By Gabrielle Kassel, Contributing writer

PSA: Sexually transmitted infections are not the only infections that can make home in or on your genital area. Yeast infections, bacterial vaginosis, and urinary tract infections are all totally curable infections that can people can get, even if they’ve never ever had sex. Really!

Important things to consider about genital infections

Read on to learn more about the three types of infections — including intel on how they differ from sexually transmitted infections also found in genital areas.

What is a urinary tract infection?

A urinary tract infection takes place when bacteria (usually E. coli) gets lodged in the urethra, occasionally traveling up the urinary tract to the bladder and/or kidneys.

What causes UTIs, exactly? Anytime outsider bacteria gets introduced to the urethra, there’s risk for infection. This could happen in a number of ways, including through sex. A UTI could also be caused from bacteria from the anus being brought forward towards the urethra, for example while wiping or during sex.

While people of all genitals can get UTIs, urinary tract infections are far more common in those with vaginas than penises because the urethra is so much shorter. This means that the distance the bacteria has to travel in order to get to the bladder is shorter, increasing the odds that the infectious agent makes it to the infection-site.

Common symptoms include:

• Frequent urination
• Pain or discomfort while urinating
• Urine that is cloudy or pink in color
• Lower abdominal or pelvic pain or cramping
• Rectal pain

A UTI can be diagnosed with a quick urine sample — for more information on how to properly collect a urine same, head here. If tested-positive, your healthcare provider will prescribe a round of antibiotics which will begin to clear the infection up in as little as 24 to 72 hours. The type of antibiotics will vary based on the type of bacteria found in the sample, as well as the location (urethra, bladder, or kidneys) of the infection.

What is a yeast infection?

Also known as candidiasis, a yeast infection occurs when there is an overgrowth of the fungi “candida” in the body.

Anybody can get a yeast infection. But those with vaginas are far (far!) more likely to be infected — nearly 75% will have a yeast infection at least once in their lifetime. Less than 1% of those with pensises will get a yeast infection in their lifetime.

The health of the internal canal of the vagina is regulated by something called the vaginal microbiome which is made up of millions of bacteria, yeast, and fungi that work the vagina’s bodyguard and janitorial staff, keeping the it clean while also warding off infectious pathogens.

When the vaginal microbiome becomes disrupted — which can occur from a variety of things including antibiotic use, pregnancy, uncontrolled diabetes, sitting in wet or sweaty clothes, oral contraceptives, interaction with another person’s natural genital bacteria, or use fragrant body washes — the owner becomes susceptible to a yeast infection.

Common symptoms include:

• Cottage-cheese-textured discharge
• Itching and irritation on the vulva, penis, or taint, or inside vaginal canal
• Pain or burning while urinating or during sex
• Redness, swelling, or irritation

Yeast infections can be diagnosed with a pelvic exam or lab test. Usually, they can be cured with a one to seven day regimen of anti-fungal topical or oral medication. However, if left untreated long enough the infection can travel elsewhere in the body and require a more rigorous course of treatment to be eliminated.

What is bacterial vaginosis?

Bacterial vaginosis names the condition in which there is an overgrowth of certain bacteria in the vaginal microbiome. As the name suggests, BV is a condition that only affects those with vaginas.

Similar to yeast infections, anything that upsets the vaginal microbiome can result in BV. However, things like douching, having sex with someone new, using fragrant washes and detergents, and smoking can all increase the risk.

Common symptoms include:

• Fishy or foul smelling odor
• Thin or loose discharge
• Vaginal or vulvar itching
• Burning while peeing

Bacterial vaginosis can be diagnosed through a pelvic exam, vaginal secretion or vaginal pH test. To treat bacterial vaginosis, your healthcare provider may prescribe an oral or intravaginal cream that should clear up the infection within a few days.

How are these infections different from STIs?

The main difference is how the infections are classified. Yeast infections, bacterial vaginosis, and UTIs are not classified as STIs.

While sex can increase risk of yeast infection, bacterial vaginosis, and UTIs, they are not considered sexually transmitted infections because they are not infections transmitted from one person to another. All sexually transmitted infections are strictly transmitted from an STI-positive person, to someone who is not positive for that STI through direct skin-to-skin contact or through exchange of bodily fluid exchange.

