Category: Fertility

Fertility, Health

Why Can’t I Get Pregnant? Here are 8 Reasons Why it Might Not be Happening

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For those actively trying to conceive, once you’ve made the choice to get pregnant, every negative test result can lead to disappointment. Everyday activities, like a stroll through your neighbourhood, can bring reminders of pregnant bellies and seemingly happy smiling families. The same goes for whenever you tune in to your favourite streaming program or social media accounts… Suddenly, there are happy pregnant people everywhere but you. Frustrating to deal with for sure but don’t worry just yet — you are not alone.

Allow me to break down some possible reasons why you might be having trouble conceiving. The key to reviewing this list is for you to remember that more than one of these possibilities can be going on in your body, at the same time :

1. Endometriosis — This condition affects between 10% and up to 20% of persons born with ovaries and often manifests as chronic pelvic pain with periods or during intercourse. Moreover, endometriosis can be overlooked or misdiagnosed in many while causing issues with diminished ovarian reserve (low egg counts) and fallopian tube scarring. This diagnosis is only formally made via surgery but a skilled gynaecologist or fertility specialist can often help you figure out if you fall into this category.

2. No Ovulation — You will not get pregnant if you are not ovulating. While this is a common fact, persons with ovaries experience the absence of ovulation for different reasons. Reproductive conditions such as dysfunctional thyroid, polycystic ovary syndrome (PCOS), prolactin tumours, primary ovarian insufficiency (aka premature menopause) and weight issues (overweight or underweight) can contribute to this type of anovulatory infertility. Seeing a gynaecologist or fertility specialist can help you determine if any of these issues are at play for you.

3. Male (sperm factor) Infertility — 50% of cases of infertility in couples, where one partner makes sperm and the other makes eggs involve something going on with the sperm! Yes, sperm factor infertility is a big deal but most people do not look into it early enough. In fact, many people just assume that sperm is normal because the person making sperm feels healthy or has sired pregnancies in the past.

However, many medical conditions, environmental factors (e.g. smoking) and simply getting older, can have a direct impact on someone’s ability to make healthy sperm.

If this is the case, diagnosis for sperm factor infertility should take place earlier rather than later! The most straightforward first step in evaluating for sperm factor is to have a semen analysis performed to identify potential issues such as low sperm counts, sperm movement issues, and other sexual related problems. There are different and very successful treatment options available to treat sperm factor infertility if it is identified.

4. Blocked Fallopian Tube — Fallopian tubes are the place in the body where sperm and egg are supposed to meet to start an embryo. The tube(s) also help transport the fertilized embryo to the uterus, where it can implant to form a pregnancy. If one or both tubes become blocked, conception can become more difficult, as chances of egg and sperm meeting go to slim or zero. Endometriosis, history of chlamydia infection or pelvic inflammatory disease (PID), and surgeries on the fallopian tubes (e.g. tubal ligation) are the leading cause of blocked fallopian tubes. Getting a hysterosalpingogram (HSG) dye test to help determine if one or both fallopian tubes are open or blocked is important when assessing your attempts to conceive.

5. Your Vices — The fun and recreational things that humans sometimes indulge in can take a toll on your fertility. Drinking alcohol in excessive amounts, smoking/ingesting cigarettes or marijuana (THC) products can directly impact your egg or sperm counts and also negatively affect how they function. Certain foods, certain packaging/storage containers and certain cosmetic ingredients can also negatively impact your hormonal functioning and your egg/sperm counts and quality. Consider talking to your fertility specialist to get more details on this.

6. Age — For the person born with ovaries, age is the BIGGEST determinant of your chances for successfully conceiving and going on to deliver a liveborn baby! This is because you are born with all the eggs that you are destined to have and those eggs age with you, while their total numbers decline with age. If you have ovaries and are under the age of 35, you should speak with a fertility specialist after 1 year of trying to conceive; if you are 35 or older, you should seek out a fertility specialist after 6 months of trying to conceive. For those born with testicles, as mentioned above, you should get a semen analysis to start.

