Talia Glickman-Simon Contributing writer

Trying to get pregnant can bring up a lot of feelings. You might be excited, scared, nervous, uncertain, or a combination. And, if you’re currently struggling with or recovering from an eating disorder or have experienced one in the past, the  challenges of this journey may feel magnified. This is completely understandable. The best thing you can do is find a supportive, trustworthy care team to help guide you through. 

Next, try asking yourself some of the following questions. Your answers will likely vary depending on the day, your mood, and/or any other life events that arise — that’s okay. The idea is to keep exploring until you find something that feels right for you.

What are the facts?

While eating disorders negatively affect fertility, having one won’t necessarily prevent you from getting pregnant. So being aware that you can still get pregnant is important when considering the timing of TTC. It’s in your best interest (and your future baby’s best interest) to get treatment for any eating disorder before becoming pregnant. A trusted health professional can help you pinpoint your greatest challenges and come up with a plan to support you as you prepare to TTC. Some of the topics you and your provider may discuss include mental health, body image, nutrition, and exercise.

What do I need?

Oftentimes people who have experienced disordered eating have certain triggers. These can be emotional, mental, and/or physical. You may already know what these triggers look like for you. If you don’t, it can be useful to identify them. Then you can consider what’s helped you avoid being triggered or cope with triggers in the past. You might also consider activities that you’ve found comforting and soothing. If nothing’s coming to mind, check out Ovia’s Daily Self-Care Checklist in your app. Some ideas might include finding ways to recharge and meditating.

Who can help me?

Because TTC can be triggering for those who have or had eating disorders, it’s especially useful to rally a support network that can help you along the way. This group can consist of anybody who makes you feel safe and comfortable when expressing your thoughts, fears, and concerns. It’s also important to involve the professionals if you’re still on the path to recovery. Some care team members might include a trusted dietitian, therapist and physician. 

What’s the bottom line on disordered eating and fertility?

Try to remember that obstacles related to disordered eating and your fertility aren’t your fault. But getting help is imperative to your recovery and health. Also remind yourself that everybody is different, requires unique care, and can likely move through these challenges with support. 

Reviewed by the Ovia Health Clinical Team

Read more

• How to advocate for yourself as a patient to get the care you deserve
• Exploring mental health with your healthcare provider
• Use smart technology to make your life easier: How Ovia fertility works 

Here, we’ll break down the basics of male fertility and what to do if you and your male partner are having trouble getting pregnant.

What typically happens when sperm meets egg

A healthy male produces tiny reproductive cells called sperm, which are made in the testicles. When he ejaculates, the sperm mixes with fluid from the prostate, forming semen. During vaginal intercourse, ejaculation carries the semen into the vagina where it travels through the cervix and into the uterus and fallopian tubes. During ovulation, an egg is released from the woman’s ovary and, if fertilized by the sperm, a ball of cells (called the oocyte) is formed. Fertilization occurs in the fallopian tube and the embryo then implants inside the uterus. If the egg is not fertilized, it disintegrates and sheds during the next menstrual period.

When to see a doctor

It’s generally recommended to see a doctor for a fertility evaluation if you and your partner have been trying to conceive for at least a year with regular, unprotected sex with no success. Depending on your and your partner’s medical history, your doctor may decide to check one or both of you for a fertility workup. You may want to seek care sooner if the female partner is over 35 years old or if the male partner has certain medical conditions such as:

• Past surgery on the groin, testicle, scrotum, or penis
• A history of testicular or prostate problems
• Problems with erection or ejaculation, low sex drive, or other issues with sexual function
• Pain, lumps, or swelling in the testicular region

What to expect when seeking care

For men having trouble with infertility, a doctor may order tests to  measure the amount and quality of the sperm. This is called a sperm analysis. Your partner will provide a semen specimen at the doctor’s office and the doctor will look at the sperm under a microscope. There are 3 factors doctors look for in a sperm analysis. 

• Sperm count: This shows the amount of sperm produced in an ejaculation. A healthy number is 20 to 150 million sperm per milliliter of semen.
• Sperm motility: This test shows how well sperm are moving. At least 60% of sperm should have normal forward motion. Sperm that move erratically or not at all can affect the ability to conceive.
• Sperm morphology (size and structure): Normal sperm have an oval head with a long tail. Damage to any part of the sperm can affect fertility by decreasing the ability to reach and penetrate an egg. Many conditions affecting the shape of sperm are genetic.

Remember that infertility is no one’s fault. It can be difficult and frustrating to experience any kind of fertility troubles on your journey to getting pregnant. Communicating and empathizing with your partner can help make the journey to parenthood a little easier.

Reviewed by the Ovia Health Clinical Team

Sources

“How common is infertility?” National Institutes of Health. National Institutes of Health. February 8, 2018. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common

Mayo Clinic Staff. “Male infertility.” Mayo Clinic. Mayo Clinic. August 13, 2021. https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773

“What is male infertility?” Urology Care Foundation. American Urological Association. n.d. https://www.urologyhealth.org/urology-a-z/m/male-infertility

Cedars-Sinai Staff. “Optimizing male fertility.” Cedars-Sinai. Cedars-Sinai Medical Center. May 31, 2017. https://www.cedars-sinai.org/blog/optimizing-male-fertility.html

Bradley D. Anawalt & Stephanie T. Page. “Patient education: Treatment of male infertility (beyond the basics).” UpToDate. UpToDate. November 11, 2020. https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics

We meditated with Faith Hunter, learned about the importance of sleep with Angela Holliday-Bell, and participated in a healing, positive affirmation exercise with Leasa Wright.

Here are the most important moments from the event, hosted by Denise Albert, in case you weren’t able to attend.

A short, guided meditation session on how to help reduce stress with Faith Hunter

Breath work gives us the ability to center ourselves. Faith led us in a breathing exercise that you can do at home, here’s how:

• Take your right hand, close your index and middle finger towards your palm
• Take your right thumb and use it to close your right nostril 
• Breath in through your left nostril
• Close off your left nostril with your ring finder 
• Release your right nostril 
• Exhale through your right nostril
• Inhale through your right nostril
• Close it off
• Exhale through your left nostril
• Inhale through your left nostril
• Repeat

Stress management and self-care with Dinah Eke, Amanda McKay, and Brooke Davis 

Dinah, Amanda, and Brooke discussed the importance of taking small moments in the middle of the day to be mindful. Check in with yourself: How are you feeling? Are you drinking enough water? Are you getting a little movement? Are you getting outside? Take a little time for yourself.

When it comes to practical ways to destress, there are two options: address the stress head-on or escape it through distraction.

Dinah offered some advice about the way list-making helps her de-stress. Just writing down the thoughts that are leading to stress can makes it feel more manageable. And when you just need to escape the stress, Amanda recommends distracting yourself away by getting outside, listening to a podcast, or just laying down for a moment. 

And remember, it’s OK to bring other people into the conversation. Ask for help from family and friends. Ask for flexibility from your manager.