Another difference is that all of the infections mentioned here are totally curable with adequate treatment. While some STIs are curable (gonorrhea, syphilis, chlamydia, trichomoniasis, and pubic lice), there are also some viral STIs that can be treated, but cannot be cured.

However, all genitals infections can be asymptomatic. Or, result in similar symptoms like itching, burning, or pain during sex or while urinating.

So…how do you know which of the genital infections you have?

Talk to your provider about your concerns and which genital (or other) infections you are worried about. Together you can come up with a plan for testing and treatment to get you feeling better as soon as possible.

Reviewed by the Ovia Health Clinical Team

Sources

• Mayo Clinic Staff. “Urinary Tract Infection (UTI).” Mayo Clinic. Mayo Clinic. October 14, 2020. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
• Mayo Clinic Staff. “Yeast infection (vaginal).” Mayo Clinic. Mayo Clinic. March 17, 2021. https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999

Sex Ed. class 2.0

Here, we’ve rounded up five things you should have learned from sex ed. class before reading this article, but will be useful to you long after you close it.

1. It is normal and healthy to masturbate

Masturbation is not just expected by boys and men, but encouraged. Yet, common cultural narratives tell girls and women that masturbation is dirty and wrong.

Here’s the thing: Nothing could be further from the truth. For people of all genders, masturbating is both normal and healthy! Benefits of masturbating include: reduced stress, boosted mood, and increased self confidence long term. And beyond being healthy, masturbating also feels good, which is absolutely reason enough to partake!

In summary: You should have been taught that masturbation is healthy. Further, you should have been encouraged to touch yourself in whatever locations, using whatever pressures, at whatever speeds, for however long, and however often you want.

2. STIs can be transmitted during oral sex

Despite the fact that many sex education curriculums rely on fear-mongering, few programs acknowledge sex acts other than penis-in-vagina intercourse exist, and therefore do not touch on potential risks of such acts. Like, oral sex for example.

From fellatio and cunnilingus to analingus, oral sex can bring Big Time pleasure for the giver and receiver alike. Still, important to know the potential risks. Ready?

While the risk is lower than it is during vaginal or anal intercourse, an STI can be transmitted during oral sex from a mouth or throat, to a penis, vagina, vulva, or anus — and vice versa. That means that, yes, an STI can infect body parts other than the genitals.

When oral STI symptoms do appear, they may include: sore throat, pain during swallowing, sores around the lips, sores and blisters in the mouth, and swollen lymph nodes. But as is true with STIs located elsewhere in the body, the most common symptom of an oral STI is no symptom at all. And that’s why it’s so important to get tested for oral STIs, between (oral sex) partners or once a year (whichever comes first). Oral STI testing involves a simple mouth or throat, and treatment typically involves an oral antibiotic or prescription mouthwash.

What can you do to reduce risk of STI transmission during oral hanky-panky? Glad you asked. With a partner who’s STI status you don’t know or who has an STI , you can use an external condom or dental dam to reduce risk of transmission.

3. PReP can be taken by all genders

PReP (pre-exposure prophylaxis) is a daily oral medication that can be taken by HIV-negative people to greatly reduce their risks of contracting HIV, if exposed to the virus. Highly effective, PrEP is one of the best additions to the sexual health space…ever.

While there is more that can be done to spread awareness about PReP to all people, cis-women in particularly tend to be less likely to take PReP. The problem is that people of all sexual orientations, genders, and genitals are susceptible to HIV, if exposed to the virus through sex, intravenous drug use, contaminated blood transfusion, or pregnancy. In fact, globally more than half (52%) of HIV-positive people in the world are women.

No matter your gender, to figure out if you’re a good candidate for PrEP read the federal guidelines put out by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) and/or talk to your healthcare provider.

4. Sex is not supposed to be painful

No, not the first time you have it. No, not during anal sex. No, not postpartum. Pain is the body’s way of telling you that something is wrong — and it’s a message worth listening to.

