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Fertility Optimization

Fertility Optimization 

Why am I not getting pregnant?

Getting pregnant is easy, right? That's what I remember learning in sex ed back in grade school, at least. Reality is a little further from that. Figuring out how to get pregnant is often a bit trickier than what we were led to believe. 


Whether you have just started trying to conceive, have been trying unsuccessfully for months on your own, or have been either considering or undergoing IVF or IUI with a fertility clinic, here are six questions to ask yourself:


  1. TIMING: Am I having sex at the right time of the month? There is only a window of about 3-5 days each month when you can have intercourse that can result in a pregnancy.


  1. OVULATION: Am I ovulating? Going by the calendar may not be enough. There are some ways you can track ovulation with urine ovulation tests (ovulation predictor kits/LH test strips), basal body temperature, and body signs of ovulation.


  1. BALANCED HORMONES: Are my hormones out of balance? They must be in the optimal ranges for creating healthy follicles, thick lining, ovulating, and maintaining pregnancy. It's important to look beyond the typical sex hormones of just estrogen and progesterone, but rather expand to look at a bigger picture that includes thyroid hormones.


  1. EGG QUALITY: Are my follicles healthy enough to be inseminated and develop into an embryo? Sometimes it's not about quantity, but quality. There are many ways to figure out how to improve egg quality. Checking nutrient status, supporting with antioxidants, and avoiding harmful exposures are just some things that can help improve egg quality at any age. 


  1. ENDOMETRIAL LINING: Is my uterine lining thick enough to support implantation of an embryo? Ultrasounds can verify, but there may be other clues, like having a very light period.


  1. PARTNER: Is the sperm good quality? For those undergoing IVF or IUI either without a partner or in a same-sex relationship, typically the donated sperm is screened and is of good quality. However, for those who are in a heterosexual relationship and are trying to conceive at home, or are considering IUI or IVF with their partner's sperm, semen quality isn't always thoroughly investigated. It's important to check in on sperm count, motility, morphology, and DNA quality (this last one, known as DNA Fragmentation Index, often gets missed or overlooked).


Being able to answer all of these questions thoroughly is a key piece in the fertility puzzle. There are so many different contributing factors, so answering these questions can help point you in the right direction for your next steps in getting pregnant.

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