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Frequently asked questions about fertility

| NOV 9, 2017

Angela Heap trained at the College of Naturopathic Medicine in London (CNM) for 3 years in 2005. During her time at CNM, the area of hormonal health and pregnancy became a real interest for her. After graduation, she continued working in this area and specializes in infertility, hormonal management and pregnancy. 

As a Nutritional Therapist, her approach is to empower people towards optimum health,  often working alongside conventional medicine practitioners. She supports her clients through a programme of good nutrition, lifestyle and a range of supplements.

In this article, Angela answers some frequently asked questions about the phases of fertility, your body's cycle and when it's best to conceive. Over to Angela...

"If I get to know my cycle, when is the best time to conceive?"

Start charting your cycle to understand your phases. I recommend you use something like - although it isn’t designed to show you when you can have sex to conceive, it's a fabulous tool to help you to get to know your cycle. Once you have followed your cycle for around 2/3 months you will have a bit more of a clue as to your ‘fertile window’. Some ladies find they have a short luteal phase by doing this, which can have implications for sustaining a pregnancy.

The best time to make sure your egg meets sperm is to have sex 2 days before ovulation, or the day before. Then have it the day of ovulation. I’ve had clients who assumed they were a classic ‘ 14 day ovulator’ and they were in fact not ovulating until day 16, so were missing it every time!

"What the heck is cervical mucus?"

You will have noticed over the years that there are some changes in your pants! This isn’t anything to worry about, in fact, it's perfectly normal. As oestrogen builds in your system you will see changes in our cervical mucus (CM). There are on average 5 different types of CM to look for:

  • Dry – a sign your body might be low in oestrogen or you could be very badly dehydrated!

  • Sticky – not fertile at this time, has a sticky consistency but not stretchy

  • Creamy – not fertile at this time, and looks like lotion!

  • Watery - Fertile.  Usually clear to touch, feels cold as opposed to menstruation wetness which is warm

  • Egg White (EWCM) - This is the most fertile CM. Looks and feels like raw egg white and is very stretchy. If you touch it between your thumb and finger it will stretch without breaking. This stuff feeds the sperm and projects it to the egg faster. EWCM is mostly clear.

"I have never seen any fertile types of cervical mucus, does this mean I'm not ovulating?"

No. Some women just never see the changes in their CM but it doesn't mean it's not there, it may be further up the pipes so to speak!

"What happens to cervical mucus after I have ovulated?"

After ovulation CM will usually return to an infertile state straight away.

"What is the difference between the follicular and luteal phases? I keep hearing about having a ‘luteal phase defect!"

Your egg will build based on a concoction of hormones and the follicle will grow to a max of 18mm - 25mm. During the final days before ovulation, there will be a ‘fight’ for dominance between 1 or 2 follicles. This is very different if you go for IVF, as the drugs will push your body to produce sometimes up to 20 or so follicles, which can give you up to 20 eggs in some cases! Under normal circumstances, you'll have 1 follicle which will produce 1 egg (or if you're lucky enough, you can produce two eggs naturally to have non-identical twins!).

When you ovulate your hormonal signals will switch from FSH and LH and oestrogen to progesterone and oestrogen. Progesterone is the hormone that will start to flow as soon as we ovulate. It's produced from the site of the corpus luteum (where the follicle has burst), so on the collapsed follicle, progesterone will start to flow.

We have now moved from follicular phase (building) to luteal (sustaining). If we haven’t fed our body adequately, nourishing the production of progesterone, this will be a ‘weak’ hormone. This is often indicated by spotting in the luteal phase or a shorter time from ovulation to period after charting for a few months. Anything less than 11 days is seen as an indication of low progesterone. However, this needs to be confirmed by a blood test, and I would say it's one of the most important tests to go for. 

Ask your reproductive specialist to order a progesterone test if you've had problems conceiving. This test is often called the 'day 21 hormone test' but, for women with longer or shorter cycles, it's vital to get this done at the right time. In order to do that, you need to chart your cycle and go for this test at exactly 7 days after ovulation to get the best result. If you do indeed become pregnant, and the uterus is not stocked full of progesterone (from many moons of making good levels), this is often the time when early miscarriages happen. This is because, from week 7 – 10, the body switches the ‘tap’ from the corpus luteum producing progesterone for the growing embryo to the uterus. If the uterus doesn’t have enough progesterone, this is when problems can happen.

You can find Angela on Instagram @fertilitynutritionist.

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