Sometimes pain during sex is a sign that you need additional lubrication or that your not-yet aroused-enough for what’s happening. In these instances, slowing down and adding lube can turn your sex session from “ouch” into “ooh!”.

When sex is consistently painful, however, or you experience these symptoms outside of sex (for example: while urinating or inserting a tampon) there may be an underlying condition. Pain during sex is a common symptom of conditions like hypertonic pelvic floor, endometriosis, vaginitis, vulvodynia, vaginismus, and pelvic inflammatory disease.

If you’re experiencing pain during sex, stop. If you want to continue having sex, try slowing down and/or add a store bought lubricant. If the pain becomes more chronic, bring it up with your healthcare provider or seek out the guidance of a trauma-informed pelvic floor specialist.

5. Consent is an informed, ongoing, and enthusiastic agreement to engage with someone that can be withdrawn at any time

As of 2020, only 9 states required consent be taught in sex education curriculum. That means that a whopping 41 states don’t teach students the importance of receiving “Y-E-S”, nor validated the decision to say “N-O” at any point during a sexual encounter.

The failure of this absence becomes obvious when looking at the responses from a recent survey of people ages 18 to 25. In it, 53% admitted that they didn’t realize that consent can be withdrawn once someone is already naked (it can!) and just 13% said they’d feel comfortable discussing consent with their sexual partner.

While the staggering sexual assault statistics cannot be blamed on any one thing — curriculums in sex ed. class suffer from widespread avoidance of consent, and it certainly isn’t doing anything to help reduce the number of people assaulted.

If you’re reading this and haven’t yet learned about consent, take the time to read The Consent Checklist by Meg-John Barker and/or Beyond Yes & No by Kai Werder.

Reviewed by the Ovia Health Clinical Team

Sources

• “Facts and figures: HIV and AIDS.” UN Women. UN Women. July 2018. https://www.unwomen.org/en/what-we-do/hiv-and-aids/facts-and-figures. 
• “Pre-exposure Prophylaxis (PrEP) Care System”. CDC. CDC. September 10, 2020. https://www.cdc.gov/hiv/effective-interventions/prevent/prep/index.html#About-PrEP. 

How long does it take (on average) to get pregnant?

Many factors can influence how long it takes to get pregnant, including your cycle, general health, fertility conditions, age, and lifestyle.

Getting pregnant faster

Although it takes the average female up to six months to conceive, there are ways to improve fertility health and reduce time to pregnancy. Staying healthy through diet and exercise and taking folic acid supplements can greatly increase your chances of conceiving, relative to those who don’t do these things. Individuals who track their fertility data to pinpoint their ovulation are also able to speed up their time to conception. Even your mood might help with your fertility: some studies have found that happier emotional states correlate with faster conception.

How long is too long?

Although any female without a condition of infertility or sterility can get pregnant naturally before menopause, some may take a bit longer than others. Doctors recommend that couples who have not conceived after one year of trying seek a fertility consultation to determine if an alternative route to conception might be explored, whether it’s in vitro fertilization (IVF), surgery, or fertility medication. It’s recommended that women over 35 should seek a fertility consultation after six months of trying.

If you have any questions about trying to conceive or your fertility health in general, don’t hesitate to reach out to your healthcare provider for more information.

Read more

• Does pregnancy loss impact future conception?
• Trying to get pregnant for more than a year

Sources

• Dr. Walter Willett. “Nurses’ Health Study II.” National Institutes of Health. United States, 1989-. Web.
• “Nutrition During Pregnancy: FAQ001.” ACOG. American College of Obstetricians and Gynecologists, 4/15/2015. Web.

Common questions about the MTHFR gene: Answered

First off, what does the MTHFR gene do exactly? It’s responsible for making the enzyme, methylenetetrahydrofolate reductase (hence the MTHFR acronym and wordy gene name). This, in turn works with the B-vitamin folate to help to reduce the level of homocysteine in the body.

What does it mean to have a MTHFR gene variant?

