number of sperm in sperm count. And so this is across the board, and that’s a huge dramatic difference. There’s this gigantic elephant in the room and I don’t know how many people are talking about it. And we’re at a state with our current healthcare system where the solution to male infertility is IVF, because when a man has really poor sperm quality or really low sperm count, that’s all they really have to offer in the traditional medical system. And that’s just not good enough, especially in this age of information where there are hundreds if not thousands of research studies on specific things that you can do to improve sperm quality naturally.

What’s really, really important if you have been trying to conceive, even if you’ve been told that it’s okay — because what happens is when you’re working with a doctor, whether it’s your reproductive endocrinologist or your family doctor or whoever your doctor is, there’s a different set of parameters for sperm quality when it is related to interventions versus natural conception. So when your doctor does the sperm analysis and you’re looking at the requisition and they have the numbers on there, those numbers are kind of like the lowest possible bar. Those are the minimum requirements that they need in order to do a procedure such as IUI, intrauterine insemination, or IVF, in vitro fertilization. And so it’s a completely different question of what is the bare minimum that we need to do a procedure versus how much sperm is optimal for natural conception. So that’s one thing that’s highly problematic.

So I would encourage all of you who are listening who have been trying to conceive for quite some time, if you have been told that everything is totally fine, then I would encourage you just to pull up the results and actually look at them, because there’s a really big difference. And what I can tell you is that over the years, I really haven’t worked with very many women whose partners’ sperm have been normal, who are in that stage of trying to conceive and they’ve been trying for quite some time and it hasn’t been working. I really to this day have not seen an optimal sperm analysis, meaning that all of the three main areas — sperm count, sperm quality, so the morphology, the count or concentration, and the motility — I have yet to see my clients who are in the trying to conceive category who’ve been trying for a long time have a truly optimal sperm analysis. Even though the numbers are really, really low, my clients are consistently told that everything is totally fine.

Another thing that I’ve seen as well is if the count is really high, they just ignore the other numbers. So if the count is really, really high, but even if the morphology number is basically zero, they’ll still say it’s totally fine and just send you along the way and just be really happy that the count is high. So it’s possible to have a really high sperm count and still not be able to get your partner pregnant, just for everyone to hear that. Because if none of the sperm are normal and they don’t have any normal forms of sperm, it kind of doesn’t matter how high that number is. Because what good is hundreds of millions of sperm that don’t have heads or tails?

So this is a factor that’s really important. It’s something that we really need to be paying attention to. And so for those of you who are curious, the lower bar reference for sperm according to the World Health Organization: 15 million sperm per milliliter concentration, abnormal forms — 4% morphology is considered to be fine — and the motility probably somewhere around 50%. But it’s like what happened is there’s a huge trend in male sperm declining and instead of acknowledging it we just lowered all the numbers, which doesn’t make any sense. So there would have been a time when a man with those parameters would have basically been considered sterile, but now we just consider it to be totally fine.

So yeah, the optimal numbers are much different. Optimal morphology is up at 15%. Optimal sperm concentration is about 50 million sperm per milliliter. And then optimal motility, according to the one study I looked at, was 68%. So those numbers are really, really different. And so what happens is you are being told that everything is totally fine when really it’s not, not for natural conception.

The good news is that there’s so much that you can do to improve sperm quality. When the sperm quality or count is really, really low, there are often specific factors — a combination of lifestyle factors, dietary nutritional factors — there are a combination of things that typically stand out and certain habits that can be changed to dramatically improve sperm count and quality. For instance, a few things that come to mind — if your partner drinks regularly, there’s a lot of research to show. I mean no one thinks alcohol is a vitamin or a health food or anything, but there is research to show that alcohol does have a negative impact on sperm quality, as well as smoking, both cigarettes and marijuana. And so just certain lifestyle factors. What I found is that when I’m working with a client whose partner’s sperm quality or morphology number is particularly low, there are usually a couple of things that if we kind of go down the list of lifestyle factors, something stands out. So that’s something to keep in mind, as well as of course diet, lifestyle, and supplementation.

And when it comes to sperm quality, the good thing about sperm is that it’s measurable. So in the fertility journey, there are few things that can be as gratifying. Before your partner makes any changes, you can have a sperm analysis done and see where the numbers are, see where the sperm concentration is, see where the morphology numbers are. And if you create and stick to a specific plan to improve sperm quality and count and all of those things for a minimum period of about four months — when it comes to sperm as well, it takes a minimum of three months to start to see a difference. And if you commit to sticking with a strategy for four months, six months, nine months, twelve months, for many of you that seems unreasonable. But what I always say is that when it comes to your fertility journey, six months, nine months, twelve months will come either way. So you may as well have it come with better sperm. And, you know, that’s a quote from the Fifth Vital Sign because I write how I talk. But ultimately, that’s really what it is.