Wellness check with Elaine Bishop

Signs that you are experiencing an amount of stress that could be damaging to your mental health:

• Overwhelming feelings of sadness 
• Difficulty enjoying things you used to enjoy
• Relationship changes: are you having more trouble reading other people’s social signals? Are you declining social invitations more than usual?
• Appetite changes: Are you experiencing significant increased or decreased appetite?
• Substance use: Are you turning to drink more often than before? Are you developing feelings of dependence?
• Thoughts of harming yourself 

If you are feeling any of these feelings, know that there is help. Try contacting the National Alliance on Mental Illness either by phone at: 1800-950-6264 or by email at: info@nami.org.

Tips from physician and sleep specialist, Dr. Holliday-Bell

The first step to getting better sleep is prioritizing better sleep. Better sleep helps reduce stress. Dr. Holliday-Bell outlined a few specific tips:

• Decide on a bedtime and wake time
• Stick to a consistent schedule (weekends count too!)
• Create a relaxing, 30-60 min bedtime routine
• Keep your bedroom dark, quiet, and cool
• Master a relaxation technique (like deep breathing)

Breath work and affirmation practice with Leasa Wright 

We closed out Stressless Fest with a series of affirmations from Leasa Wright. To try and reduce stress levels, practice this at home. Close your eyes and think of a happy memory or a happy place. Then repeat out loud to yourself:

• I live in my truth
• I boldly and freely express myself
• I follow my dreams
• I welcome goodness; I welcome love 

This may feel uncomfortable at first, but after a few rounds of these affirmations, the Stressless Fest attendees felt calmer, lighter, and more confident. We hope you will too!

Sponsored by Airwick, Enfamil, and Beyond Yoga 

Stress and fertility

Stress interferes with fertility because when you’re experiencing chronic stressors, your brain produces more hormones like cortisol and epinephrine, which can interfere with your ovulation. More importantly, stress can impact other factors such as weight problems, sleep deprivation, and lack of sex drive. All of these can significantly interfere with fertility and make conception more difficult, which is where yoga comes in play.

Yoga and other athletic pursuits are an important part of weight and stress management, which in turn, can lead to higher fertility rates and greater chance at conceiving. The stretching and breath techniques practiced during yoga can help relieve stress by releasing endorphins, your body’s “feel-good” hormones.

Physical benefits of yoga

• Slow your mind and release stress and tension: Practicing gentle yoga such as Hatha or Kripalu once a day, alongside other activities such as meditating, allows your body to get rid of all your daily stressors and increase wellness.
• Strengthens your pelvic floor: These muscles are essential for pregnancy and even your sex life. Squats are a good way to help tone these integral muscles.
• Aligns your hips, pelvis, and lower back: Positions such as bridge facilitate lower body alignment and stimulates your endocrine and immune systems.
• Brings you closer to your partner: Yoga can wring out your insides and release emotion, helping connect and build emotional and physical strength with your partner.

Read more

• 5 herbs to boost fertility
• Can fertility supplements help me conceive?

Sources

• Smith C, Hancock H, Blake-Mortimer J, Eckert K. “A randomised comparative trial of yoga and relaxation to reduce stress and anxiety.” Complementary Therapies in Medicine. 15(2):77-83. Web. June is 7, 2015.
• Gyorgy Csemiczky, Britt-Marie Landgren, Aila Collins. “The influence of stress and state anxiety on the outcome of IVF-treatment: Psychological and endocrinological assessment of Swedish women entering IVF-treatment.” Acta Obstetrica et Gynecologica Scandinavica. Volume 79, Issue 2, pages 113-118. Web. December 24, 2001.
• Louis GM, Lum KJ, Sundaram R, Chen Z, Kim S, Lynch CD, Schisterman EF, Pyper C. “Stress reduces conception probabilities across the fertile window: evidence in support of relaxation.” Fertility & Sterility. 95(7):2184-9. Web. June 11, 2015.

What artificial insemination is and the types to consider

It’s essentially when sperm is introduced into a female’s uterus or cervix with the hope of getting pregnant without sexual intercourse. You might think of it as a little bit of assistance with getting pregnant. Just how are these methods different?

IUI

IUI stands for intrauterine insemination. This insemination method injects the sperm directly into the uterus. Because this insemination method will place sperm closer to the egg that other insemination methods, IUI is believed to have a slightly higher success rate than other methods. Many people who undergo IUI (and the following two forms of insemination, ICI and IVI) do it while also taking fertility drugs to increase egg production and, as a result, increase the chances of getting pregnant. If you’ve heard about IUI leading to a higher chance of multiples, it’s likely because of accompanying fertility treatments, not the procedure itself.

ICI

ICI isn’t a tasty frozen treat you can get at your local movie theatre – it stands for intracervical insemination. Intracervical insemination happens when sperm is injected into the cervix, which is the tissue that connects the vagina and the uterus. Unlike IUI, you can perform ICI with unwashed sperm. There is a recommendation that IUI and ICI be performed by a healthcare provider, but some couples have found success performing these methods of artificial insemination at home.

IVI

IVI means intravaginal insemination, which is when sperm is injected into the vagina. Of the three methods of artificial insemination, this one places the sperm farthest from the egg and therefore has the lowest success rate. However, it’s the cheapest method and doesn’t necessarily require assistance from a healthcare provider. If you’d like to try intravaginal insemination at home, it can be done with a clean syringe or a cervical cap.

IVF

You’ve probably heard of IVF, which stands for in-vitro fertilization, but this procedure isn’t actually a method of artificial insemination. IVF is sometimes confused with the above methods and believed to be a kind of artificial insemination, but it’s actually another type of assisted reproductive technology. For IVF, semen and an egg are combined to form an embryo, and that embryo is then implanted into the uterus.

So which method is best?

Each method of artificial insemination has its own set of benefits. The cheapest method of artificial insemination is IVI, and if you’re looking to inseminate at home, you might want to consider this method. But the most effective method might be IUI. And IVF is an effective form of assisted reproductive technology, but it’s expensive, and, like all of these methods, it isn’t guaranteed to work. Really, if you need a little bit of help getting pregnant and are considering one of these methods, it’s advisable to speak with your healthcare provider or a fertility specialist so that they can help you decide which method will be best for you.

Gina Nebesar, Co-Founder of Ovia Health

I was so excited to speak with my two dear friends Becca and Jean Ann recently. Just this year they started on the crazy journey that is parenthood with their beautiful baby girl, Roz. They’re total badasses at home and at work, they’re incredible people, and now they have this gorgeous family. Their TTC journey took them a little while, and IVF helped them get pregnant, and I’m really grateful they could share their story – including incredible advice about choosing and buying sperm, real talk about IVF shots, and really candid conversation about adjusting to life as new moms.