There are two common gene variants (which is when the DNA sequence of a gene is different in different people) of this gene, and these are called C677T and A1298C. Studies have shown that women with two C677T variants have an increased risk of having children with neural tube defects (though these defects are rare, so the risk is still low). Men and women with the same two variants and elevated homocysteine levels may have an increased risk of blood clots (and people who have elevated homocysteine levels rarely have elevated levels just from the gene variants, so they should be evaluated for other risk factors that are known to cause this). Too much homocysteine in the body can be one risk factor for blood clots and heart disease, however many environmental and genetic factors influence risk for this.

Can the MTHFR gene affect pregnancy?

Associations between these common gene variants and a number of complications have been speculated and evaluated for in different ways, but no association has been found. These gene variants have not proven to be a risk factor for problems that may arise during pregnancy such as blood clots, pregnancy loss, or other negative health outcomes. Because of this, the American Congress of Obstetricians and Gynecologists (ACOG) do not recommend testing for MTHFR gene variants. If genetic testing does show a MTHFR variant, these variants on their own will not impact an individual’s medical treatment. And a medical geneticist will work hard to do a thorough and appropriate evaluation of symptoms to prevent incorrectly attributing medical problems to positive MTHFR status, which is not uncommon.

And what this all means for pregnant individuals is that prenatal care – including recommendations for prenatal vitamins or folate supplementation – will not change in major ways based on the presence of an MTHFR gene variation. Impacts include if, for example, a person has high homocysteine levels, medical providers will seek to identify all possible causes, and pregnant individuals will be advised to take standard folate dosages to reduce the risk of neural tube defects. Or, to use another example, if other symptoms indicate that it’s necessary, an individual may be referred from a medical geneticist to a hematologist or maternal–fetal medicine specialist for further evaluation.

Talk to your healthcare provider if you still have questions or concerns

If you have any questions or concerns about this, talk to your healthcare provider, as they can answer your questions.

Read more

• Genetic testing before pregnancy
• Getting healthy for fertility and pregnancy

Sources

• Scott E. Hickey, Cynthia J. Curry, and Helga V. Toriello. “ACMG Practice Guideline: lack of evidence for MTHFR polymorphism testing. Genetics in Medicine. 15(2): 153-156. February 2013. Retrieved August 28 2018. https://www.acmg.net/docs/mthfr_gim2012165a_feb2013.pdf.
• “Basic information about the MTHFR Gene.” Kaiser Permanente. The Permanente Medical Group, Inc., May 2018. Retrieved August 28 2018. https://mydoctor.kaiserpermanente.org/ncal/Images/GEN_MTHFR_tcm63-938252.pdf.
• “MTHFR gene variant.” U.S. Department of Health & Human Services, National Institutes of Health, National Center for Advancing Translational Services. Genetic and Rare Diseases Information Center, April 18 2018. Retrieved August 28 2018. https://rarediseases.info.nih.gov/diseases/10953/mthfr-gene-mutation.

Potential causes of infertility

There are many different possible causes of infertility in both men and women, so it’s recommended that couples who are struggling to conceive visit a fertility specialist to identify and treat the particular condition of infertility. Many fertility problems can be fixed, and couples go on to have healthy, successful pregnancies.

Women

Women can suffer from a range of different infertility conditions with various causes, including hormonal and anatomical issues.

• Polycystic Ovarian Syndrome (PCOS) – PCOS develops from a hormonal imbalance that usually results in the growth of small, benign cysts on the outer edge of the ovaries. Women with PCOS tend to have irregular and absent periods and ovulations, making getting pregnant more difficult. The disorder can have wide-ranging effects, from weight gain, acne, and increased risk of diabetes, to thinned hair on the head and excess hair growth on the face and body. People with PCOS can benefit from tracking their cycles to best predict their ovulation, but if this is ineffective by itself, a fertility specialist may recommend an ovulation-inducing medication like Clomid, possibly in conjunction with Metformin. Surgical options like ovarian drilling, which induces ovulation by making tiny holes in the ovaries, also have significant success rates and minor recoveries. There is no test to diagnose PCOS, so doctors will often only diagnose PCOS if all other explanations have been ruled out.
• Endometriosis – Caused by a buildup of uterine tissue in the pelvic area outside of the uterus, endometriosis can result in fallopian tube blockages, scarring, cysts, and other damage. These blockages bar eggs that the ovaries release from making their way through the tubes, preventing fertilization. Endometriosis can also be quite painful, especially during your period. Women who have endometriosis may want to consult a fertility specialist about surgical options, both to better understand the extent of the extent of the possible tissue damage and to remove it. Laparoscopic surgery can remove the obstructive tissue and help clear the way for eggs to move through the fallopian tube. In vitro fertilization (IVF), in which the egg is fertilized in a laboratory before being transferred to the womb, is another option for women battling endometriosis.
• Hormonal problems – Oftentimes, women who have irregular cycles will have trouble getting pregnant, due to irregular, infrequent, or absent ovulations. Short luteal phases may also contribute to the problem, in which menstruation begins before a fertilized egg would have time to implant in the uterine lining. Hormone supplements are a good option for women with hormonal disorders, in order to regulate the condition and induce ovulation.

