Hands up if you spent most of your twenties and early thirties trying not to get pregnant? Travelling, brunching and living the dream right? Only to meet the right person, decide to have kids and realise that it’s not quite as simple as the sex education teacher made it sound when she put the fear of god into you all those years ago.
Yes, that was me in 2011. Fast forward 2 years and I was emotionally and physically exhausted and broke following 3 rounds of IVF but, finally pregnant. It was at this point that I had time to stop, take a breather and reflect on my whole fertility experience. Which inevitably bought up some questions.
Perhaps the most frustrating question and one for which I was desperate to know the answer was ‘Why was my body not capable of achieving what I so longed for naturally without medical intervention?’ I was only 32 when I finally conceived so surely it shouldn’t be so hard? After all, the sex education teacher didn’t mention fertility issues, more concerned about lowering the teenage pregnancy rate.
So many years later I think I have finally found some of the answers and coincidentally they led me to a change of career and lifestyle on the journey to better health, so what did I learn?
How crazy is it that in this day and age of advanced medical science that we can still use the term ‘unexplained’. I mean seriously? We can send people to outer space but we can’t explain why a woman can’t conceive. It seems to me that this may be a case of we just don’t know yet or more commonly, we don’t have the resources to help you find out.
It’s only now looking back that I realise how lucky I was to be under the care of a consultant that thought outside of the fertility box. After two failed cycles, with good egg and sperm quality, good numbers of blastocysts and an endometrial lining to rival a posh hotel pillow, my consultant sent me to The Reproductive Immunology Centre in Sutton, Surrey. My bloods were checked and it was confirmed that my body was rejecting the embryos due to an over active immune system. More commonly known as elevated Natural Killer Cells. So on the 3rd and final cycle, I had my immune system suppressed with something called IVIg and finally, I got that blue line on the pregnancy test that I had been desperately longing for.
It was totally perplexing to me how it’s possible to suffer from a condition that inhibits your ability to conceive whilst outwardly having no or few symptoms of that condition. Yet on the inside, it’s causing total havoc and stopping you getting pregnant. However, I now know that my body had given me lots of subtle symptoms that my immune system was not functioning correctly, I just didn’t have the personal knowledge (why would I?!) or more importantly, professional advice, to help me recognise it.
Another example of a condition that can hide like this is Endometriosis. The prevalence of endometriosis in women with infertility can be as high as to 30–50%. It can even take up to eight years (on average) for a woman to get diagnosed with endometriosis from the time she starts experiencing symptoms. However, 20-25% of women with endometriosis are asymptomatic with no pain or bleeding! That’s a lot of women with potential endometriosis trying to get pregnant and not understanding why they can’t.
Not to mention sub-clinical thyroid problems, hormonal imbalances, blood clotting disorders, sperm DNA fragmentation and un-diagnosed auto-immune conditions. All of which can present with very mild or un-recognisable symptoms or require further investigation than just your standard Day 3 hormone tests. Guess what, all of these fit nicely into the extremely frustrating category of ‘unexplained infertility’!
So whilst it was highly likely that in my personal case I would need some sort of fertility treatment, you can start to see why full blown IVF or ISCI may not always be the best or first option for every couple. At least not without further investigation that would potentially uncover the root cause of the problem and enable the treatment cycle to be tailored uniquely. Whether that means different drug regimes, medications, blood thinners, immune suppressants or simply lifestyle changes, vitamin and mineral supplementation and complementary therapies that have been proven to help. Uniqueness is a quality that we commend in so many ways nowadays so surely your fertility treatment deserves an individualised approach as well?! Especially if that means your chances of it working are increased.
The unfortunate disadvantage of free IVF cycles is they tend to offer a standard protocol for all, without some of the more in depth investigations that can be available privately. That’s not to say they won’t be as effective, however for some people, myself included, it’s just not enough, a standard treatment protocol would never have worked for me.
Private clinics tend to have more fertility diagnostics available but of course these are normally an additional cost. However the need for these diagnostic tests needs to be identified and then utilised to be of any help. Sadly, I now see many women who have had repeated failed cycles and are just being told to ‘try again’ without any further investigations being made.
One option I recommend to my patients that can’t afford private IVF, is to try and get a diagnosis using private testing and then take these results to your NHS clinic and see how they can treat you. Sometimes the treatment drugs may be available on the NHS it’s just the long wait and referral process for any testing that means avenues get missed.
Who knows, if a little more time could be put into uncovering the correct diagnosis then maybe fertility treatment is not even needed. I remember so well that feeling of panic, time slipping away along with egg reserve, or so I thought before I realised there is so much more to fertility that your AMH test result. Hindsight is such a wonderful thing hey. Had I been just a smidge more patient and prepared to invest more in my health as a whole could I potentially have avoided fertility treatment or at least reduced the number of rounds, and still had the same happy outcome?
Of course for some women IVF really is the only option, for example women who have had their fallopian tubes removed, women with early menopause who may require egg donation or more severe issues with male factor infertility. This is when fertility treatment really should be considered the first option.
As women, we don’t give up easily and Western reproductive medicine promises us the miracles of modern science. When someone tells you that you probably won’t conceive naturally and your best resort is assisted reproduction, you are led to believe this is the only option and with your maternal clock ticking you start googling IVF clinics immediately.
Remember, our reproductive system was designed to conceive and carry a child! We are born with all the eggs we need, we just need them to be well nourished, fertilised with healthy sperm and in the right part of the right environment at the right time. Therefore it makes sense that how we nurture our internal environment and address imbalances that create barriers to our fertility can make the difference. Of course, this goes for male factor fertility issues also.
We just need the diagnosis in the first place and for this we need knowledge, confidence to question and a certain level of persistence (aka nagging)! Taking ownership and responsibility for our own health will give us the best chance at improving our chances of pregnancy, whichever road we go down. So if you have been given that frustrating diagnosis of ‘unexplained infertility’ I implore you all to push a bit harder, dig a little deeper and leave no stone un-turned.
Education around ‘unexplained infertility’ was the sole driver for setting up my online fertility advice service. To educate and advise women on where to turn next at that crossroads. I offer a 90 minute zoom call to go through your history and follow up with a written advice sheet detailing next steps. Follow up online advice consults are available to go through any further test results. For more information please visit my website at www.oxtedacupuncture.com.
It also formed the basis for my new labour of love ‘The Fertility Method’, launching in January 2021. A 12 week online fertility prep programme, suitable for natural or assisted conception and offering nutrition, recipes, coaching, yoga, pilates, lifestyle advice and informative webinars to get you on track to achieve a healthy pregnancy. For more information please visit www.thefertilitymethod.com
Written by Rachel Sherriff, founder of Oxted Acupuncture & Fertility Services and The Fertility Method.