Every month, Dr. Gleaton answers all your questions about fertility, pregnancy, birth and more. Follow us on Instagram to ask your questions!

 

By OBGYN Dr. Gleaton

Is there any way to know if you're infertile before trying for a baby? 

You can ask your OBGYN about fertility tests including labs testing egg quality/quantity, tubal assessment, and sperm assessment to get an idea of any challenges you may face. However, while these may offer useful information, the only true test is to start trying!

I’ve been trying to conceive while breastfeeding and my cycle is all over the place. Any advice? 

Irregular cycles can be a normal part of breastfeeding and can take up to 1.5 years postpartum to completely regulate. Consider abruptly dropping one feeding which can sometimes help. In addition, focus on optimizing your nutrition, ingesting sufficient calories, and learn to identify your body’s ovulation signals. Using ovulation tests can help. 

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Do I need collagen protein supplement when TTC/pregnant? 

Collagen protein is typically considered safe while ttc and during pregnancy and offers benefits for bone, hair, and joints. Everyone has individual needs based on their diet and risk factors. Discuss with your OBGYN provider if collagen supplementation is right for you.

I have been trying to get pregnant for two years. Is it beneficial to see a new doctor?

Although most couples will conceive within the first year of trying, this is not true for all couples. Everyone’s journey to parenthood is unique and different, and timeframes vary widely.

It's best to openly discuss your desires and expectations with your OBGYN early on. Ask for a specific plan to evaluate and achieve your fertility goals. If you’ve met with your OBGYN  and feel unsupported in your fertility journey, then by all means seek a second opinion. 

I have been seeing a lot of things about choline. Can you talk more about the need for it?

Approximately 90%–95% of pregnant women don't get enough choline through diet, and most prenatals contain little—if any—choline. Some evidence indicates that lower choline levels are associated with an increased risk of neural tube defects.

Most prenatals lack choline. But growing evidence of its benefits shows choline improves several pregnancy outcomes and protects against certain neural and metabolic disorders. 

What can I do (in addition to medication) to get my egg count up? 

Since women are born with all the eggs we’ll ever have, our egg count can’t be increased. However, there are certain practices that are associated with improved egg quality and in some cases improved fertility outcomes. 

For enhanced egg quality, focus on exercise, stress reduction, a healthy diet, not smoking, and maintaining a normal BMI. Several supplements have also been linked to improved egg quality including Vitamin D, DHA, and Coenzyme Q10.

What does it mean if your luteal phase is short? How do you lengthen it? 

A short luteal phase is one that lasts less than 8 days and is associated with low progesterone levels. Progesterone is vital for proper preparation of the uterine lining for implantation. In the last decade there has been considerable debate as to whether luteal phase defect (LPD) impacts fertility rates. However, if you suspect a problem with your luteal phase, discuss with your provider and aim to correct the underlying cause. Treatment may include progesterone supplementation, stress reduction, weight loss, and correction of other hormone imbalances. 

When should I start using the ovulation strips? After my period? Any time? 

For an average 28 day cycle, I suggest daily testing starting day 10.

Can people with endo conceive naturally? 

While getting pregnant with endometriosis can be more difficult in some cases, it is definitely not impossible by any means! Check out my article “Getting Pregnant With Endometriosis” for more information. 

How long should you wait to start TTC after giving birth?

ACOG recommends waiting at least six months, but further acknowledges optimal spacing as 18 months since intervals less than 18 months are often associated with adverse outcomes. Although most US data supports this association, studies have not consistently shown a cause-effect relationship. Read more on child spacing.

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What basic tips do you have for getting pregnant? 

  1. Get to know your fertile window by using ovulation tests - aim to have sex every other day during this window
  2. Eliminate smoking, drinking, and any drug use 
  3. Get your BMI in a healthy range
  4. Start taking a prenatal

For more tips about on TTC best practices, check out our article “Tips to Increase Your Chances of Getting Pregnant This Month.”

TTC while breastfeeding (an 18 month old). I’m having trouble. Is it possible? Do I have to wean?  

When you are exclusively breastfeeding, your body naturally stops ovulating. And if you’re not ovulating, you can’t get pregnant. I suggest… 

Tips for getting pregnant with only one fallopian tube after ectopic pregnancy? 

Pregnancy can still be achieved in the setting of only one tube. However, when one fallopian tube is damaged or blocked, it's important to ensure the health of the opposite or remaining tube and confirm that it is open. This can be done with a hysterosalpingogram - an xray dye test or sometimes a special ultrasound procedure utilizing fluid.  The basic principles of conception also still apply, so identify your fertile window, optimize your health, and work on stress reduction.Lastly, tubal factor infertility should most often be managed with an early REI referral to discuss treatment options that can bypass the fallopian tubes if needed. 

If all my labs come back normal, is it possible to still have a hormone imbalance from foods, skin products, etc leading to my “unexplained fertility?”

Yes. Hormone levels can easily confirm abnormalities that may affect fertility. However, if these are normal, certain practices may still affect pregnancy rates. Focus on eliminating or reducing processed foods, artificial substances, parabens, dyes, etc and increasing fertility friendly supplements such as CoQ10, vitamin D, prenatal vitamins, and folic acid. 

 

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