And the gratifying thing about sperm quality is that if you follow evidence-based practices, if you actually incorporate some of those lifestyle changes, then you can actually see the improvements. And of course, it’s hard to say exactly when pregnancy will occur in advance because we can’t predict these things. But if you started out, let’s say your partner started out with like a four or five percent morphology number, and over the course of nine to twelve months, you improved that number to 10% — like you doubled it — which is possible. I’ve seen numbers double and triple with a concentrated effort for a period of time. Then your chances of conception are much higher because you just have increased the number of viable sperm by double, twice as much. And if you think about the concentration numbers, we’re talking about millions of sperm per milliliter. So if you improve that morphology number by one, two, three, four, five percent — yeah, that’s millions and millions of sperm that are now normal and able to fertilize an egg where before they didn’t even exist.

So these are important things to think about. In the Fifth Vital Sign, I go through a number of different nutrients that have been shown to improve sperm count and quality. And so specific nutrients include vitamin A, zinc, folate, vitamin D is important, the antioxidants, selenium, vitamin C, as well as coenzyme Q10. And there’s other nutrients that are implicated in sperm quality. And in chapter 17, I share one particularly interesting study. All of the participants, before they began the study, all of the men had been shown to have sperm parameters in the subfertile range, and none of the couples had successfully been able to conceive during that time. And in that particular study, they gave the men coenzyme Q10 at a specific dose, and I think it was twice a day over a period of a year. So they continued with the supplementation for a year and the results were really staggering. The sperm count quality — specifically morphology, motility, and the count — all improved significantly. And at the end of the study, 30% of the participants had conceived with really only that one intervention. So this isn’t to say that this is magical or that you just take a little bit of CoQ10 for a week and everything’s gonna be great, but it’s meant to say that a men’s semen analysis is similar to a woman’s menstrual cycle in that it is a reflection of their overall health. And by making specific changes in your lifestyle factors, your dietary factors, supplementation, things like that that are known specifically to improve sperm parameters, you can actually see a difference.

And unlike a lot of the other fertility-related factors, sperm is something that you can actually put a number on. So you can actually see if your interventions are working, provided that you give it enough time. So I wouldn’t retest for at least four months. But during that time, like I said, that time is going to pass anyways. So I highly recommend chapter 17 of the Fifth Vital Sign, where I go through all of this information in great detail, all the different lifestyle factors that are known to impact sperm quality and count and morphology and motility, as well as specific dietary factors, so specific fertility foods to incorporate to improve sperm production, and specific supplementation to consider.

We often think, again, of fertility as a woman’s issue, and we don’t even think of the men. And for that reason as well, when you make an appointment with your doctor, when you see a naturopath, when you start acupuncture, when you start to look at all of your different options, you are the patient, as the woman, as the female. So what if we, for a moment, thought of your partner as a patient? What if he had an appointment with the naturopath, the acupuncturist, and specifically worked to see what was going on. One of the things that in one of my previous episodes, I believe it’s episode 54 with Diane and Ketty, where we talked about the MTHFR gene mutation — so that’s something that we’ve talked about on the podcast a couple of times, on how specifically it can negatively impact fertility. We often think only of how that could affect female fertility. So folate — when you have the MTHFR gene mutation, for example, it interferes with how your body can methylate folic acid. So all of the supplements that we typically take, unless we’re sourcing specific supplements with the methylated version, contain folic acid. And our body then has to break that down into folate, and it’s a lot more complicated than I’m making it sound. But let’s just say that when you have that gene, it interferes with how your body processes folate, and we know how important folate is for normal fetal development and the link between folate deficiency and spina bifida and all the different types of developmental issues that can arise. Well, folate is also crucial for sperm development. So if a man has the MTHFR gene mutation and he’s not aware, for example, that can interfere with his ability to produce normal sperm if he’s not getting enough of the methylated folate. So that just gives you just again an idea that in some cases, especially when we know that the sperm quality is poor, perhaps we should consider for a moment — what if our partner is the patient for a moment? What if we can strategize to get him on a very specific plan to improve sperm quality?

