Being a nutritional therapist and yoga teacher, I consider myself to be a relatively healthy person. I have regular periods, exercise 3 times a week and I didn't think it would take too much to get pregnant. My husband was a fit and healthy man too, so it seemed, like many friends around us, that it might be a straightforward thing.
I knew that my age was against me as I was 34 when I started trying, and it's a well known fact that a woman's fertility dramatically decreases as she reaches her mid thirties. So I did take care to implement all of the usual things I would suggest our fertility clients to do; eat organic, stop drinking alcohol, remove harsh cleaning products and chemicals from our home and go for more natural products, try to reduce stress levels, and get a good amount of sleep.
To track my ovulation window I was using the internal Ovusense ovulation monitor which is the most accurate way to track your cycle. In order to have the best chances of conception, we were following the one week window either side of ovulation where you aim to have sex every couple of days to maximise the chances of a sperm meeting an egg. Something which is much less fun and sexy once you have to plan this into your weekly diary! Ask any couple religiously trying for a baby and you’ll get the same response.
After about 3 months I was late on my period and did a pregnancy test. It said I was 1 week pregnant, however for some reason I didn't feel like this was a ‘true’ pregnancy and I didn't allow myself to get excited by the prospect of having a baby just yet. Sure enough, a few days later, after some period pains and cramps, I miscarried. This is what can be called a ‘chemical pregnancy’, a pregnancy that miscarries in the first few weeks and is often missed by most women, or just dismissed as a ‘late period’. The good news was that I could get pregnant. So we continued to try naturally.
Understanding More with Fertility Testing
After around 6 months of trying naturally, my husband and I decided to get some routine fertility tests done. This commonly consists of an internal ultrasound for a female - to check your uterus, lining of the womb, and follicle count on each ovary, a blood test for AMH, which gives an indication of your egg reserve as well as various other sex hormones. For the men, its a much easier and simpler process…ejaculate into a plastic pot.
When the results came in we were a little shocked. Luckily for me, everything was structurally sound, womb, thickness of lining and ovaries, but worryingly, my egg count was very low - 4.6 to be precise. For my age range it should be somewhere between 6 and 50.
Next came my husbands results. He had a low sperm count, poor morphology of 1% (relating to the shape and structure of the sperm - average is 4% and above), and poor motility, meaning they're moving either in the wrong direction or not fast enough.
Whilst these results were not totally game over for making a baby naturally, we were advised that we shouldn't leave it too long as my age was against me and that my egg count could drop even more, quite quickly. I asked the clinic what we could do to improve on these results and they simply said “as a nutritionist, you will know more than us about how to improve this. We simply give you the results and suggest you start assisted fertility treatment sooner rather than later”. Hmm ok, not the helpful answer we were hoping for.
This was all incredibly scary and a bit shocking. I don't think either of us thought that we would be seemingly so ‘inadequate’ in the fertility department considering our seemingly healthy diet and lifestyle. We decided to embark on a full scale ‘chuck the kitchen sink’ approach to making a baby. This meant lots more testing.
Luckily, working with fertility in my own nutrition clinic, I was fairly confident of what to do and where to look for answers. So here's a brief outline of what we investigated and why
For me:
Vaginal microbiome testing - this checks for a range of bacteria which may hinder conception - eg: BV, Gardnerella
Full thyroid panel - thyroid hormones play a big part in a woman's ovulation cycle
Day 21 ovulation progesterone test - this indicates if your egg has actually ovulated out of the ovary
Sex hormone panel - oestrogen, progesterone, LH, FSH - does the body have too much oestrogen and not enough progesterone? Is there an imbalance between the LH and FSH ratio? Could polycystic ovaries be something to do with it?
Prolactin - too high (which can be related to stress) can stop ovulation
For my husband:
DNA fragmentation/ COMET test - this assesses any damage to the DNA of sperm which can be a huge reason for miscarriage
Bacterial test - is there any infection or bacteria negatively associated with sperm health
Nutrition and Diet for Improved Fertility
Once we had all our tests back we implemented a strict nutrition and supplement regime to get the best quality sperm and eggs we could for the best chances of making a baby. For men, sperm is continuously made in the testes every 3 months. So luckily for them, they can see huge improvements in the quality of their sperm in a short period of time.
Unfortunately for us women, we are born with all our eggs we will ever have. Each year once we start menstruating, the number of eggs starts to dwindle and as we reach our mid thirties, the numbers can really start to drop off quite quickly. Whilst we cannot magic up more eggs, like a man can with his sperm, we can aim to make the environment and fluid our eggs bathe in, the best it possibly can be, so that we can have a good quality egg.
Many reasons for miscarriage are a poor quality sperm and egg, which can hugely be impacted by diet, lifestyle and stress.
Whilst our diet was already in a pretty good place, we took it even more seriously to ensure we were giving our bodies the best nutrients we could. This involved lots of home cooking, healthy fats in the form of fresh oily fish from the fishmongers, such as salmon and mackerel, antioxidant rich foods to help reduce oxidative stress in our bodies, reducing caffeine and completely cutting out alcohol. Sorry guys, but alcohol has a much bigger impact on sperm health than egg health and should really be avoided altogether!