7. Uterine Fibroids (aka Myomas) — When it comes to fibroids, it’s about Location! Location! Location! Knowing the exact location of fibroids is critical to determining if they are impacting your fertility. In fact, a small fibroid sitting within the cavity of the uterus (where a baby is supposed to implant and grow) can have a major negative impact on your ability to get pregnant and stay pregnant while a large fibroid that sits outside of the uterus will have little to no impact. Similarly, a small fibroid pressing against the point where your fallopian tubes meet the uterus can also negatively impact your ability to get pregnant.

8. Stress — Although we do not directly link stress to infertility, we understand that it is hard to relax and calm down when you’re high in emotion due to the frustrations of not being able to conceive. This can in turn lead to behaviours that undermine your efforts to conceive or lead to shifts in hormones, such as cortisol, that do not favour ovulation or implantation. Therefore, we encourage seeking out ways to manage stress while you work on looking into everything else listed above.

If you are struggling to get that positive pregnancy test, the first step to do is to identify if any of the above potential roadblocks exist for you. Start by evaluating your lifestyle habits and your health history. If the months keep passing and the sign of pregnancy is still out of reach, consult a fertility specialist to further address any underlying issues.

All the best!

Fertility, Health

Sleep and Infertility: How Sleep Disturbance Can Hurt Your Fertility Journey

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As adults who are busy in our everyday lives, we tend to forget that sleep plays a major role in our overall health and well being. Oftentimes, we are so overwhelmed by responsibilities that we forget to rest. However, we should never compromise quality sleep; especially if you are trying to boost your fertility. 

Yes, as surprising as it may seem, sleep and fertility link to one another! Sleeping not only regulates the maintenance of healthy cells, it also refreshes and restores your brain and organ systems, including balancing all of your hormones; especially your reproductive hormones. 

Beyond sleep’s impact on your overall health (and of course, the healthier you are, you get a better chance of conceiving), there have been studies which implicate that one’s sleep can greatly impact one’s fertility. For example, sleeping disorders usually contribute to a lot of other health problems. Specifically, for women, sleep deprivation can negatively affect their reproductive health. 

Numerous research studies have shown that poor sleeping habits are associated with weight problems, menstrual disorders, inflammatory dysfunction, and mood issues. For those struggling with infertility, irritability, or mood issues can, in turn, strain your intimate relationships and lead to fewer opportunities for conception. 

Sleep disturbance also greatly impacts the frequency and duration of menstruation, the health of pregnancies, incidence of postpartum depression, and menopausal transition, according to this research article from the US National Library of Medicine and National Institutes of Health. 

The hormones that are responsible for regulating reproduction, sperm production, and egg quality are closely related to your sleep cycle. In fact, one’s fertility is not only affected by the quantity and quality of their sleep, but also by their circadian rhythm! 

What is the Circadian Rhythm?

Ever noticed that you tend to feel sleepy or energized around the same time every day? If your answer is yes, then you know how the circadian rhythm works! Your circadian rhythm is basically a 24-hour internal clock that runs within a special gland in your brain (the pineal gland) and regularly cycles between when you are sleepy or when you are alert. Circadian rhythm is also commonly known as the “sleep or wake cycle“. 

Many of our body’s essential hormones peak while sleeping, especially during dawn or early morning hours. The United States’ Centers for Disease and Control (CDC) and Prevention has reported that people who are sleep deprived — a reality for more than one-third of Americans — tend to be more at risk of infertility. Research also suggests that women who are struggling with sleep, tend to be three to four times more likely to experience infertility. 

The Role of Melatonin in Your Circadian Rhythm, and Fertility

Melatonin, a hormone that regulates sleep, is also closely related to the circadian rhythm. In fact, melatonin helps in signaling your circadian rhythm that it is time to be resting. People who have sleep disorders, and those who work at night, have lower levels of melatonin. This is why melatonin supplementation for infertile patients may result in improved chances of conceiving.

Since melatonin greatly impacts your sleeping habits, I have come up with a list to help you increase your melatonin hormone levels, naturally.