IVF success stories: Two moms talk about growing their family… and how

I want to start by saying congrats! I know you just celebrated your 5 year anniversary, a big milestone. And an even bigger milestone is the birth of your baby girl! I’d love if you could start by telling us a little about your beautiful family.

Becca: We did just celebrate our five-year wedding anniversary, and in April we had our baby girl Roz. She’s almost 5 months old. And it’s been great so far!

I just left town for the first time, and left her alone this weekend with Jean Ann, her other mom. And in that 48 hours she learned how to roll over, without me there! And now she sleeps on her stomach, so I came home to a totally different baby. But I feel like she’s changing every single day, so it’s really awesome.

I love hearing about how people make the decision to start a family. Could you tell us a little bit about your journey to becoming parents?

Jean Ann: Because we’re two women, one question that I asked a lot is how we decided who will carry. And when your partner basically says, “One thing I’ve always wanted to do in my life is be pregnant and give birth, like, totally unprompted,” you’re like, “Cool, that seemed too easy.” Becca had always wanted to do that, and I’m still sort of on the fence – it doesn’t seem like something I have to do. So Becca had decided that she was excited about that a few years ago, and eventually I got more excited about it.

The first thing we had to do was choose a sperm donor. That was probably one of the biggest decisions we’ve ever made. Because you have to decide if you want an anonymous donor or someone you know. And we actually had a good friend who offered. And we took it pretty seriously, but ultimately decided it was important for us to have our own separate family unit. So then we looked at a lot of the websites for sperm. It’s basically like a KAYAK for sperm, and you can sort for different things.

Becca: It’s almost like online dating!

Jean Ann: We wanted someone that hopefully shared a lot of my characteristics. So were able to find someone who was half-Asian, he was getting a graduate degree in chemistry. We could even listen to a 45-minute interview with him where he talked about his favorite books, and he just seemed very thoughtful, quiet, serious, and nice.

Becca: We spent a lot of time looking for sperm – really thinking about these profiles and listening and narrowing it down. I remember we had all these pieces of paper on the kitchen table – we had written down the different donor numbers and which ones we liked – and then we narrowed it down.

And we actually had kind of had a long journey. It was about two and a half years from buying sperm until having Roz. Buying the sperm was step one. I remember, they were having an end-of-year sale, so we had to get it in before the end of 2015!

Were they really? Like, they were really having a sale?

Jean Ann: Yeah, it’s expensive. It’s something that there’s a lot of in the world, but it’s not cheap!

Becca: Well, it wasn’t quite a sale, but they were like, “We’ll throw in an Amazon gift card if you buy today!”

Jean Ann: “And three years of free storage!” But, yeah, we’ve actually spent several thousands of dollars on sperm, if you can believe it.

So, obviously, you found a great deal, but how did you get started with that process?

Becca: Really, we just Googled.

Jean Ann: There’s three or four big sperm cryo websites.

Becca: The one we went with is called California Cryo, one of the largest ones. For us, they felt right— it was a good website experience, and their customer service has been great. We did look at the big ones, some other small ones, and some local ones.

Jean Ann: But I think, for us, wanting a donor who was half-Asian like me was important, and that actually narrowed it down a lot. It went from like 550 to like, eight.

Becca: So then we could spend our time kind of really thinking through those people.

Jean Ann: You can definitely get a situation where there’s a run on the sperm. So we had this total disaster about a year later, where we had used up half the vials that we’d bought, and we were getting really low, and we went online, and they had sold out! And the donor had stopped donating! So we recommend you check what’s in stock a lot.

Becca: Yes, check frequently! And if you can afford it, buy more than you think you need.

Jean Ann: Buy a lot!

Becca: Because you can store it, and you can sell it back if you don’t need it.

Jean Ann: Nothing is worse than the feeling of having decided on someone to be your sperm donor and being very excited about them, and being halfway through the journey, and then realizing that if you want to have more than just one kid that you’re going to run out of sperm.

Becca: You’re going to run out and you may have to use different sperm.

Any other advice about that process for others that are just starting out with sperm donation?

Jean Ann: Just check your sperm stock frequently. And if you’re really excited and settled on someone, I would buy more than you need or just be willing to have a weekly reminder to check that it’s not running out.

Becca: I think the other thing is I would pony up for the extra access to information. Because I think, for us, the interviews with the sperm donors, that was the most impactful. You can only tell so much from a baby picture and some  generic likes and dislikes – which is the basic info you get – but I actually think you can get a pretty good feel for a person from something like an audio interview. It’s like a typical website where it’s like, “Pay to unlock this feature!” but it’s worth it to pay for that premium membership.

So, in December 2015, once you made that decision about your donor, how did things progress from there?

Becca: So that winter when we were back home from the holidays, we started trying to get pregnant, and we were doing IUI.

Jean Ann: You basically have two options, you can do IUI or IVF with donated sperm. IUI is basically artificial insemination.

Becca: Turkey baster!

Jean Ann: The turkey baster method, but at a facility. So we started with IUI.

Becca: I actually got very lucky with the first IUI try in February 2016. I was tracking my ovulation – I was using the Ovia app – and I was peeing on sticks and all of that, and when my ovulation test said I was ovulating we went in for the IUI, we did IUI, and I got pregnant that very first time. And it was amazing! We were so excited! First try!

And then in the spring at about 12 weeks I had a miscarriage. So I got almost through my first trimester, and I had a miscarriage. That sucked, that was a setback and sad, and that was really hard.

So the summer of 2016 was kind of recovering from that, and then it takes a while to get back on track, especially when you have a miscarriage when you’re that far along there’s a lot that your body has a lot to process and then re-regulate. And then we didn’t have a chance to try again until September of that year. So we got back on the horse and started trying again. And we were gonna continue to do IUI at that same facility because it had worked that first time.

And I started tracking my ovulation and going back in monthly, but something was wonky with my cycles. I would think I was ovulating, but I would go in and I wasn’t ovulating. I think one or two times we did get an ovulation, and we tried, but I didn’t get pregnant.

Jean Ann: And that’s when we started running out of sperm. And we realized that there wasn’t more. So that’s when we panicked, realized we couldn’t get anymore, and so we decided to move to IVF. But neither of our insurances, we thought, really covered IVF.  We were both on my insurance, and it wasn’t explicit. It was basically like, “Your IVF is covered, if it’s for a medical reason.”

Becca: “Medically necessary.”

Jean Ann: Yeah, “medically necessary,” that’s the phrase that’s used – and so I went down this whole rabbit hole to figure out if that means coverage if you’re gay. It took forever. But basically, no, being gay was not a “medically neccessary” reason, so it wouldn’t be covered. So I fumed about this for a while.

And then I ended up talking to our company’s head of HR kind of randomly about something else, and I just kind of mentioned this to her and didn’t expect it to go anywhere—I just figured this would sort of take some kind of lawsuit situation to change it— but she was like, “Oh, really? I didn’t know that!” Then two days later somebody that worked for her called and they were like, “Oh, we added it for same-sex couples to our insurance, so it’s covered now!” So I guess some advice would be to know that in terms of your health insurance, you may be able to change the coverage for something like this, depending on your company.

