When and how to suspect infertility

How long it takes to conceive is a common question and hot discussion topic. On average, for any given month, there’s a 30% chance of conception for a couple that’s trying. This number decreases if you are older, especially after 40, and if you smoke, etc. On the other hand if you know when you ovulate, for instance with NaturalCycles, and manage to time intercourse, the chances are higher. 95% of pregnancies happened when the couple had sex either on the day of ovulation or the two days prior to ovulation.

On average it takes a couple 6 months to fall pregnant, but what is hidden behind this number is the fact that for most couples it goes faster and for a few it can take significantly longer. About 15% of couples have trouble conceiving, but only 5% of those are truly infertile. This means that 95% of couples will be able to conceive naturally if they time intercourse well and have a little patience. Especially if you are a bit older, it’s important to time intercourse on the most fertile day in the cycle.

Infertility causes - NaturalCycles

Credit: Wikipedia

When a couple tries to conceive and doesn’t fall pregnant, it can be due to several causes. Maybe they simply didn’t time intercourse right or the woman was having an anovulatory cycle. If the conditions of sperm meeting egg were good, there’s a chance that no high-quality sperm made it up into the fallopian tubes and managed to fertilize the egg. But even if the egg did manage to get fertilized, it still has to travel down to the uterus and get implanted about 9 days later. One common problem is that the woman’s luteal phase isn’t long enough for the egg to have time to implant in the uterine lining. This condition is called the Luteal Phase Defect.

If the egg gets fertilized and implanted, the risk of having a very early miscarriage, also called a “chemical pregnancy”, is high. This is your body’s way to getting rid of a fetus that is somehow damaged or has chromosomal abnormalities. Most women do not notice if they’ve had a chemical pregnancies unless they’ve already seen a faint line on a pregnancy test followed by menstruation a few days later. If you use NaturalCycles, you would see it as a delayed menstruation and hence a longer than usually luteal phase. How common chemical pregnancies actually are is hard to say, since they usually go unnoticed.

Things to ask yourself if you suspect infertility:

– In your NaturalCycles account you can see how often you have anovulatory cycles or very long cycles (> 40 days). This might be due to a hormonal imbalance that could be fixed. Show your doctor your cycle information.

Infertility - NaturalCycles

– Check with your NaturalCycles account how long your average luteal phase is. If it is shorter than 9 days this might impose problems for the fertilized egg to implant. Consult your doctor on this, as taking extra progesterone can prolong the luteal phase and help you conceive.

Infertility - Luteal phase - NaturalCycles

– Be aware if you frequently have chemical pregnancies (early miscarriages). You would see this as a positive pregnancy test followed by menstruation a few days later or a delayed menstruation with a longer than usual luteal phase.

– If nothing seems to be wrong with you or your cycle, remember that about half of infertility problems originate from the man. Nowadays one can buy very cheap sperm count tests to try at home. Here’s an example. So you can make a first test together in peace before you need to go to the clinic and spend a lot of time and money.

One thing to remember is to not to worry or stress too much about this. As I mentioned before, only 5% of couples are declared completely infertile and more than 50% of those will respond to fertility treatments. Don’t rush to the IVF clinic to go through the most expensive and emotionally exhausting treatment right away. Try to conceive naturally first, and follow your cycle closely to see if there’s indeed a problem that is easy to fix.

Temperature chart for a cycle that includes conception

Looking promising so far! A temperature chart for a cycle that includes conception is usually triphasic.

Firstly, the temperature rises with ovulation, and then the second rise is due to the further increased progesterone levels caused by the very early stage of pregnancy.

I am now 9 days past ovulation and implantation of the fertilized egg in the uterus should occur about now. My period is expected on Sunday and usually my temperature starts decreasing a day or two in advance, which means tomorrow. It will therefore be very interesting to see if the temperature will rise further tomorrow or if it will go down, implying that the higher levels today and yesterday were simply fluctuations.

Temperature chart - NaturalCycles

Getting strangely attached to women’s data

In the last months I have been staring at countless of temperature charts from women of different age and lifestyle. It is funny how difficult it is not to get attached and have a personal relationship with the data.

This might sound odd to you, but during the development phase of NaturalCycles, the best part of my day was waking up in the morning and going straight to checking the new data entries of all “my” women. Did the period appear as expected for Ms X? Did the temperature rise further to give green days for Ms Y? And did Ms Z finally find her LH peak? This is why it is good to have a statistical algorithm analyzing the data and not the personal opinion. It is funny how your own perception can bias the temperature reading.

Charting by yourself can easily lead to misinterpretations

As an example take Sara. She had been on the pill for several years before stopping and trying out NaturalCycles. The hormones strongly affected her body and cycle and her first cycle was more than four months long. Only after a year did her cycles become less than 40 days long. I got very attached to Sara’s data and was desperately hoping for a temperature rise indicating ovulation every single morning. One day I was sure she had ovulated, but NaturalCycles still gave her red days. I was wondering how come – it should definitely be green!

Data - NaturalCycles

Luckily I am not personally analyzing the data and putting my feelings into the mix. Some days later, Sara’s temperature was as low as ever and ovulation followed shortly thereafter. This is why I think a charting by yourself or using a non-sophisticated tool can be even dangerous, especially if you are using the method to avoid pregnancies.

Data - NaturalCycles

The perfect temperature chart

As I am a big fan of evening relaxation with the help of a glass of wine (ok, fine, several glasses of wine), my own temperature data is quite jumpy and far from perfect. This is of course fine, and perfectly safe, but I still envy those women with perfect curves. Temperature curves, that is… 😉 Below you can see the chart of one of my favorite curvy women. There are of course some fluctuations here and there, but overall it looks like a perfect sine wave gently flowing over the course of time.

Data - NaturalCycles

Ok, enough charting porn for today. I guess I’ll always remain a bit of a physics geek, getting all excited about the amazing data the female body so naturally produces.