A bit of context for my fertility advice for late 30s:
A few years ago I decided all I wanted out the next portion of my life was to have a child (or more). I was no longer focused on a specific career or income goal, I was recently married and living in the location of my dreams. Luckily, my husband and I both wanted children, whether or not we were ready for them. Married at 33, by 34 I knew I was tick-tocking. Although we lived a pretty healthy lifestyle I had some poor habits. So after our honeymoon I decided to start taking this whole pre-conception thing a bit more seriously. The first thing I had to do was quit smoking weed. I am a medical marijuana patient, using the herb primarily for a reoccurring knee pain and menstrual cramps, but I really liked to smoke a little weed with a little tobacco. A poor habit for a mom. And I really liked to drink multiple coffees a day and multiple alcoholic beverages at night. So, I decided to do a preconception cleanse called Purium Lifestyle Transformation. You can read more about this preconception cleanse in this article I wrote. As a note while I do advise the transformation for pre-conception cleansing, I don’t think the “lifestyle” program was what I needed for conception itself.
This definitely helped me kick the most important bad habits. But I still had work to do. After a few personal hurdles I started drinking again. I worked late managing and serving at a bar & restaurant. My coworkers and I would stay after work socializing and having a few drinks. I ate dinner late, then drank beers late, and then went to sleep late. Etc. So I kinda took off time from trying to be a good girl. But regardless my husband finally agreed to start trying to conceive with me.
That was Feb 2020. Then covid hit us in here in Hawaii on March 2020. It took a little time for him to come around again and we tried again for months, during what we thought was our “fertile” window based on the “Glow” App, you know the magic day 14. But months went by and I kept getting my periods. Then I took some advice from my OBGYN and a friend and started tracking my ovulation and my cervical mucus in August. Which by the way was a really bad month for me. I was under a lot of emotional stress. My summer babysitting gig just ended, my bar was no where near reopening and a friend I went to graduate school with was brutally murdered by her boyfriend leaving me in shock and wondering what I was doing with my life. I wanted to run home to Connecticut. I wanted to hide in my room and drink wine all day. And the only thing I really motivated me at all was wanting to have a baby. I didn’t care about anything else. In fact, one of the reasons why I didn’t go home to CT was because I knew my chances of getting pregnant there was zero.
So I stuck around, planned an anniversary staycation with my husband and used those ovulation strips I had been meaning to try. I had already been pretty good about updating my Glow App when I got my period. But I was bad about tracking how long it really lasted, how heavy the flow was, when I was spotting etc. But I knew my cycle was usually around 26 days. Of course, those past months I was trying to get pregnant I was using the “rhythm” method of my app which said my fertile days are right around the 14th. But when I used my ovulation strips, that August, It showed I was ovulating more like day 17,18. Which at first I thought that was fine, “yay! I’m ovulating”. But then bam! I got my period “on time” of my 26 day cycle. After some thinking, and research I realized this meant my luteal phase that cycle was only 8 days!!! Way too short to have successful implantation. Now, this could have been exacerbated by my unusually stressful month leading up to ovulation or it could have been this way all along. I wish I had started tracking when I first tried to get pregnant.
For the rest of August and September I began to research the hell out of fertility and try everything I could. I specifically looked into lengthening my luteal phase and increasing progesterone. As well as increasing cervical mucus and uterine lining. I read books (sometimes 2-3 times), I looked up lay articles, peer-reviewed articles, I listened to podcasts. I took notes. Whenever I saw a lot of crossover in my research I decided it was something worth trying.
Then, in September, I ovulated a little earlier day 16 or 17 with a 10 day luteal phase. So by this time, I am still pretty worried but it felt like maybe somethings I was trying were helping. Although there are varying definitions, a general one that I kept seeing was that Luteal Phase Defect (LPD) is an infertility issued defined by more than one luteal phase 11 days or shorter in a given year, and insufficient progesterone. At this point, I really wanted an infertility check up. But, I was now on MedQuest insurance, trying to switch providers, and waiting for all my records to be transferred from 3 different offices before they would schedule an appointment. So i really had no choice, but to believe my self-diagnosis with luteal phases problems, possible progesterone problems, scared my uterine lining was insufficient as well. Furthermore, I read in a scientific article that LPD only occurs in 3% of women my age. Great.