I constantly tell women to ask for those benefits, because they might end up with that exact same story. I was in a meeting recently with a health plan and an employer where we we pointed out in the language of the plan how it was alienating to same-sex couples. And the woman didn’t even realize it and was like, “I’ve gotta change it!” She had just never read the fine print before, but then took action to change it as well. I’m so glad that you asked about it, and I wish more people would!

Becca: Yeah, it was pretty awesome. So, we started IVF in the summer of 2017, and there’s a whole series of tests and all sorts of painful things they need to do to make sure you’re ready for it. And that takes months— you have to wait a few cycles, you have to get on the right timing. So I remember this being such a frustrating time in our lives. It felt like everything was going slowly and like everyday I had to be at the doctor doing some other painful thing. It was a rough period. It is funny now looking back on it, because it all feels like such a blur in retrospect, but at the time it felt really pronounced and painful.

Jean Ann: As someone that has now done IVF three times myself – and Becca has done it once – it’s not as bad as people think it is. It sucks giving yourself the shots, but it’s fast. It’s like a two week period of shots.

Becca: At this point we’ve both done it, because as the journey continues, we ended up having a baby and decided that we wanted to at least give ourselves the option to having another baby in the future with Jean Ann’s eggs.

Can you share more about that experience and what it’s like? Again, I’m sorry to hear about this part of the journey. I just can’t imagine having the 12 week miscarriage, that’s just awful, and the fear of the sperm running out, and then going through the pain of IVF. And I know you say it’s not that bad, but I think maybe you’re just tougher than many – that sounds really hard to me!

Becca: Honestly after being pregnant for nine months, you can barely remember the IVF, it’s like a blip. But I think that the shots – for us at least – I think the shots look scarier than they end up being.

Jean Ann: I feel like the first and second time you’re really just like, am I really going to stab myself in the leg with this needle?

Becca: The thought of it is tough. The first time is the hardest, because you’re just staring at this needle and you’re like looking at your leg, and you’re just like, so I’m really just going to push this in, huh? But it’s a needle, and it’s made to go in. I actually think over the two week period of shots, it gets progressively more painful toward the end. So the last few days are the worst. I think at that point you’re feeling a little bit bloated, you’re not allowed to go to the gym, you’re giving yourself shots every single night. For some reason those last few nights hurt the worst. At that point you’ve shot yourself everywhere on your legs, everywhere on your stomach, and you’re looking for a new spot. So those last few nights, you just want it to be over.

Jean Ann: And then you have the trigger shot, and everybody makes a big deal of the trigger shot. Somebody else gives you that one, and it has to be at an exact time – like, 1:45 in the morning, 10:30 p.m. – so when you go in to have your eggs be retrieved, it’s exactly 36 hours after the trigger shot.

Becca: And then for the egg retrieval process you do go under.

Jean Ann: Under some very temporary anesthesia. You’re all the way under, but it’s very short. And then you’re done!

Becca: And then there’s some anxiety as you wait to hear your egg count. For us we were doing embryos, so right when they retrieved the eggs they fertilized them with our frozen donor sperm. So after that you’re kind of waiting on eggshells – no pun intended – to hear how many of your embryos made it to day 3 or day 5, or just what the status of them is. And we’ve been on both sides of the spectrum. For me, I was really fortunate, I had a pretty high egg count, and with just one retrieval I got enough embryos that we felt comfortable and were able to freeze them. For Jean Ann, on her first and second try she didn’t get that many, and so she’s had to go through the egg retrieval process three times now.

Jean Ann: I will just add that for anybody that’s getting close to age 35, 35, you can get a blood test that will give you your AMH number. It basically tells you how many eggs, roughly, you have left. It’s a very good indicator or whether IVF is going to be a breeze and you’ll just have to do that once, or if your egg yield is going to be low and you’re going to have to do it multiple times like me. It is also a good predictor of if you will have to do IVF at all because the same number is also a good indicator of whether or not you will naturally be able to get pregnant. It’s a very easy first step.

Did you know about this AMH (or Anti-Mullerian Hormone) test before starting the IVF process, or did you learn about that after?

Jean Ann: Actually, someone at work told me about it. Because I was like, “I don’t think I want kids for a few years,” and this very matter of fact 40 year old man was like, “How old are you?” And I said, “35.” And he was like, “Just go get your AMH number. My wife had a low AMH number and it took us 5 years of trying and then we ended up adopting.” I was like, oh, my gosh!

And then I got the test, my AMH number was bad, and, indeed, it took me multiple times to do IVF. So I feel like this AMH blood test is pretty much free information.

A lot of healthcare providers might say no to that sort of testing, but I always suggest that people go to their provider and just insist on it. So, through this process, who was supporting you along the way? Obviously, you had each other. Was there anyone else in your life who was particularly helpful during this time?

Becca: Each other, for sure. I’m not a big oversharer, but it’s been really helpful for me to share, because what I’ve found is that as soon as I start talking about it, everyone has either a similar story themselves, or their friend does, or their sister does. So when I had my miscarriage, it was really helpful for me to tell people about it – even at work – and then people would share these success stories, and that made me feel better. And it was similar when going through IVF. I would talk about it with my friends, and they all had someone they knew who had been through it. At the time, I was really the first of my very good friends who was having a lot of trouble getting pregnant, and I felt a little bit alone, so their IVF success stories were helpful for me.

Jean Ann: But since then, now we know several people who’ve been through this.

Becca: We know people who’ve had miscarriages, been through IVF, and now I’ve been able to help them because we have this success story. So, for me, I would tell anyone who’d listen! And that helped me a lot.

Jean Ann: Then you had a pretty good pregnancy.

Becca: Yeah, and the IVF really worked well for us. We did an egg transfer, and I got pregnant on that first one, and then I had a pretty good pregnancy.

Jean Ann: And you have to give yourself these progesterone shots for the first 12 weeks.

Becca: No one talks about this!

Jean Ann: No one talks about this, but these are actually really terrible shots. And every night for the first 12 weeks that you’re pregnant—

Becca: You give yourself a progesterone shot in the butt.

Jean Ann: That was probably the worst part.

Becca: I think some doctors will allow you to do a suppository instead. So I went, like, running in after three nights of shots and was like, “Give me the suppository!” And they were like, “No, we highly recommend the shots.” They wouldn’t do it. So you’re giving yourself shots for 12 weeks. So much worse that the two weeks of IVF shots! It’s so much longer! So you’re basically so sore in the butt for the entire first trimester. But once we got through that, things were okay.

Jean Ann: Smooth sailing.

Becca: Yeah. I had a lot of heartburn, and that was my main symptom really.

Jean Ann: Then because you were a geriatric pregnancy, they told us that they wouldn’t let you go past one week over your due date. So we got an induction date for almost a week past your due date.