  1. Get Some Sunlight – Sometimes, being chronically unexposed to the sun can confuse your sleep cycle, as the brain’s programming for our pineal gland and thus our circadian rhythm, is in part determined by being able to see the rise and fall (diurnal rhythm) of the sun.
  2. No Gadgets Before Sleep – Phones, tablets, and computers have blue light. Not only will blue light affect your eyesight, it also blocks melatonin release, by interfering with your body’s normal circadian rhythm. This is why scanning through your phone before bed, does not really help. 
  3. Eat Melatonin Rich Food – Eating food that is rich in tryptophan will definitely help increase your melatonin levels. Tryptophan is found in protein, oats, chicken, and many more. 

These small adjustments might be able to help you get better sleep which, can boost your chances of conceiving. 

In a nutshell, quality sleep is highly essential in one’s overall health. The healthier you are, the higher your chances of conceiving. This is why you should never compromise your sleep. Sleeping does not only “refresh” your thoughts and your muscles but it restores your cells, allows your body systems to reboot and leaves room for your key reproductive hormones to begin to peak when they should. Lack of sleep, however, does the total opposite of this. 

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Knowledge is like gold for any individual or couple who is in the process of trying to conceive. It is imperative to explicate the effects of sleep on your own fertility journey, by assessing your lifestyle habits. If you believe that you or your loved one may have a sleep disorder, especially if you are also struggling to conceive, addressing the sleep disorder is critically important. This includes being evaluated by a sleep specialist and completing a sleep study.

The success of your fertility journey is dependent on various lifestyle factors such as diet, physical activity, vices, stress management, and the most basic one, quality of sleep. Start winning on these checklists so that you can optimize not only your fertility but also your overall well-being!

Fertility, Health

Fibroids & Fertility – Everything that You Need to Know!

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A lot of factors can affect a woman’s fertility. One of these factors could be Fibroids, which are also more commonly known as Myomas. Fibroids are not as uncommon as people might think. They affect at least 7 out of 10 women. For Black women, the statistics are higher — Fibroids affect 9 out of every 10 Black Women. 

So what are Fibroids and how do they affect one’s fertility? Let’s find out! 

Fibroids, or also known as Myomas, are benign tumors that are made of smooth muscle cells and fibrous connective tissue and usually develop in the uterus. Although statistics say that about 70% to 80% of women will develop Fibroids, not all of them will show symptoms or would need treatment. So how do we, doctors, determine when Myomas need to be addressed? 

© www.healthdirect.gov.au/fibroids

When Anemia Occurs Due to Heavy Periods

Fibroids should be addressed once they start causing heavy periods leading a person to become anemic or require blood transfusions. So how does one know that they are anemic? Signs of anemia are variable but the most common and concerning include fatigue, nausea, shortness of breath, new onset frequent headaches, muscle weakness/cramps, tiredness or sleepiness, heat or cold intolerance, and mental slowing.

If They are Causing “Bulk Symptoms”

“Bulk Symptoms” are symptoms that compress on the bladder, rectum or ureters (the tubes draining the kidneys) and cause you to need to pee often or (rarely), they block the drainage of blood or fluid from your kidneys or legs leading to leg or kidney swelling. Bulk Symptoms can cause difficulty with emptying your bowels or they can make it difficult during times of intimacy because you just feel “full”. They can also cause your abdomen to enlarge such that clothes don’t fit anymore or you appear chronically bloated or pregnant.

When it Starts to Affect Your Fertility

So, how do these pesky Fibroids affect your fertility? Well, there are several ways that Fibroids could affect your fertility. Their location and size are essential in determining if it can affect your fertility or not. Fibroids that are too large or those which are sitting inside the uterine cavity can affect your fertility. This is why getting yourself checked by a professional will definitely help you determine if one, you have Fibroids, and two, if those Fibroids will affect your fertility, pregnancy, or overall health in any way. 

There are various reasons why having Fibroids could mean that you would need treatment. One of the major reasons would be to preserve one’s fertility. There are various ways we can remove the Fibroids. Let’s talk about my favorite way of extracting Fibroids! 

 Fertility preserving surgery for fibroids is called Myomectomy. The type of myomectomy is determined by your surgeon & their assessment of your symptoms and fibroid location. 

Hysteroscopic Myomectomy

This type of myomectomy is my personal favorite. The procedure basically involves two steps: using a hysteroscope (a telescope made to check one’s uterus), we determine where the Fibroids are located in the uterus, then the Myomas are carefully removed through the channels in the scope. 