So I continued my investigative mission. I read more. I changed several things in my daily routine, diet, psyche, After really ramping up my fertility routines with dogmatic behavior and lots of supplements, finally in October I tested positive for ovulation on day 14. Meaning in my 26 day cycled I’d have at least 12 days luteal phase. Enough to have successful implantation, if my uterine lining was thick enough and hormones balanced enough.
Basically, I’m sharing this personal story to set the stage for why I sought the answers and went after the possible solutions I did. So for you reading that don’t know me, as I write this I am 13 weeks pregnant. I successfully conceived that last cycle in mid-October which still seems like a miracle to me given how messed up I thought my cycles were. Below my goal is to share with you everything I learned and believed to make a significnat impact. A lot of these things seems too basic to be true but I believe them to be soooooo important.
Now to the FERTILITY MUSTS! I call these MUSTS because I believe there are NECESSARY to put your mind and body into gear. After, I’ll talk about additional supplements I highly recommend and then other supplements and activities that I encourage.
While really all these things should be considered pre-conception. Before you start trying, these first 2 steps I recommend immediately if you’re even close to thinking about having a baby.
Stop hormonal birth control
As soon as you start to think you MAY want to conceive you should stop hormonal birth control. Duh. It is anti-fertility . During my quest for knowledge I listened to several podcasts on the show Fertility Friday by Lisa Briden, Author of “The Fifth Vital Sign“. There was a plethora of information on fertility and she is especially passionate about coming off of birth control. I hadn’t been on birth control since I was 20 so I skipped this research but there is a lot of information you should learn about. Hormonal birth control of course mixes up your hormones but it also nutritionally depletes you. Do your homework!
Track your menstrual cycle in detail
A second immensely important pre-conception step – Understand your body, your menstrual cycles, your hormones. Empower yourself and learn about how your amazing system works. “Taking Charge of your Fertility“is the best book I came across for this. I read it 4 times. You should start tracking your cycle before you think you want to conceive. There are a few important points here that are worth mentioning. The easiest way to track is with an smart phone app. But there are definite downside to that. I used an app and falsely believed for 6 months that I was within my “fertile window”. The app doesn’t account for how all women’s bodies are different and relies on the “rhythm” method that cycles are predictable and stable. You can also download paper charts, I always intended to try that but it just wasn’t practical for me.
- The first day of your period is the first day of significant bleeding. If you are spotting before your period (or any time) note this in your chart or app. But do not count it as the first day of your period. If you are spotting for more than 1-2 days before your significant bleeding, this could be a sign that progesterone is low. You body wants to shed the uterine lining too soon. This was what I was experiencing in the few cycles I tracked in detail. I’d spot for at least 2 days and on top of that my luteal phase was short. So I started to assume I was having a progesterone problem. More on that later.
- Mark how long your period lasts. If you period is too heavy and too long or too light and too short this could also clue you into potential difficulties. I noticed that my period was only lasting 2-3 days. So again, I thought crap! Maybe I don’t have enough uterine lining. Maybe it is thin, maybe (in the eye of Chinese medicine) I was blood deficient, meaning I didn’t have enough BLOOD and needed to build my blood. Of course, more on that later.
- Take note of your cervical mucus starting around day 10 of your cycle. Pay attention to your underwear, when you use the toilet, when you wipe, the vaginal sensation (dry/sticky/clear/egg white/wet/lubricative). Sperm need cervical mucus. Your PEAK ovulation day is the last day you experience fertile quality mucus (slippery, clear, stretchy, egg white) OR have wet lubricative vaginal sensation. Again the Fertility Friday podcast and of course Lisa’s book are easy ways to learn more about how to track your cycles. But the holy grail of books on this subject with a LOT of instruction on how to track your cycles, determine when you are fertile and troubleshoot is “Taking Charge of Your Fertility“.
- At least for a few months track your ovulation using ovulation tests. There are a lot of tests out there. Big range in prices. I opted for a test kit of 20 strip from CVS, generic brand for about $20. This allowed me to track starting on day 8 up to the beginning of my period if I needed. Or 2x a day if I really wanted. Sometimes the kits with just 5 or 7 may not be enough if your cycle is very irregular. The generic “cheap” one’s I chose shows 2 dark pink lines when you are ovulating similar to pregnancy test. For some people this may be too ambiguous. The line gets darker and darker as your luteinizing hormone (LH) levels rise.