Because like I said, and I’ll just say it again, unlike a lot of the other fertility-related parameters, sperm is something that we can monitor. It’s something we have numbers for. We can really monitor that progress over a period of time.

That brings us to the end of our list. So just to recap, the top four reasons why conception may not be happening for you: number one, you’re not getting the timing right. So we talked about rhythm method thinking and moving away from the idea that ovulation always happens on day 14 and actually paying attention to what’s happening in our body, recognizing that ovulation is the most variable aspect of the menstrual cycle and it can shift and be either earlier or later in any given cycle and you wouldn’t necessarily have advanced warning. So you’re always going to be watching for your cervical fluid. Which brings us to number two, which is that if you’re not focusing on your cervical mucus production, then that can be impairing your chances of conceiving. Because when you’re trying to conceive naturally, cervical mucus is the number one thing that you should be looking for. Not necessarily the only thing if you’re using tools like OPKs or your BBT — again, cervical mucus always has to come first, and then all of the other tools and strategies have to come second.

Number three, you just got off the pill. So if you have taken the pill, it’s really important to know that the pill impacts your fertility temporarily. The pill is associated with a temporary reduction in your normal fertility. And on average, it takes about twice as long if you’re coming off of the birth control pill — the combined contraceptive — so any version of the pill, the patch, the ring. If you’re taking the shot, it’s different. There’s a lengthier period of subfertility. So the shot has the longest, and it’s more like 18 months as opposed to, on average, it takes 18 months to conception after the shot. But just so that you have that in mind: if you just got off the pill, your body does go through a transition period that lasts an average of about nine to twelve cycles, which is closer to twelve to eighteen months, depending on how quickly your period returns.

And the last one that we talked about, your partner’s sperm is not up to par. So this is a huge issue that we’ve talked about. We talked about the global implications and how it’s much bigger than just you and your partner. And so we really have to look at that. If anything, you just want to empower yourself. Make sure that whenever you’re getting lab work done, whether it’s yourself or your partner, you want to make sure you get a copy of that and you can take it home and analyze it, compare the readings to the specific parameters that are listed for optimal conception in the Fifth Vital Sign. So if you take anything from that section, it’s that the numbers for optimal conception are very different than the numbers that are often listed on the lab results. The numbers that are listed on the labs and the numbers that most doctors are going by are the bare minimum numbers that are required to do a procedure. And it’s a very different question of what is the absolute minimum that we require for a procedure versus what is optimal for natural conception.

And so that really brings us to the end. That brings us to the end of our conversation today. I wanted to share with you the top four reasons why you may not be conceiving — not because these are the only reasons, but because these are some of the most common factors that I see that really need to be discussed, based on some of the most common misconceptions. And for any of you who’ve been listening to the podcast for a while, you know one of my favorite things to do is to really smash myths. And when it comes to fertility, these myths are harmful. The myth around timing and when to conceive, the myth that fertility is solely a woman’s issue and that the majority of the time there must be an issue with her on her side, and completely neglecting the male side — all of these are myths that can be extremely harmful for couples who are trying to conceive. And so it’s really important to educate ourselves and to do what we can. Because there’s a lot of this process that is out of our control, but there are parts of the process that are within our control, and at least those are the things that we can focus on.

Thank you for listening. If you enjoyed today’s episode, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/407. I hope that you enjoyed today’s episode. When it comes to conception, fertility awareness cycle charting is invaluable to identify the correct timing — and certainly that is an issue for some couples where they’re just not timing it correctly or following rhythm method kind of strategies, day 14 sex all the time. So fertility awareness cycle charting can certainly play a crucial role in helping to identify correct timing and really ensuring that that is taken care of. Because at the end of the day, if you’re not having sex at the correct time in the cycle, conception just can’t happen. And that’s why fertility awareness can be used so effectively for birth control.

But with that said, fertility challenges are complex. And what works for one couple, what happens to solve the issue for one couple, won’t necessarily solve the issue for another, because there are many reasons why conception is delayed or conception doesn’t happen. So hopefully this episode has given you some ideas, given you a couple of places to start looking, and certainly a few things to start diving deeper into, to determine the true fertility status of both you and your partner. Because one thing that I can say is common for pretty much all of my conception clients is that the male partner tends to be under-evaluated, under-analyzed, because there’s a societal predisposition to assume that the female is the one where the problem lies, so all of the effort and testing and energy goes into her.

So with that said, I hope you have a wonderful week, weekend, whenever you’re tuning into the show. And of course, as always, until next time, be well and happy charting.