A lot of couples have questions about fertility, hormones, and genitals in general. We don’t often see other people’s genitals and some of us don’t spend any time looking at our own! Therefore there are a lot of questions about what is “normal” down there. Fertility and miscarriage is something else that often isn’t openly discussed, meaning most couples don’t know much about it until they experience infertility issues themselves. This week, we interviewed Dr. Allison Rodgers (an amazing fertility doctor) with all our questions about infertility and reproductive health.
Why are We talking about Reproductive Health?
Typically on this blog we talk about all things sex. But there is so much more to our intimate relationships and marriages then just sex! You may be thinking, “why is the ‘fun and spicy’ Get Your Marriage On! Talking about health?”. Although we like to talk about sex (a lot) we also believe infertility and reproductive health is a big deal in marriages. Here are a few reasons why we think this topic belongs on our blog.
- We are about bettering marriage! We often focus on the act of having sex, but we care about all aspects of marriage. A couple may experience changes in their relationship as they struggle with infertility. A couple who is uneducated about reproductive health could experience unnecessary pain, both physically (painful sex) and emotionally (raw and sometimes misplaced feelings after miscarriage).
- Infertility and other health factors can greatly affect our attitude about sex or our comfort levels in the bedroom. For example, a woman with low estrogen levels may experience pain or discomfort during sex. As another example, a couple who hasn’t been able to get pregnant may start to have a negative association with sex and the fact that it’s not bringing them towards their goal of a child. The purpose of this post is to educate our audience to hopefully help avoid some of these problems. If you find yourself already in a situation where sex is painful or if infertility has affected your intimacy, try reading the linked blog posts for specific help!
Infertility and Miscarriage
Infertility is a more common problem than many people realize. According to Dr. Allison, 1 in 8 couples will struggle with infertility at some point. Infertility is defined by the Mayo Clinic as over a year of consistently trying to get pregnant with no pregnancies. Subfertility refers to the condition of having a reduced fertility level.
Miscarriage is also more common than most couples realize. For women under 35 years old, about 20% of pregnancies will end in miscarraige. That rate starts to increase at age 35, and by the age of 40 the percent of miscarriages is 40%.
I don’t include these statistics to scare you, but to let you know these are common occurrences! If you struggle to get pregnant, you are not alone. Many women and couples struggle, and many have overcome .Many other couples still have found much joy living childless lives or building their families in unconventional ways. While infertility can be a great trial in one’s life, there are people there to lift you and guide you through the process, such as Allison Rodgers with her amazingly fun and educational videos on TikTok, or our friend Jaina with her educational Instagram @ttcboxes.
Why Do Infertility and Miscarriage Increase with Age?
Unlike men, women are born with all the eggs they will ever have. Over the course of our lives, eggs age. When eggs age they may develop chromosomal abnormalities. These extra or missing chromosomes can often leads to miscarriage or subfertiltiy. Aging also increases the risk of your uterus developing fibroids (non-cancerous growths on the uterus) or other problems that can make it more difficult to get pregnant.
What Fertility Problems can Men Have?
Although men continue creating sperm throughout most of their lives, certain health factors can decrease sperm health. Conditions like diabetes or obesity will lead to less healthy sperm. Substances like alcohol, nicotine, caffeine, and marijuaina can kill sperm. Even toxins in your environment and hormonal imbalances can affect sperm negatively!
Many men don’t realize that taking testosterone will stop sperm production. The excess levels of testosterone in your body will signal your pituitary gland to stop testosterone production as there is already too much. The hormones that signal the stop to the cells producing testosterone also signal a stop to the cells producing sperm, causing sperm production to lessen or stop altogether.
What Can Be Done about Infertility
Doctors like Allison Rodgers specialize in helping couples fight infertility and build their families. Dr. Rodgers recommended if you (or your wife) is under 35 years old to try getting pregnant naturally for about a year before scheduling an appointment with a fertility doctor. If you are older than that, you may want to schedule an appointment after 6 months of trying. All that being said, in specific conditions you may want to see a doctor sooner. For example, if you haven’t had a period in a while or have a history of cancer or a genetic disorder that could affect fertility such as PCOS (polycystic ovary syndrome), you may want to see a doctor sooner.