- I’ll admit I was confused several times because I would test positive 3 days in a row. And there was little literature out there about this. Basically, I chalked it up to catching the LH rise, peak and descent. The Glow app actually lets you take a picture of the strips and analyzes them for you. While this is kinda of amusing it can also falsely predict when you are ovulating. I noticed if it was a slightly lighter shade it would automatically mess up my predictions for ovulation and future periods. So I had to figure out how to turn off the predictions on my app. Basically with me, my ovulation days changed over the 3 months I tracked, but my period always came “on time”. Meaning my luteal phases wasn’t stable. (It is supposed to be in most fertile women). It is the follicular phase that more commonly varies. Again, if you have no idea what I’m talking about check out the book “Taking Charge of your Fertility” from the library. Or just buy it. I ended up borrowing it 3 times over 1 year and lending it out to friends.
Keeping your stress in check makes your body feel safe enough to conceive.
I honestly don’t have too much to say about this other than it is really important! If you are in fight and flight mode, your body is not going to allow you to take on the extra added stress of building a baby inside of you. You body will naturally try to reserve everything it has for your body. Not procreation. Learn how to manage your stress. We’ve all heard it before but exercise, sleep, fun, eating well, relaxing activities, getting toxins and toxic relationships, situations etc. out of your life is a must. For me, I actually started seeing a therapist on facetime. He helped me focus on my goal (having a baby), worked with me to relieve my stresses in a practical manner (fix my house to make it baby ready, examine my finances and my relationships with others and myself). We focused on real-time things I could do to feel better and not worry without diving into my childhood trauma or poor adult decisions.
The next portion are my MUSTS when your trying to conceive (TTC).
Getting 8 hours + of sleep in a completely dark room
Your body needs sleep to produce hormones at the correct levels. Without sleep, your hormones are imbalanced, without balanced hormones, you cannot sustain life in the uterus. Not just any sleep, here are some important sleep guidelines:
a) you need deep restful sleep with an average of at least 8 hours. Ideally your in bed by 9 or 10 at night, rising with the sun in the morning.
b) Practice good sleep hygiene. Stop using electronics at least 30 minutes to 1 hour before bed to keep your eyes away from the bluelight which disrupt your circadian rhythm.
c) Keep your iphone, ipad etc. out of the bedroom or at least on airplane mode while you get ready for bed and sleep. Years ago I thought this was silly, then, I starting thinking its probably not a bad thing. But when I got serious about getting pregnant, I got serious about EMFs. No phone after 9 or before 6. Especially not in bed. I even put our wifi router on a timed outlet to turn off at 10pm and on at 6am to at least have part of the day free from some EMFs. You can read more about EMFs in this article on EMFs and TTC.
d) For me I think it made a huge difference to sleep in complete darkness! Black out curtains all the way. It took a lot of convincing my husband that it was essential because he doesn’t care for curtains and like the fresh breeze of an open window. But of all the things I changed to increase fertility I really feel like this one had a huge impact. This is because the hormone melatonin has an impact on your fertility, egg quality, and fetal development. In fact there is darkness/light therapy that systematically exposes women to darkness or light at certain phases of their cycles to improve cycle irregularities. I specifically became dogmatic about my sleeping in the dark routine because I read about how successful it is at increasing the luteal phase length. Here is a good podcast episode on Fertility Friday interviewing Joy De Felice about the important of light on the menstrual cycle.
Get regular exercise, but not too strenuous.
Now, again this has to do with stress. Exercise helps relieve stress but, if your body is under a lot of stress it will use its reserves for you, not for conception. If you are used to strenuous training, long distance running, etc., then continuing with the same exercise should be fine. But if you are just starting to try to conceive, starting a diet and a strict intense work-out routine may not be the best bet. Continuing with your current level of activity, and adding gentle strength training and walks, yoga, etc. Another fact I re-learned, is that you need enough body fat to produce hormones at correct levels. In my research I found some conflicting numbers for ideal body fat levels for conception, but 17%-19% body fat being at the low end of what experts considered ideal. Of course they always admitted that everyone’s body’s are different), which explain why gorgeous thin women have the cutest baby bumps.