Exercise & Impact on Men and Women's Fertility
I reduced the amount of HIIT exercise I was doing as this can be a stressor on the body, and focused more on weights, running, circuits and swimming to keep me fit. I started acupuncture to reduce stress in my body and increased my yoga and meditation.
For my husband, he cut back on his long, lycra clad bike rides that he loved so much, as heating up the testes can really impact sperm quality. Too much heat oxidises and damages the fat in sperm. So hot baths, saunas, cycling were all off the cards. The poor guy even had to change up his whole underwear drawer to more loose fitting boxers and invested in special ice packs which went in his underwear, to reduce heat in the testes after exercise.
Fertility Supplements
Next, we had a strict daily regime of fertility supplements and rattled about taking these throughout the day. I must add though, that you should always consult a specialist before taking any supplements as there may be contraindications with your medication and it's important to take the right dosage and quantity when balancing with other supplements, to ensure there are no interactions.
For me:
Prenatal multi
Coq10
Omega 3
Vitamin C, D and E
Myoinositol
For him:
Male multi
Coq10
Omega 3
Selenium
Alpha Lipoic Acid
L Carnitine
Exploring Assisted Fertility Options
Whilst all of this had been going on, we had also registered with our GP to be referred to the fertility clinic. I knew there was going to be a long waiting list and wanted to make sure I was taking the necessary steps to get the ball rolling, should we need to go down the assisted fertility route.
After 4 months of our new fertility diet, lifestyle and supplement regime, we decided to retest my husband's sperm. Due to his high DNA fragmentation and low morphology, we knew this was one of the big reasons we were struggling to get pregnant.
To our astonishment and that of his private urologist we had been working with for all the testing, he had seen huge improvements! We had managed to drastically reduce the sperm DNA fragmentation, we improved his morphology by 400%, his motility had increased by 32% and his sperm count had gone up too. This was apparently unheard of! We were so pleased with the results.
But despite this good news, we were still not pregnant. It had been coming up to a year since we first started our journey and we knew that time was against us.
We had our first call with the fertility clinic, and whilst they told us it was great that we had made such improvements to our egg and sperm quality, it was probably wise to consider assisted fertility if we wanted to have a baby. They said it was likely that we could get pregnant naturally, but that it could take a while. Since we wanted to have more than one child, and knowing I was at this point on my way to being 36 and the odds of successful IVF reduced greatly with age, we decided to go ahead.
I do remember feeling a little sad that all our hard work had not enabled us to get pregnant naturally, but we wanted to start a family and knew this was the card we had been dealt and that it was best to think positively and hope for the best.
Our IVF journey
We were assigned to the fertility clinic at UCLH and taken for more testing. I had more ultrasounds on my ovaries and uterus, hormone tests and then a HyCoSy. A rather uncomfortable procedure where they inject a dye into your fallopian tubes to check for any blockages. This is another common reason that women don't get pregnant, as the egg cannot reach the uterus. Once all of this was done and clear we started treatment.
I could write a whole other blog post on my journey through IVF (and I probably will!) but as a summary here (to the happy ending), I will explain the basics and the reasons for the success we had with egg retrieval and good quality embryos.
Apart from the hundreds of hormone injections, supplements, vaginal and anal pessaries and various other medications I had to take over several months, I didn't actually find IVF that bad. Whilst it took some getting used to all the injections, I was determined to not let it hinder my summer fun and I was soon taking them out with me and continued my daily regime of injecting in various disabled toilets at concerts, festivals and shopping centres!
When it came to the egg retrieval, I was told there were 7 possible eggs they could get. Of this, the likelihood is that less than 50% will survive and even less will survive once they are fertilised with the sperm with the hope of making it to a day 5 or 6 blastocyst. So in reality, it wasn't looking that promising at all that we would get a good batch of eggs.
By a miracle, and by that I mean, months of eating well, managing stress levels, cutting out alcohol, avoiding exposure to harsh chemicals and exercising regularly, we kept an astonishing 7 out of 7 eggs. Not only that, but all of them fertilised with the sperm and were grown to a day 5 or 6 blastocyst, meaning they were ready to be implanted.
This was overwhelmingly the best results we could have ever hoped for. The embryologist was astonished and said it was a huge success and not something she saw every day. It was without doubt, down to the hard work we put in to get our bodies in the best shape to create a good quality sperm and egg, which meant we ended up with 7 high quality graded embryos.
A couple of months later (after a bout of Covid which delayed things!) we did a frozen embryo transfer cycle and it was successful the first time. Nine months later we gave birth to our beautiful baby boy and still have 6 embryos on ice.
We love making babies here at The Natural Balance, and have so many more success stories just like mine. If you would like to discuss anything you've read in this blog in relation to your own concerns around fertility, please book a call with our fertility specialist.
Kelly Mulhall
Registered Nutritional Therapist, Health Coach, Master SIBO Practitioner
Kelly is a Registered Nutritional Therapist who focuses on positive physical and mental wellbeing, achieved through diet, lifestyle, sleep and exercise. Having struggled for years with IBS and hormonal imbalance, and increasingly frustrated with the lack of support and helpful advice from her GP, Kelly began her own journey of healing the body from the inside out. After seeing huge improvements she quit her job to study nutrition and focus on harnessing the healing powers of food to help other people in similar situations.