Men

• Poor sperm quality: Whether due to age, lifestyle factors, or bad luck, some men’s sperm have trouble making their way to, or fertilizing, an egg waiting in the fallopian tube. Some men may have a low sperm count, while others could have poor sperm motility. Couples can still get pregnant if a man has poor sperm quality, but the likelihood is reduced. A fertility specialist may be able to recommend a course of action for the best chance of conception.
• Varicocele: Varicoceles are enlarged veins in the scrotum that raise the temperature of the testes, hindering sperm production. Because varicoceles can reduce sperm count or harm the quality of sperm produced, they make conception difficult. If the varicocele is severe enough, a fertility specialist might recommend surgery to cut the veins contributing to the varicocele. Surgery is relatively minor, and men recovery fully within about a week.
• Blockages: Some men may have blockages in the vas deferens or epididymis, which can prevent healthy sperm from reaching and fertilizing the egg. A fertility specialist might recommend a surgical procedure to remove the obstruction. Men with blockages also generally have otherwise healthy sperm, meaning in vitro fertilization with one’s own sperm is entirely possible.

Read more

• Infertility treatments
• Other options

Sources

• Mayo Clinic Staff. “Infertility Causes.” Mayo Clinic. Mayo Clinic, 7/2/2014. Web.
• “What Causes Female Infertility?” Stanford University. Stanford University, n.d. Web.

Types of fertility treatments

Specific types of fertility treatments include medical and surgical options and Assisted Reproductive Technologies like in vitro fertilization (IVF).

Medication for infertility

• Clomid (female): Clomid is an ovulation-inducing medication that causes the hypothalamus and pituitary gland to release GnRH (gonadotrophin-releasing hormone), FSH (follicle-stimulating hormone), and LH (luteinizing hormone), which help promote follicle maturation and the release of an egg. Doctors may prescribe Clomid to women who suffer from Polycystic Ovarian Syndrome (PCOS), or those who otherwise experience irregular or absent periods or ovulations. You’ll take Clomid as an oral pill on a few days of your menstrual cycle. About 60 to 80% of women who take Clomid will ovulate. If you suffer from abnormal or absent ovulations, your fertility specialist will likely talk to you about Clomid.
• Injectable hormones (female): Hormones like hCG (human chorionic gonadotrophin), FSH, and GnRH may be injected to stimulate ovulation in women, either in addition to taking a Clomid regimen or when Clomid is ineffective. The chances of conceiving multiples are fairly high with hormone treatments: about 30% of women who conceive with the help of hormones have more than one baby.
• Hormone Treatments (male): If a hormonal imbalance is the culprit in male-factor infertility, a fertility specialist may prescribe Clomid or hCG-boosters. The same hormones control reproductive function in both men and women, and addressing these imbalances to help men re-regulate their hormones often leads to success in overcoming fertility problems.