It is best to have both spouses get fertility tests performed when starting this process. Issues with sperm creation are much more common than most people realize, and while we often think of infertility as a woman’s issue, that simply isn’t the case for about half of all infertile couples. If you do find your sperm are unhealthy or fewer than normal, avoid the substances listed above, extreme temperatures (like sitting in a very hot jacuzzi), or excessive bike riding. Reproductive health is very connected to just general, physical health. Remember, sperm production takes about 10 weeks, so changes in lifestyle may take up to 3 months to have an effect on sperm quality.
The same goes for egg quality. While women are born with all the eggs they will ever have, there are certain dietary and lifestyle things that can be done to increase or decrease the quality of those existing eggs. A few ways to do this include avoiding toxic substances such as tobacco, alcohol, and many things in household cleaners (phthalates and parabens, formaldehyde, hydroquinone and more), eating proper amounts of protein, fruits, and vegetables, and managing your stress levels the best you can. Just like it can take up to 3 months to increase your sperm production again in men, it can also take roughly 3 months for any changes you are implementing to impact your egg quality, so start now to make the biggest difference.
After a while of not getting pregnant, it may be time to visit a fertility doctor. An OBGYN may be able to make a few suggestions, but if those don’t work they will most likely refer you to a specific fertility doctor, otherwise known as an Reproductive Endocrinologist. Fertility doctors have a ton of resources to help increase your chances of getting pregnant, and will help you find what will work best for your body and specific situation
For example, you could be prescribed medications that will give your pituitary gland a boost. The pituitary gland is in charge of telling your uterus to prepare eggs for ovulation. Medication like this can help your uterus prepare more higher quality eggs each month. Doctors could also simply use ultrasound equipment to tell you exactly when you are ovulating.
Another thing doctors can help with is the male side of things through intrauterine insemination. This process includes taking a sample of semen, washing it to get only the vital sperm, and inserting them straight into the uterus. With normal intercourse, only about 1% of sperm make it from the vagaina to the uterus, so insemination alone raises your odds of fertilization by about 33%.
If other things have failed, In vitro fertilization (IVF) is an option where both sperm and egg are collected and fertilized, then inserted into the uterus. Doctors will prescribe medications that will enhance the body’s natural processes, help the woman’s body produce more healthy eggs, then observe the eggs after retrieving them to ensure they become embryos and that the process is going well before implanting those embryos back into the women’s uterus.
Will my Beliefs be Respected?
It is so important to find a doctor who will be open and flexible to working with you and your beliefs. Dr. Rodgers emphasized the importance of letting your doctor know what you believe, and finding someone who will work with you. She even recommended that you may want to get a member of your clergy involved to advise you on what to do in your specific situation along with the advice of your fertility doctor.
A lot of women have questions about what is and isn’t “normal” about vaginal health. Know that most likely discharge, fluctuating periods, and smelly vaginas are completely normal!
Vaginas are usually pretty good at caring for themselves. Dr. Allison does not recommend using products to clean out the vagina; it’s almost always better to leave it alone. Vaginas do have a natural smell. Products trying to change that smell are not healthy and can disrupt the natural PH of your vagina causing all havoc to break loose in your nether regions.
After sex, make sure you go to the bathroom! The urethra can easily get infected and bring bacteria up to the bladder, so peeing right after sex can help make sure the urethra stays clean. The outside of the vagina can definitely be washed after sex, but never put anything with perfumes or that is intended to clean up inside the vaginal canal.
If you do experience problems with viginal health, consult your OBGYN.
It takes courage to make an appointment with a fertility doctor. It takes a great deal of faith to keep trying even after heartache. Know that it is possible to build the family of your dreams, even if the family building process may look a different than others. You can do this. We are cheering you on and so are so many others who are in your corner!
Written by Amanda Severson (with lots of help 🙂 ) with Get Your Marriage On!