Becca: Yeah, 5 days past my due date they scheduled us for an induction. We went in, I got induced, and like these things do, it took forever to get a room, it took forever for the induction to start.

But then, like, once it started, it really started.I had pretty strong contractions for a long time, for like 15 hours. But I really wasn’t dilating. So, it was kind of sad, I kept having these big contractions and the doctor would go away and then come back a couple hours later to check my cervix and every time I was like, “Oh, I think I’m making progress!” and then she would check and be like, “Nope, still 3 cm. You’ve barely made it to 4 cm.” So I just wasn’t dilating. And then at some point, in about hour 16 or 17 of labor, I got a fever, and they said we’ve got to do a C-section. So we went in on a Thursday night, that Friday night at 11:30 p.m. she was born via C-section. And she was great!

Jean Ann: There’s so much pressure to not have a C-section and to be able to breastfeed right away and all this stuff, and, like, if you walk out with a healthy baby, that’s the goal, that is 100% success. I feel like people shouldn’t put that much pressure on how they want everything to turn out.

I know. There’s so much pressure for birth to be this perfect experience, just as planned. And I remember, too, even with me, I had a C-section, just feeling guilt, feeling like a failure, and realizing that, like, my baby’s awesome, and I really don’t care about how I got her! Do you remember what the first couple of days after Roz was born were like?

Becca: It’s funny, it’s such a blur. And I remember at the time saying to myself, I’m totally lucid and I’m recovering fine and I’m gonna remember all of this. And now I realize I don’t remember much of what those days were like!

I remember stumbling out of bed in the middle of the night and either feeding or pumping, and I remember napping a lot. Because I was recovering from a C-section, I needed a lot of help both during the days and the nights. So luckily I had Jean Ann to help, we had family, we got some help for me during the day when she went back to work. We were fortunate to be able to do that because I couldn’t lift the baby, but it’s all such a blur.

I do remember her being so cute. Like everything she did was so cute. I would feed her, and she’d fall asleep on me right after, and it was the cutest thing I’d ever seen! This weekend, actually, I saw a picture of Roz from her first few weeks. And I remember at the time looking at her and thinking, My newborn is so cute! She doesn’t look like a weird scrunched up newborn like every other one! She’s a perfect baby! And, like, five months later I realize that she definitely looked weird! But you just don’t see it at the time.

You do have an exceptionally cute baby! So what is it like now versus what it was like then?

Becca: I just feel like we’re getting more into what our life will look like for the next few years. Those first few weeks in my maternity leave I just kept thinking about how it was a temporary time – and it was wonderful, and I really enjoyed it – but now we’re trying to figure out what our real life looks like. Like how we manage the jobs and the baby, how we manage finding time for ourselves, how we manage time for the extended family who wants to visit. So, it’s different – I’m much more lucid, I’ve recovered from the C-section, all of that kind of blurriness is gone – but I’m in this, like, this half-place where I feel like, we don’t quite have enough time for everything. And I don’t know if this is just what the new normal is, or if we’re still figuring it out. So that’s kind of the phase we’re in now.

I feel like our journey has taken a lot of different turns. And where we are now – we’re so so happy and so lucky that we have this wonderful healthy baby – but it took a while. And it took a lot of different types of interventions, and along the way there were times when it felt like it wasn’t going to happen, but now she’s here, and she’s perfect, and it makes the last two and a half years feel like a blur, like just a blip. So it was all worth it.

Jean Ann: But at the time, it was tough. It can be very tough.

Becca: Yeah, and I guess some advice we would give is to try to release some of the expectations that you have and some of the perfection that you’re striving for, because you really just don’t know how things will turn out. Like, you might not always be able to hit that exact timing for getting pregnant that you want. Or we thought we wanted a boy, but we obviously love our baby girl! It turns out it doesn’t matter. So just to try to release some of that, to the extent that you can, because the journey is hard enough.

The differences between an IVF and an ICSI

Articles and websites are known to use the two names (IVF and ICSI) interchangeably, without explanation, or definition. How are people supposed to know what these treatments are and how they’re different? Wait, are they different? Let’s start from the beginning.

In Vitro Fertilization (IVF)

You may already know a little about IVF because it’s probably the most popular form of assisted reproductive technology (ART) out there. It’s also the most expensive. One IVF cycle can cost anywhere from $8,000 to $30,000 depending on factors like age, health, or if you plan on using donor sperm or eggs. However, if IVF turns out to be the right choice for you, it may very well be worth the hefty price tag.

Many people who seek out IVF treatment do so because they have issues with fertility. These could include endometriosis, polycystic ovary syndrome (PCOS), problems with sperm function, and unexplained infertility. For people over 35, IVF may also offer a better chance of conceiving than traditional intercourse, ICI, or IUI. It’s always a good idea to speak to your healthcare provider when you are thinking about moving forward with any ART or other fertility treatments.

How IVF works

The IVF process can take up to two weeks, and there are several different ways to prepare the body for treatment based on individual health. These preparations include taking hormone-encouraging drugs to boost ovulation and improve chances of producing a high number of mature eggs. There are also medications to help prepare the uterine lining for fertilized embryos. Specialists work closely with patients to help develop a game plan.

When a healthcare provider gives the green light, mature eggs will be carefully retrieved from the ovaries. These eggs (or donor eggs) are taken to a lab where they will then be put in a petri dish with fresh sperm (collected shortly before the procedure), or sperm that has been thawed and prepared beforehand. These close living quarters will allow sperm to mingle with eggs in a way that is isn’t really possible during traditional intercourse. Aside from the setting of the petri dish, the fertilization process is much the same as during intercourse. In the end, one sperm should match up with one egg. Then it’s a bit of a waiting game. If the procedure is successful, after a period of two to six days, the fertilized embryo or embryos will finally be transferred to the uterus, where, hopefully, implantation will be successful and result in pregnancy! With IVF and ICSI, it’s sometimes possible to find out if it worked by taking a pregnancy test as soon as two weeks after implantation.

Intracytoplasmic sperm injection (ICSI)

This treatment is also used when people are having trouble getting pregnant, or by people using donor eggs or sperm. The name “intracytoplasmic sperm injection” makes ICSI sound like a very complicated treatment, but when you break it down, the concept is pretty straightforward. In truth, the term is just a really formal way of saying that during the ICSI process, sperm will be directly injected into an egg to fertilize it. But, what exactly does that mean, and how is it possible?

How ICSI works

ICSI is a form of IVF treatment, often referred to as “IVF with ICSI,” so both processes take place in a IVF lab. As for preparation, traditional IVF and ICSI are very similar, if not identical in some cases. The real difference between the two happens after the sperm and eggs have already been taken to the lab. Unlike traditional IVF, ICSI samples are not mixed together in a petri dish and left to match up on their own. Through the ICSI process, you are able to make the connection for them. A single egg is delicately held in a specialized pipette, while a very small and hollow needle carefully selects a single sperm and immobilizes it by picking it up. Once both parties are secured, the needle is slowly brought through the shell of the egg (zona) before reaching its goal at the center of the egg (cytoplasm). The needle then places the sperm within the cytoplasm. After injecting the sperm, the process is complete, and the needle is removed. Eggs are checked after a day or so to see if the process of “normal fertilization” has begun. Just like traditional IVF, the successfully fertilized eggs are then implanted in the uterine lining once they are mature enough.