Surgeries for infertility

• Ovarian drilling (women): If Clomid does not work, a fertility specialist might recommend ovarian drilling (also called ovarian diathermy). This procedure can trigger ovulation by piercing small holes in the ovaries, which can curb hormonal imbalances. A doctor first makes a very small incision in the belly button, then uses a laparascope to view the ovaries and make tiny holes using a laser. Recovery is quick, often taking only a few days, and about 50% of women are able to become pregnant after the surgery, even if they don’t respond to medications like Clomid previously.
• Laparoscopic surgery for endometriosis (women): Because women with endometriosis may experience difficulty conceiving due to blockage of the egg’s path to the fallopian tube, a fertility specialist might recommend laparoscopic surgery to clear the obstruction and allow eggs to pass down the fallopian tube to be fertilized. During the surgery, a doctor will use a laparoscope to view the pelvic organs, searching for blockages, cysts, scarring, and other damage, and removing any foreign bodies or tissues. As with ovarian drilling, recovery is usually quick.
• Varicocele repair (men): Varicoceles are varicose veins found in the scrotum. They can increase the temperature of the testes, making them less effective at producing sperm. During a varicocele repair procedure, doctors make a small incision through the abdomen and cut the veins that produce the varicocele to reduce blood flow to it. Most men fully recover from this procedure within one week.

Assisted Reproductive Technologies (ART) and other procedures

• In vitro fertilization: In vitro fertilization (IVF) is probably the most well known form of Assisted Reproductive Technology. A fertility specialist might recommend IVF when other infertility treatments are unsuccessful. IVF involves removing an egg from an ovary and fertilizing it in a laboratory with either your partner’s or a donor’s sperm. Doctors then surgically implant the fertilized egg into the uterus, and if successful, it will develop like any other embryo. IVF carries about a 40% success rate per cycle, and is most commonly used when a woman has an ovulatory disorder.
• Intrauterine insemination (IUI): Intrauterine insemination involves extracting sperm cells from the male and introducing them directly to the uterus for the highest chances of conceiving possible. IUI is less expensive than IVF and is often used with male-factor infertility when there is a low sperm count or the sperm cannot move as they should.
• Gamete intrafallopian transfer (GIFT): In this procedure, sperm and an egg are extracted and mixed together before immediately being placed into a fallopian tube where they will may come together in conception. Gamete intrafallopian transfer differs from in vitro fertilization because the egg is fertilized inside the fallopian tube in GIFT, whereas the egg is fertilized in a laboratory in IVF treatments.

Regardless of the condition of infertility affecting you or your partner, fertility specialists have many different medical and surgical techniques available to promote fertility and conception. One option might be right for you. If you’re having trouble, you may want to speak with a fertility specialist in your area who can make your dreams of conceiving a reality.

Read more

• Everything you need to know about intrauterine insemination
• IVF and assisted reproductive technologies

Sources

• Mayo Clinic Staff. “Male infertility: Treatments and drugs.” Mayo Clinic. Mayo Clinic, 8/11/2015. Web.
• Mayo Clinic Staff. “Female infertility: Treatments and drugs.” Mayo Clinic. Mayo Clinic, 7/16/2013. Web.

Causes of infertility a fertility specialist can help with

All people can be affected by conditions of infertility, due to a wide variety of factors. Fertility specialists can address with the following conditions:

Female Factors

• Polycystic Ovarian Syndrome (PCOS): Developing due to a hormonal imbalance where a person’s body creates excess androgens, PCOS usually causes small, otherwise benign cysts to grow on the edge of each ovary. PCOS often results in irregular periods and ovulations, if ovulation occurs at all, making conception difficult. It has a wide range of other symptoms that not all people experience, including extra hair growth, acne, and darkened areas of skin. A fertility specialist might treat PCOS with Clomid, a drug that induces ovulation, or through a procedure called ovarian drilling, in which ovarian follicles are bored with small holes to encourage ovulation. Some research suggests that a healthy diet is very effective in reducing PCOS symptoms and complications.
• Endometriosis: Caused by a buildup of uterine tissue outside of the uterus, endometriosis can result in blockage that prevents the passage of the egg through the fallopian tube. Endometriosis can sometimes be treated with hormonal supplements, but your fertility specialist may also recommend laparoscopic surgery to remove the obstructive endometrial tissue. Endometriosis can cause pain, cyst development, bleeding, and scarring in the pelvic region and make it more difficult to get pregnant. Symptoms are typically most severe during your menstrual phase.
• Hormonal problems: Often, people who have irregular cycles will have trouble getting pregnant due to irregular, infrequent, or absent ovulations, as well as short luteal phases. A fertility specialist might try to treat these conditions with a medication like Clomid, or other hormone regulators. In vitro fertilization (IVF) is another option for people who experience infertility due to ovulation problems.