Hysteroscopy is the gold standard, non-invasive procedure for looking inside the uterus. It involves no cuts on the skin and is typically performed while the patient is under anesthesia. Although a simple look inside the uterus with the camera (diagnostic hysteroscopy) can be done without anesthesia, in suitable patients at the office, operative hysteroscopy such as myomectomy, polypectomy, or lysis of adhesions is performed under anesthesia in an operating room/surgical theater!

In a nutshell, Fibroids are very common benign tumors in the uterus. Symptoms from Fibroids can vary and that depends on their location and size. Size also matters because even a small submucosal fibroid, for example, can cause heavy bleeding or miscarriage or preterm delivery. They can also recur even if you have had them removed in the past.

If you think you are showing symptoms of Fibroids, talk to your gynecologist today! It is so much better to make sure that you can take all the necessary steps to preserve your fertility earlier, rather than later. 

Fertility, Guest Blog, Health

Eggs Over Easy: Black Women & Fertility

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A couple of years ago, during my annual exam, my gynecologist looked at my chart, smiled and said, “You have a birthday coming up. Your eggs are turning 40! Do you want to do anything with them? It’s not too late for you to have a baby, but we’d need to start now.” That one jarring question became the catalyst for Eggs Over Easy: Black Women & Fertility, a documentary that focuses on Black Women, our fertility options, and the reasons we don’t talk about it. 

It is heartbreaking to know that for most women who suffer from infertility, the choice to carry a child is virtually non-existent if they don’t have a six-figure income because insurance companies don’t provide coverage for infertility treatment. So, instead of being able to pursue the traditional routes towards motherhood, these women stay silent… and take care of nieces or nephews or cousins whose own parents can’t take care of them. This is such an interwoven concept in our community that we rarely even look at it as “adoption”, even though it is.

The actual act of having IVF (in vitro fertilization) and Oocyte Cryopreservation (Egg Freezing) isn’t as “taboo” as discussing it is. In the Black community, we tend not to talk about fertility. Period. Since slavery, there’s been an idea that Black women are naturally fertile. The price of a woman of childbearing age was more than that of a woman post-menopause on the auction block. So, of course, there are 400-year-old stigmas attached to our fertility in the US but also in our own community. These deeply rooted notions keep mothers and aunts from talking to their daughters about fertility issues like Fibroids, which affect 80% of Black women by age 50. 

So, we don’t talk about fertility. In addition to the historical implications of fertility conversations, there is also another, bigger elephant in the room: Costs. Infertility treatments are not covered by most insurance companies, unless a company requires a fertility rider for their respective staffs. This means that the average middle class woman can’t afford a $20k IVF cycle, which may or may not require multiple cycles to achieve a successful pregnancy. This means that the average woman doesn’t have an extra $15k to freeze her eggs. And by the time she reaches a salary level that can support the weight of these out-of-pocket costs, she’s late 30s or early 40s, which greatly diminishes her chances at a successful process because of the dramatic drop in egg reserves after age 35. [The suggested age for Egg Freezing is before 36]. These costs affect women of every race, but when compounded by the fact that Black women earn 61 cents for every dollar earned by white men, the goal of motherhood seems all the more difficult.     

There is a range of available fertility treatments for a range of medical conditions. IVF is a process whereby an egg is removed from a woman’s body and turned into an embryo using sperm taken from a man’s body. There are less invasive processes, like IUI and Clomid pills for women who don’t need advanced treatment to conceive. Egg Freezing is the recommendation for women who aren’t at a place in their lives where they are ready to have a baby, but still want to be able to conceive when the time is right—even if that time is later in life. For Black women who are climbing the ladder in their careers or waiting later for marriage, this is a viable option—if they can afford it.

And for women who are fortunate enough to be able to afford infertility treatments like Surrogacy, IVF or Egg Freezing, they are then met with almost complete erasure from medical offices that have few patients who look like them and even lesser representation in brochures or commercials. The thought is that black women don’t have fertility problems, so we’re marginalized and rarely given a second thought within the reproductive industry.