Other things to consider

In the end, there really isn’t a “qualifying factor” that can say for sure whether you should use traditional IVF or ICSI treatment (though ICSI may be more effective in cases of severely low sperm count and unexplained male infertility). The process of egg retrieval and insertion of embryos into the uterus are the same between both options. Both are mostly painless, and have mild side effects. In fact, because ICSI has become more popular over the last decade with a 70% to 85% fertilization rate, many clinics have begun to use the two procedures interchangeably, and some have even begun using ICSI for every treatment!

We all know that it’s sometimes difficult to get a straight answer from the internet. We’ve covered the basics, but nothing can replace your healthcare provider’s knowledge and advice. Asking them detailed questions may be the first step in beginning your IVF journey!

Read more

• Sperm donation 101
• Egg donation: thinking it through

Sources

• Mayo Clinic Staff. “In Vitro Fertilization (IVF)”. Mayo Clinic. Mayo Clinic. March 22, 2018. https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716
• “Intracytoplasmic Sperm Injection- ICSI and IVF. Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/icsi.htm
• “Egg Donation Cost at the Advanced Fertility Center of Chicago”. Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/eggdonationcost.htm

There are many factors that might have you considering alternative insemination, and using a sperm donor to help you in start (or expand) your family.

If you’re thinking about sperm donation, here’s what you should know

Your primary care provider (PCP) will be able to give you a fertility evaluation, and this will help you decide whether using donor sperm, or other reproductive assistance, is right for you. During this appointment, you’ll be asked to provide information about your lifestyle, but don’t worry, this isn’t a test. You won’t “fail” the exam if you admit to being a couch potato every once in a while, and it’s important to be honest if you want a care plan that’s specific to your family’s health and needs.

Choosing sperm

After meeting with your PCP, your mind may shift to figuring out the type of sperm you’d like to use. “Known” sperm (the sperm of someone you know) and anonymous sperm are the two options you’ll find. Both can be the right choice, but each has different emotional and legal considerations that go with them, so take your time with this decision.

Remember, all donations (anonymous or not) are screened for sexually transmitted diseases, as well as any evidence of genetic disorders. In the case of anonymous donation, the sperm is usually frozen and kept for 6 months after it is deposited, before it is then re-tested and given to patients.

In addition to deciding whose sperm to use, there is also the matter of what form of sperm you’re going to use. As with insemination procedures, there are few different options that are available:

• ICI-ready sperm: Semen in this category is used for intracervical insemination. This process is probably the closest to the movie and TV representations of sperm donation. These specimens are not “prepared” or altered before they are frozen (but of course they go through the same thorough screening process). Often, this sperm is injected into a patient at a clinic or doctor’s office, but this type of sperm can also be used for private home insemination. ICI is the least invasive form of alternative insemination, and has success rates of anywhere from 10% to 18% (tracking your cycle can help give you the best odds).
• IUI-prepared sperm: These samples are prepared for intrauterine insemination. The seminal fluid is removed or, “washed” from the donor’s semen to isolate sperm, and all dead swimmers are removed before the sample is frozen. This option is more expensive  than ICI sperm because of the process the semen goes through, and because by eliminating seminal fluid and dead sperm, there is a better chance of fertilization.The IUI procedure is also a little more invasive than ICI because the sperm is directly inserted into the uterus rather than the cervix. This process is always performed in office, and has a success rate of 18% to 30%.
• IVF-prepared sperm: This is the cheapest form of prepared sperm, but it isn’t offered by every sperm bank. These samples have a lower sperm count than ICI or IUI prepared sperm. This is because it is believed that less sperm is needed to conceive through IVF, and that saves you some money. But despite saving a couple of bucks on sperm, IVF is one of the most expensive options for alternative insemination. This process involves taking already fertilized embryos and inserting them into a uterus. And again, this increases the success rates to 13% to 41%.

The varying success rates within methods are due to a lot of situational factors including medication, health, age, and lifestyle.

Because the cost of donor insemination can range from $300 to $4,000 depending on what sperm is used, and an average cost of $12,000 per IVF cycle, be sure to ask your provider how many vials of sperm you’ll need!

Preparation

Sometimes people are prescribed medication to help prepare the body by encouraging fertilization. Every case is different, but many medications prescribed in these situations are follicle stimulating hormone (FSH) treatments. FSH is a naturally occurring hormone in your body that helps mature an egg living in the ovaries, while also causing a follicle to grow around that egg as it continues to mature before ovulation. The medications prescribed by healthcare providers encourage this process in the same way.

The day of

Traditionally ICI, IUI, and IVF are all outpatient procedures. IVF can be a little different because the process may involve two outpatient procedures. In those cases, there is a standard egg retrieval and a seperate embryo transfer performed after the eggs have been fertilized. Though all of these procedures may be a little different, a benefit of all three options is that once the insemination process is over, you’ll be able to resume your day as normal.

After insemination

After these outpatient procedures, you’ve made it! And despite popular belief, there’s no need to lay on your back with your legs in the air. You may be asked to lay down or relax for a while, but your legs won’t be airborne, and this downtime could help you process your excitement or calm your nerves. After insemination, you may experience some mild cramping or bloating. This is normal, and shouldn’t be too intense. Then, you may be able to take a pregnancy test as soon as two weeks after insemination! On the other hand, some healthcare providers may suggest waiting a longer period of time. Waiting a little longer will be hard, but if you can do it, you’ll get a more accurate reading on whether or not the insemination was successful.

The bottom line

Alternative insemination is a procedure without many physical risks, and is a great option for people looking to expand their families. Because there are varying success rates to each procedure, your PCP can offer a great deal of guidance and support when making this decision. Be sure to keep all of your personal needs in mind, and take everything at your own pace.