Male Factors

• Poor sperm quality: Whether due to age, lifestyle factors, or bad luck, some people’s sperm have trouble making their way to or fertilizing an egg waiting in the fallopian tube. This may be because of the sperm’s shape (called morphology), ability to swim (called motility), or genetic makeup (including damaged DNA), among other possibilities. Various tests can reveal if low sperm quality is an issue for your partner. If this is the case, a fertility specialist may recommend lifestyle changes, certain medications, IVF, or other forms of Assisted Reproductive Technology.
• Low sperm count: Sperm quality isn’t the only thing that affects fertility: the number of sperm contained in ejaculate also matters. Also called oligospermia, a low sperm count means fewer than 15 million sperm per milliliter of seminal fluid. There may be no outward symptoms of low sperm count, but some people with this issue also experience hormone imbalances, testicular or groin pain or swelling, erectile dysfunction, or low libido. There are a wide variety of lifestyle and medical factors that can cause low sperm count, including smoking, being overweight, exposure to x-rays or chemicals, heavy bicycle riding, taking certain medications, and excessive heat. A doctor will perform a physical exam and semen analysis to determine whether sperm count is within normal range, then may prescribe a variety of medications and treatments depending on the cause.
• Varicocele: Varicoceles are enlarged veins in the scrotum, which raise the temperature of the testes and hinder sperm production. They sometimes feel like a heaviness or an ache, and the veins may be visibly enlarged. A fertility specialist may recommend surgery to repair the varicocele, or IVF.
• Blockages: Some people may have blockages in the vas deferens or epididymis, which can prevent healthy sperm from reaching and fertilizing the egg. These obstructions are common, affecting about one in every five infertile people. A fertility specialist may treat blockages with surgery or recommend IVF.

Why get genetic testing before a pregnancy?

Even if neither you nor your partner have a genetic condition, there may be a chance that you are “carriers” of a disease. This means that even though you do not have the condition, you may “carry” and pass on the genes that cause that condition to your children. Some diseases are passed down from just one parent, so you might know if there’s a family history of a certain condition. However, recessive diseases are those that only become active in a child if the trait is passed down from both parents. This means that both parents must be carriers of a disease, like Cystic Fibrosis, in order for the child to contract it. Carrier status can pass through generations without a person developing the disease, so anybody could benefit from genetic testing to rule out any unexpected coincidence.

What are some common diseases that genetic testing looks for?

If you opt for genetic testing, you’ll be able to find out whether you are a carrier of a number of different genetic diseases. Some diseases can affect anybody, while others tend to be more prevalent among people of certain ethnicities. Listed below are some of the more common recessive conditions that are tested for, along with the particular ethnicity they tend to affect:

• Cystic fibrosis: Most common among Caucasians, Eastern European Jews, and French Canadians
• Tay-Sachs: Most common among Eastern European Jews and French Canadians
• Sickle cell anemia: Most common in those from the Mediterranean and African-Americans

Although genetic testing isn’t a necessity, many couples will choose to do it to rule out any genetic disorders. You’ll have to decide what’s best for you. And, as always, if you have questions, do talk to your healthcare provider.

Read more

• Breast and cervical cancer sounseling and screenings
• What is carrier screening and do I need it?

Sources

• Mayo Clinic Staff. “Genetic testing.” Mayo Clinic. Mayo Clinic, 7/19/2013. Web.
• “Carrier Testing for CF.” CFF. Cystic Fibrosis Foundation, n.d. Web.
• “Genetic Testing: How it is Used for Healthcare.” NIH. U.S Department of Health & Human Services, n.d. Web.
• Green RC, Berg JS, Grody WW, Kalia SS, Korf BR, Martin CL, McGuire AL, Nussbaum RL, O’Daniel JM, Ormond KE, Rehm HL, Watson MS, Williams MS, Biesecker LG; American College of Medical Genetics and Genomics. “ACMG recommendations for reporting of incidental findings in clinical exome and genome sequencing.” Genetics in Medicine. 15(7):565-74. Web. 7/13/2015.