Over the course of this past year, I have spoken with women who have experienced the full range of fertility challenges. Did you know that women who are childfree by choice have some of the most agonizing conversations with their own mothers who want to see them birth a child? It takes courage to be childfree these days. Did you know that you should never ask a woman whether or not she’s planning to have a baby? You have no idea what her struggle may be. And, it’s none of your business if you aren’t her spouse or physician. The documentary addresses this topic with women who suffered debilitating symptoms from fibroids– including infertility, as well as doctors, both board certified and holistic, on what treatment options work best. One of the more astonishing topics focuses on women who suffer miscarriages and the stigma that causes many of them to suffer alone. They don’t talk about it because, in many cases, they feel ashamed. 

Great strides have been made in the space of fertility, which is evidenced in so many celebrities bucking the norm and having healthy pregnancies past the age of 40, but the reality for many women without millions in the bank is that the process to motherhood is sometimes a daunting one. 


Take-Away: Don’t wait to have the conversation with your physician about your reproductive options. Ask for a fertility test if you don’t know your numbers. Specifically, ask for an AMH, FSH, and antral follicle (ultrasound) test. These tests are simple blood tests and an ultrasound. This will let you know the state of your egg reserve. Knowing these numbers will help you navigate your priorities in regards to becoming a mother. Also, don’t panic! There are many ways to become a mother, if that’s your desire. You can adopt children. You can also adopt donor eggs and embryos if you want to carry a child. The goal is to be equipped to make decisions about your body, which means that knowledge is power. For any woman over 25 who may one day want to be a mother, be proactive in gaining knowledge so that you can make informed decisions about your future. This means that maybe you choose to work for a company that provides fertility treatments in their insurance plans, instead of a company that doesn’t. “Prepare for your body the same way that you prepare for your career.” (~ Phylicia Fant, Executive Producer Eggs Over Easy Film)

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About The Author

Chiquita Lockley is producer and director of the forthcoming documentary, Eggs Over Easy: Black Women & Fertility (2020). She is also the producer of the award-winning documentary Kunta Kinteh Island: Coming Home Without Shackles. She holds a BA in English from Spelman College and an MA in Film Studies from Emory University. She currently resides in Atlanta, GA where she continues to give back by serving on the Boards of AIR Serenbe (an artist-in-residency program) and the Black Women Film Network.

You can follow the film’s progress and join the conversation at: www.EggsOverEasyFilm.com, www.facebook.com/eggsovereasyfilm or IG: @EggsOverEasyFilm.

Adoption and Family Building, Fertility, General Health, Health

OMG, the Positive Pregnancy Test – What This Doctor Wants You to Know!

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When infertile patients, who have been trying for some time, get the positive pregnancy test result, they go through a roller coaster of emotions where their fear of “Will I get pregnant?” quickly turns into “How do I stay pregnant?”. 

These fears and mixed emotions are totally understandable. A lot of infertile patients that get a positive pregnancy test result usually feel anxious about what they can do to help keep the pregnancy. This is why most of these patients often turn to spending hours diving down the internet rabbit hole, researching how they can keep the pregnancy safe. 

Although doing your research and getting yourself educated is great, I really want you to know that it is so much better for you to simply enjoy your victory (it’s a big deal!) and directly ask your doctor questions about how you can keep the pregnancy safe. This way, all the tips are tailored to fit your particular situation and are not based on some generalization that you find on the internet. 

To help ease your mind, let me list the top 10 things that I tell my patients and friends to do, during the first trimester. You can go over these tips with your doctor so that they can help guide you through the things you should and should not be doing. At the end of the day, we all want one thing: for you to get your dream of being a parent! 

