A brief look at fertility

      CONTRACEPTIVES AND PREGNANCY

      Chemical contraceptives like hormone tablets (the pill) and injections are generally very effective. Oral contraceptives need to be taken exactly as prescribed to be effective. In other words, you should not skip a day. If you use the mini-pill (progesterone only), you need to take the pill at the same time every day. If you are taking antibiotics or have a digestive disturbance like vomiting or diarrhoea, oral contraceptives may not be effectively absorbed and you might fall pregnant. In this case, it is important to abstain from lovemaking or to use alternative contraceptive methods for the rest of the month, while continuing to take the pill. This does not apply if you are using injectable contraception.

      Women do sometimes fall pregnant despite taking contraceptives correctly. In most cases this does not appear to hold any dangers for the pregnant woman or her developing baby although, according to research, malformations in babies are sometimes attributed to this. If, however, you cannot accept an unplanned pregnancy, consult your doctor to discuss termination as early as possible in the first trimester.

      You should complete a full pack of the oral hormonal contraceptive pill before trying to fall pregnant, to disturb the hormonal balance as little as possible. It is generally advised to give your body about three months to adjust after prolonged use of contraceptives (hormonal and intrauterine devices), although many women fall pregnant almost immediately or even while using contraceptives without apparent problems. Homeopathic remedies can help the endocrine system to settle sooner and improve the likelihood of conception if your menstrual cycle is irregular.

      Generally, the longer you have used hormonal contraceptives, the longer it takes to fall pregnant, but this remains a very individual matter. There are many factors that influence how long it takes to fall pregnant, but if you have not conceived within six to twelve months, you should see your gynaecologist for a general checkup. It is advisable to have a general examination when you stop using contraceptives or plan to fall pregnant and if you have difficulty falling pregnant. Your partner might need a checkup if nothing seems to be the matter with you. Research shows that the male partner experiences as many fertility problems as the female.

      OVULATION

      Ovulation is the release of an egg from a woman’s ovary. The woman is most likely to fall pregnant in the few days around this time. Traditionally, ovulation occurs close to midcycle or about fourteen days before the next menstruation in an average 28-day cycle. (Day One is the first day of the menstrual period.) Adjust this for a longer or shorter cycle where midcycle will be a few days later or earlier.

      We are beginning to realise that menstruation should be seen as the culmination rather than the start of a woman’s cycle. From this point of view, ovulation and pregnancy become most likely as soon as a woman notices a moist vaginal discharge. In other words, the idea that ovulation will occur strictly fourteen days before a period is not necessarily true. Discharge might be a more accurate indicator.

      There are also other symptoms of ovulation that are recognised by women who are finely attuned to the functioning of their bodies. You might experience pain in the region of the ovary that releases the egg that month. Basal temperature (early morning body temperature) can also help determine your time of ovulation. These natural family planning and contraception techniques can help increase fertility.

      FERTILITY, AGE AND HEALTH

      Fertility declines quite markedly from the age of about 35 years and this may contribute to prolonged conception problems. This does not happen overnight though, and in a time when couples are choosing to have babies later in life, it should not be an overriding concern. Read more about how age affects fertility in The best age to have a baby.

      Cysts and fibroids in a woman’s reproductive organs (ovaries, Fallopian tubes or womb) may affect fertility, but often do not. Many women discover for the first time that they have cysts or fibroids when an early pregnancy scan is done. Often these have never worried them at all, other than making menstruation uncomfortable at times. Read more about this in The pregnant mom’s health.

      Conditions like endometriosis are also associated with difficulty in conceiving. Endometriosis is a condition where the lining of the womb becomes much thicker than normal and similar tissue grows in places other than the womb, such as the abdominal cavity, on the Fallopian tubes and even in the lungs. Exposure to synthetic oestrogens (like those in contraceptives and from various environmental sources) may be a factor in endometriosis. There is often also a family tendency to this condition. Women with a perfectionistic nature, who are incredibly aware of time management and are driven to succeed, are more at risk than others.

      Endometriosis causes severe pain, especially during menstruation. It is usually treated with a combination of medication and surgery to remove the tissue. Taking measures to relax and become less agitated about life often helps, although professional therapy to achieve this is sometimes required.

      Many women benefit from consulting a homeopath about compromised fertility. The tissue-salt