Sources

• Office Andrology. Illustrated Edition. Battaglia, David E. and Patton, Phillip E.. Human Press. 2010. Web. https://books.google.com/books?id=WMazHT_VXrcC&printsec=frontcover&dq=Office+Andrology&hl=en&sa=X&ved=0ahUKEwjh9tXSqJfcAhVDn-AKHZDTCcYQ6AEIJzAA#v=onepage&q=Office%20Andrology&f=false
• “Single Cycle IVF Cost Details – Advanced Fertility Center of Chicago.” Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/ivfprice.htm
• Mayo Clinic Staff. “Female Infertility”. Mayo Clinic. Mayo Clinic. March 8, 2018. https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
• Seattle Sperm Bank Staff. “Demystifying IUI, ICI, IVI, and IVF”. Seattle Sperm Bank. Seattle Sperm Bank. 2015. https://www.seattlespermbank.com/demystifying-iui-ici-ivi-and-ivf/
• Seattle Sperm Bank Staff. “How to Inseminate at Home Using Donor Sperm.” Seattle Sperm Bank. Seattle Sperm Bank. 2015. https://www.seattlespermbank.com/how-to-inseminate-at-home-using-donor-sperm/
• Pacific Fertility Center Staff. “Donor Sperm.” Pacific Fertility Center. Pacific Fertility Center. 2018. https://www.pacificfertilitycenter.com/treatment-care/donor-sperm
• “In Vitro Insemination: IVF”. American Pregnancy Association. American Pregnancy Association. 2018. http://americanpregnancy.org/infertility/in-vitro-fertilization/
• “Artificial Insemination (Intrauterine Insemination, IUI)”. University of Wisconsin Hospitals and Clinics. University of Wisconsin Hospital and Clinics. 2018. https://www.uwhealth.org/infertility/intrauterine-insemination-iui/26136

Jennifer Heinen, MS, RDN, LDN Founder, Nourish for Life

As couples begin their journey toward pregnancy, they may consider making changes to their lifestyle. Many are aware that a nutritious diet, exercise, stress reduction, and improving sleep habits are keys to preparing the body for reproduction. However, after 6 months to a year of trying without becoming pregnant, it’s time to start looking at what each partner can do to improve their chances of conceiving. As information directed at women and fertility is abundant and readily-available, we are going to focus instead on what male partners can do on their own.

If you’re looking to boost male fertility, consider these diet changes

According to research, male factor infertility is the cause of infertility about 40% of the time, and yet less than 15% of people in this category seek independent medical advice for infertility. Considering that it takes both partners to make a baby, male lifestyle and diet also play a role in TTC. The good news is that men can take some control over their reproductive health by making simple changes to daily habits.

Maintaining a healthy weight is one way to improve fertility for men. Obesity and being overweight are acknowledged risk factors that can impact male fertility, as they can lead to lower testosterone levels and reduced semen quality. According to one study, the chances of infertility increase by 10% for every 20 pounds a man is overweight. Following a healthy eating plan and getting regular exercise to help manage weight can be a first step towards improving a couple’s chances of getting pregnant.

But not all men struggling with infertility are overweight. Even those at a healthy weight can practice unhealthy behaviors. For instance, smoking, drug use, and excessive alcohol intake can negatively affect chances of conception. Men at a normal BMI that do not eat a well-balanced diet may not reap the benefits that good nutrition could have on their fertility.

Add more produce to the mix

So what is a fertility-friendly meal plan for men? Begin by eating more fresh produce. This can easily be done by getting at least one serving at each meal and snack, or filling half the plate with fruits or vegetables. Focus on the most colorful veggies, which are packed with antioxidants like Vitamin E, Vitamin C, and beta carotene. Also, enjoy fatty fish, like salmon, sardines, and mackerel on a regular basis. They are high in DHA, a fatty acid that is found in sperm. Other healthy foods to focus on are chicken, low-fat dairy, and whole grains.

Reduce consumption of processed meats

Some research suggests that certain foods have a negative effect on fertility in men. These include processed meats (like hot dogs, deli meats, bacon, and canned meats), sweets, fatty foods (especially trans-fats and saturated fats), and other highly processed foods. Replacing these with healthier options may increase sperm motility and quality.

Although the research around male fertility and diet is limited, following a healthy eating pattern and managing weight is a solid recommendation – not only to benefit conception, but the overall health for the father-to-be. Men play an important role in baby-making, so discuss ways you can help make changes and support each other in your journey towards starting a family.

Reviewed by the Ovia Health Clinical Team

Read more

• Finding a fertility specialist
• What you need to know about fertility and perimenopause

Sources

• Myriam C. Afeiche, et al. “Meat intake and reproductive parameters in young men.” Epidemiology. 2014 Oct. 1. 25(3): 323-330. Retrieved September 19 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180710/.
• Phil Berardelli. “Sugar and Sperm Don’t Mix.” Science. American Association for the Advancement of Science, May 3 2007. Retrieved September 19 2017. http://www.sciencemag.org/news/2007/05/sugar-and-sperm-dont-mix.
• Giahi L, et al. “Nutritional modifications in male infertility: a systematic review covering 2 decades.” Nutr Rev. 2016 Feb;74(2):118-30. https://www.ncbi.nlm.nih.gov/pubmed/26705308.
• Katib, A. “Mechanisms linking obesity to make infertility.” Cent European J Urol. 2015; 68(1): 79–85. Retrieved September 19 2017. https://www.ncbi.nlm.nih.gov/pubmed/25914843.
• Sallmén M, et al. “Reduced fertility among overweight and obese men.” Epidemiology. 2006; 17: 520–523. Retrieved September 19 2017. https://www.ncbi.nlm.nih.gov/pubmed/16837825.
• Nancy Shute. “Fatty Foods Bad for Sperm.” NPR. NPR, March 14 2012. Retrieved September 19 2017. http://www.npr.org/sections/health-shots/2012/03/13/148540108/fatty-foods-bad-for-sperm.
• “Infertility FAQs.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, March 30 2017. Retrieved June 7 2017. https://www.cdc.gov/reproductivehealth/infertility/index.htm.
• “Less processed meat, more fish and exercise may boost sperm count, quality.” Harvard School of Public Health. The President and Fellows of Harvard College. Retrieved September 19 2017. https://www.hsph.harvard.edu/news/hsph-in-the-news/less-processed-meat-more-fish-and-exercise-may-boost-sperm-count-quality/.
• De Jonge CJ, Gellatly SA, Vazquez-Levin MH, Barratt CLR, Rautakallio-Hokkanen S. Male Attitudes towards Infertility: Results from a Global Questionnaire. World J Mens Health. 2023 Jan;41(1):204-214. doi: 10.5534/wjmh.220099. Epub 2022 Aug 16. PMID: 36047077; PMCID: PMC9826912.

Is it unsafe to use? Learn about common household products

Depending on what your routine is, you may end up needing to make a few changes to make sure you’re keeping yourself and your future baby as safe as possible.

Hair dye

Many hair dyes are vegetable-based, and so there’s not much concern about harmful chemicals being absorbed by your scalp, and aiming for vegetable-based dyes can help to limit any risk. You can also take additional precautions by wearing gloves, coloring in a space with good ventilation, and following package instructions. If you have your hair colored professionally, you can still check in about the ingredients in the dye they use. 

Nail polish

During pregnancy, many experts recommend sticking to non-acetone based products when you can – including nail polish and nail polish remover. Since new moms don’t know they’re pregnant during the earliest part of pregnancy, some choose to get started avoiding acetone-based products early on. Some of the ingredients in these products – like phthalates – can affect fertility, too, if you’re exposed to them often in the long-term. Acetone-free products and good ventilation can help limit exposure to potentially troublesome chemicals while TTC. Products that are labeled “three-free,” “five-free” and even “seven-,” “eight-,” and “nine-free” mark a commitment not to use potentially harmful ingredients, and the number corresponds to just how many of those ingredients are left out. Here, it’s what’s missing that counts.