To have more “fertility points” I realized I had to be ok with keeping on the extra pounds. This one was hard for me. I’ve always had body image issues, wanting to weigh and look a certain way, but not always attaining that in balance. But this past fall, I was definitely packing some extra pounds from my Covid world of decreased activity. I really wanted to lose 5-10 pounds, but because of my research on the subject I just left myself stay a little fluffy and kept those extra pounds. So I would consider your diet and workout goals if what I am saying resonates with you. I’m in the “normal weight/BMI” category and can only speak for myself. But, I realized starting a intense workout regime is not the condition my body would perceive as safe to grow a baby. Even though I felt chubby, my impedance body weight scale told me that at 132 pounds, 5″5″, my body fat was 17%. So I decided it was not the time to diet and try to loose weight. Instead I focused on getting my 15,000 steps a day, learning yoga and eating healthy.
Nutrition is really important.
First off, detoxing from conventional foods is important. I recommend a wholefoods diet, organic as much as possible, that is low in refined grains and sugars and high in vegetables, protein, and fat. One really big change that I made however, was from switching from a Western Diet culture view of raw fruits and vegetables, salads, low fat, low carb; to a Eastern Diet cultural view point. This was specifically focused on building my blood, in case my uterine lining was too thin, and balancing my hormones. In Eastern medicine, warm meals unlock the nutrients, as opposed to big cold salads, smoothies and raw vegetables. Also, animal fats are highly valued in moderation for providing the building blocks for hormone production. So I went off the Purium lifestyle diet style of shakes and salads, and endless cucumbers and celery and starting incorporating more cooked meals, warms soups, animals fats instead of shying away from them in choice of “healthier” alternatives. A few types of foods I included to specifically build my blood:
- dark green leafy veggies
- dark red and black foods like beets, molasses, prunes, berries, cherries, purple kale, purple bok choy, anything dark!
- Probiotics in pill form as well as sauerkraut and kefir
- Fats: butter,eggs, avocado, coconut
- Proteins: red meat, fish, beans, eggs, lentils, organ meats (think Pate)
- Other boosters: Bone broth, Bone Broth Powder, apricots, raisins, almonds, black sesame, dates, maca, chia, Bee Pollen
Also, it is important to decrease caffeine intake (yes, I’m 35 and I switched to decaf) and alcohol intake. This was hard because I really like beer and wine but really important to balancing hormones and replacing those “empty” calories with nutrition.
My top fertility supplements
I do really believe you need to have the previously listed things in check before you even think that supplements will “fix” your cycles. But hell, I went for all of it all at the same time. Tick Tock Tick Tock.
The NUMBER 1 supplement I believed helped me get pregnant and lengthen my cycles is VITEX.
Chaste Tree berry. Every book, and every major article I read about fertility and short cycles, short luteal phases, fertility issues recommended vitex. Check out this article on the benefits of vitex on fertility. There is a lots of research on vitex – keep googling and be inspired. Vitex is known for regulating cycles, lengthening luteal phases, increasing progesterone production, and many more things.
The only thing I will say is that after 1.5 months on vitex I got pregnant. Yay! And I’m assuming it helped with my progesterone BUT because of this I was unsure if I should continue or stop it. Like everything else in pregnancy, it was not proven to be safe for pregnancy itself. The morning I took my pregnancy test, at 5 am alone in the dark, then popped my vitex, and then got a positive. And then I freaked out, looked it it up online for safety during pregnancy and tried to make myself vomit the pill up. Then I relaxed, convinced myself it wasn’t going to harm me or baby. But it was still really hard to get answers. The first OBGYN I saw had no idea what it was. The next midwife neither. And there were horror stories online forums of women who stopped vitex abruptly and miscarried. So I opted to slowly wean my self off it. Taking 1/2 pill a day. Then finally I spoke to the midwife who will probably deliver my baby and with confidence she told me to wean myself off as I had planned. 1/2 pill a day for a few weeks, then 1/2 pill every other day another few weeks , then 1/2 pill every 3 days etc. up until 12 weeks when the placenta takes over hormone production.
A few notes about Vitex. There’s different ways to take it. Some say during just the luteal phase. Others say from the end of your period to the first day of your next period (taking a break during your bleeding so that your body doesn’t get too used to it). Yet others take it all month long. They also say to start taking it before you try to conceive. And that you should know in 6 months if it is working. If you still want to keep taking it, they say to take a month off. It is a powerful herb. Obviously it is best to take under the guidance of a doctor/naturopath who knows what they’re doing. I choose to take it during my whole cycle except for 4-5 days during my period.
Ok – more to come. I have lots of other really beneficial supplements to try and a lot of editing to do.