  1. You May Not “Feel” Pregnant. This is a fear that some newly pregnant persons can experience and it unnecessarily leads to a lot of stress. Not experiencing major changes in your body or how you feel, overall, is perfectly normal! Not everyone feels a definite change in their body during the first trimester, even if you have been pregnant before. 
  1. Your Appetite. Appetite during pregnancy differs from person to person. Even though many people use the analogy of ‘eating for two’, you definitely do not need to eat more than what you are comfortable with. As a matter of fact, some pregnant persons experience a drop in their appetite, while some others experience early and very specific cravings. 
  1. Minimal Bleeding is Okay. Light to moderate vaginal bleeding is normal. For some women, this is their first sign of pregnancy. So, do not panic if you experience minimal bleeding. However, if you are pregnant and the amount of bleeding is excessive, you should notify your clinic as soon as possible. A general objective rule of thumb: we consider bleeding where you are completely soaking through two normal maxi pads per hour, for greater than 2 hours, as excessive.
  1. Avoid Raw Seafood. During pregnancy, there are some seafood that you have to avoid, even when they are cooked. Eating raw seafood can expose your baby to mercury, harmful bacteria, and parasites. If you regularly eat fish high in mercury, this heavy metal can accumulate in your bloodstream, cross the placenta into the fetus’ own circulatory system and then damage your baby’s developing brain and nervous system.
  1. Take Your Prenatal Vitamins. If you can tolerate it, I suggest you take your prenatal vitamins daily. If you cannot tolerate the vitamins, at least make sure you take folic acid. You need at least 400 micrograms of folic acid per day. However, if you are pregnant with two or more babies (i.e a multiple gestation), or if you have a history of a seizure disorder, or if you have a prior pregnancy, or had a baby that was born with signs of a folate deficiency (e.g a baby born with spina bifida or meningomyelocele), your doctor will want you to be on a higher dose of folate in subsequent pregnancies. So, check with your doctor before choosing between prenatal vitamins or starting higher doses of folic acid.
  1. Stop Herbal and Non-prenatal Supplements. There is not much data available on Herbal supplements and their impact on a pregnancy or the fetus. Therefore, we recommend discontinuing all non-essential herbs, vitamins, and supplements, including CoQ10 and DHEA, during pregnancy. If you are not sure whether your supplement is essential, contact your doctor to confirm, right away.
  1. Continue Taking Your Thyroid, Diabetes, Blood Pressure, Prolactin, or Heart Medicines. Managing these medicines is highly essential for a successful pregnancy. If you have not told your doctor about these medications before, let them know as soon as possible. Patients with poorly controlled thyroid, diabetes, blood pressure or prolactin levels are at increased risk for miscarriages, stillbirth, small (growth restricted babies), certain special birth defects and poor neurological development in the fetuses.
  1. Exercise Heartily. We suggest moderate exercise during pregnancy. However, you should always first verify what type of exercises and the level of intensity you should be doing, with your doctor. For certain underlying medical conditions in the person carrying the pregnancy, your doctor may even recommend against any exercise at all. 
  1. Continue Taking DHA or Fish Oil and Only Consume Pasteurized Milk Products. DHA (Docosahexaenoic acid) or fish oil intake can help prevent preterm labor and delivery, lower the risk of preeclampsia, and may even positively increase the birth weight of your baby. Consuming only pasteurized milk products can help protect you and your baby from harmful bacteria. 
  1. Avoid Hot Tubs or Saunas. It is advisable to avoid hot tubs and saunas because they may cause dehydration, overheating, and even fainting. Exposure to elevated internal body temperatures, like what occurs with soaking in a hot tub or sitting in a sauna for a while, during the first trimester, can also lead to some genetic changes in the developing embryo which, in turn, can result in certain congenital birth defects in your baby. In one study, special heat shock proteins are produced in the fetus as a response to exposure to stressful events such as prolonged high temperatures and these negatively affect your fetus’ development, during the critical period of organ formation and result in anatomical malformation.
  1. Avoid Alcohol and Limit Intake of Drugs like marijuana, cocaine, heroin, other opiates or other chemicals. These substances are known to cause serious malformations in different organs as well as severe mental disability in babies who were exposed to these drugs while they were in the womb.

All these tips that I have listed above are meant to help you keep your pregnancy safe. However, you should still go over them with your doctor so that they can help safely guide you through your pregnancy. It is also important that you do not let your fears interfere with celebrating your pregnancy. Enjoy this joyous moment and make sure to follow your doctor’s instructions, throughout your journey. 

Fertility, Women's Health

Weight and Fertility

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Did you know weight can affect one’s fertility and one’s chances of getting pregnant? In terms of a woman, we’re talking about the extremes of weight; whether someone is underweight, or whether someone is overweight, and especially, if someone is in what we call the obesity range.     Women …