Face and body products

Products like face lotion or facial scrubs that contain retinoids, salicylic acid, or benzoyl peroxide, which are used to treat and prevent wrinkles and acne can be harmful in large doses during pregnancy, so many doctors suggest erring on the side of caution and cutting them out early. Some alternatives that have the green light are ingredients like glycolic acid, alpha-hydroxy acid, and vitamin C.

You may also want to skip products containing parabens and phthalates – found in everything from body lotion to shampoo to perfumes. Because parabens can take on the characteristics of estrogen, there’s some evidence that exposure to too much of this can throw hormones out of whack and affect fertility. Beyond that, exposure to a lot of phthalates has been linked to preterm birth and impaired neurodevelopment. Fortunately, there are more and more products available today that are paraben- and phthalate-free, so you should have a wealth of other options.

Bug spray

You may have heard about potentially adverse side effects of certain ingredients found in insect repellents, such as DEET, but depending on where you live, what’s even more concerning is the risk of being exposed to serious mosquito and tick borne illnesses, including the Zika virus. There are DEET-free repellents on the market, but for the best protection, many experts recommend products that do contain DEET, and there are now formulations on the market that use lower concentrations of DEET that you may simply need to apply more often. Recent studies show that DEET and some of the other popular ingredients in insect repellants do not cause adverse health issues when used as recommended. The Centers for Disease Prevention and Control actually recommend ingredients like DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol products.

House paint

Steering clear of oil-based paints, paint thinner, and any painting supplies that contain mercury or lead is recommended during pregnancy, and women trying to conceive may also choose to avoid exposure. Latex based paints with ethylene glycol ethers and biocides, which includes most indoor paints, aren’t known to be dangerous, but they also haven’t been studied much for the effect they may have on early fetal development. Organic solvents like benzene, toluene, and perchloroethylene could increase the risk of preterm birth, stillbirth, or birth defects. This is also a great time to ask for help from friends or family if there are any painting projects on the horizon in your home.

Cleaning products and detergents

Most cleaning products are safe to use when TTC as long as you use them as advised, wear gloves when necessary, and work in a well-ventilated area. However, some products with fragrance contain phthalates, some oven and glass cleaners contain glycol ethers, and some mildew cleaners contain phenols. There isn’t clear evidence of what effect each of these chemicals might have, but there have been studies that suggest that a negative effect is possible, and that more research is needed. Parents-to-be who find themselves needing to use these products may choose to use products that omit these substances when possible, or they may choose to ask a partner to take over tasks that involve these chemicals for a little while.

Flame-retardant products

Flame-repellant chemicals are meant to do just what they sound like – prevent products like building insulation, furniture foam, and upholstery from catching on fire – but they can have unexpected effects as well. The chemicals used in flame-retardants don’t just stay in products, and can make their way into dust which can then be ingested. This is significant when TTC or pregnant because flame-retardants can reduce the chances of becoming pregnant using assisted reproductive technology, and, in women who are pregnant, can hurt the chances of live birth. When buying new products, it can be helpful to look for those that are marked flame-retardent-free, and with materials that are already a part of your life, just making sure to wash your hands before meals can help to prevent the ingestion of any questionable dust.  

Pesticides

Eating organic is the most common strategy people use to avoid pesticides, but it can be more helpful to limit direct exposure to organophosphate pesticides in other ways, like the use of these pesticides in your yard or on your family pets.

It isn’t always clear where the danger in pesticides lies – what ingredients, in what form, and at what dosage? If you find yourself stressing that you can’t possibly limit your exposure to all proven and potentially harmful chemicals, do keep in mind that when it comes to exposure to many of these substances, the dose makes the poison. If you occasionally use acetone-based nail polish before finding out you’re pregnant, you probably don’t need to worry. But if you work in a nail salon without great ventilation and are exposed to these sort of ingredients every day, the chance of an adverse effect may start to grow. Your healthcare provider is a great resource for guidance about specific products you’re using or are being exposed to.

Read more:

• Why do I keep hearing about toxins?
• Household items that could affect fertility

Sources:

• DB Barr et al. “Pesticide concentrations in maternal and umbilical cord sera and their relation to birth outcomes in a population of pregnant women and newborns in New Jersey.” Science of the Total Environment. 408(4): 790-5. January 2010. Retrieved August 28 2017. https://www.ncbi.nlm.nih.gov/pubmed/19900697.
• Yvonne Butler Tobah. “Is it OK to use hair dye during pregnancy?” Mayo Clinic. Mayo Foundation for Medical Education and Research, July 13 2017. Retrieved August 28 2017. http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/hair-dye-and-pregnancy/faq-20058484.
• Jeneen Interlandi. “How safe is DEET?” Consumer Reports. Consumer Reports, August 20 2017. Retrieved August 28 2017. https://www.consumerreports.org/insect-repellent/how-safe-is-deet-insect-repellent-safety/.
• R McGready et al. “Safety of the insect repellent N,N-diethyl-M-toluamide (DEET) in pregnancy.” The American Journal of Tropical Medicine and Hygiene. 65(4): 285-9. October 2001. Retrieved August 28 2017. https://www.ncbi.nlm.nih.gov/pubmed/11693870.
• The American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women, American Society for Reproductive Medicine Practice Committee, the University of California, San Fransisco Program on Reproductive Health and the Environment.  “Exposure to toxic environmental agents.” Obstetrics & Gynecology. 122(4): 931-5. October 2013. Retrieved August 28 2017. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Exposure-to-Toxic-Environmental-Agents.
• “Common flame-retardant chemicals may reduce likelihood of clinical pregnancy, live birth among women undergoing fertility treatments.” Harvard School of Public Health, The President and Fellows of Harvard College, August 25 2017. Retrieved September 25 2017. https://www.hsph.harvard.edu/news/press-releases/chemicals-flame-retardants-pregnancy/.
• “DEET.” United States Environmental Protection Agency. United States Environmental Protection Agency. Retrieved August 28 2017. https://www.epa.gov/insect-repellents/deet.
• “Household products database.” U.S. Department of Health & Human Services. National Institutes of Health: Health & Human Services, September 2016. Retrieved August 28 2017. https://householdproducts.nlm.nih.gov.
• “Insect repellent use & safety” Centers for Disease Control and Prevention. U.S. Department of Health & Human Services,  March 31 2015. Retrieved August 28 2017. https://www.cdc.gov/westnile/faq/repellent.html.
• “Zika virus.” World Health Organization. World Health Organization, September 6 2016. Retrieved August 28 2017. http://www.who.int/mediacentre/factsheets/zika/en/.