How long should it take to get pregnant?

Many factors can influence how long it takes to get pregnant, including your cycle, general health, fertility conditions, age, and lifestyle.

Getting pregnant faster

Although it takes the average female up to six months to conceive, there are ways to improve fertility health and reduce time to pregnancy. Staying healthy through diet and exercise and taking folic acid supplements can greatly increase your chances of conceiving, relative to those who don’t do these things. Individuals who track their fertility data to pinpoint their ovulation are also able to speed up their time to conception. Even your mood might help with your fertility: some studies have found that happier emotional states correlate with faster conception.

How long is too long?

Although any female without a condition of infertility or sterility can get pregnant naturally before menopause, some may take a bit longer than others. Doctors recommend that couples who have not conceived after one year of trying seek a fertility consultation to determine if an alternative route to conception might be explored, whether it’s in vitro fertilization (IVF), surgery, or fertility medication. It’s recommended that women over 35 should seek a fertility consultation after six months of trying.

If you have any questions about trying to conceive or your fertility health in general, don’t hesitate to reach out to your healthcare provider for more information.

Read more

• Does pregnancy loss impact future conception?
• Trying to get pregnant for more than a year

Sources

• Dr. Walter Willett. “Nurses’ Health Study II.” National Institutes of Health. United States, 1989-. Web.
• “Nutrition During Pregnancy: FAQ001.” ACOG. American College of Obstetricians and Gynecologists, 4/15/2015. Web.

Ovulation is a pretty amazing and intricate process, so let’s start with the basics: Ovulation is the phase of the menstrual cycle when an ovary releases an egg. Once released, time is of the essence: that egg cell then has about 24 hours to, potentially, be fertilized by a sperm cell. If the egg is not fertilized, menstruation will soon begin, and a new menstrual cycle starts. If the egg is fertilized, this means that conception has taken place. Following conception, once the egg implants into the uterine wall, this will mark the start of a pregnancy. Like we said, pretty amazing!

Beyond the basics of ovulation

Within each of the ovaries are ovarian follicles, which are fluid-filled sacs of cells; each ovarian follicle surrounds an egg, and this is where each egg will grow to maturity. Ovulation is triggered by the release of luteinizing hormone (LH), which causes one ovarian follicle to rupture and release an egg. That egg will then make its way into a fallopian tube – which is where egg and sperm would meet if fertilization were to take place – and then make its way to the uterus.

Ovulation is the only phase of the menstrual cycle when it’s possible to conceive. Although an egg only has only about 24 hours after ovulation before it disintegrates, sperm can live inside the vagina or the upper genital tract for up to five days. This means if you have intercourse in the few days leading up to ovulation, and there is already sperm present when the egg makes its big entrance, it’s possible to conceive. Because of this, the period of time when it’s possible to conceive, known as the fertile window, includes the five days before ovulation and the day of ovulation. Because you’re only able to conceive for these few days each cycle, it’s important to be able to recognize signs of ovulation.

Signs of ovulation

So, when do you ovulate? In a perfectly “normal” 28-day cycle, ovulation begins about 14 days after the beginning of your period. But it’s worth keeping in mind that when exactly ovulation occurs will vary from person to person and even cycle to cycle. Some people may be able to determine when they’re ovulating based on physical signs, including one-sided abdominal cramping, lower backaches, or breast tenderness. There are also emotional symptoms to look for, such as an increase in libido or feelings of excitement or confidence. If you track your moods and find that you’re often feeling a particular way during your fertile window, you can use that trend to identify when you’re ovulating.

Not everyone experiences or notices these changes, and that’s okay! The three most reliable indicators of ovulation are basal body temperature, cervical fluid, and the luteinizing hormone. You can monitor these indicators in combination with other signs and symptoms to find out exactly when you’re ovulating:

• Basal body temperature is the lowest body temperature you have in a day. Changes in your basal body temperature can help indicate an upcoming or past ovulation, as it may dip right before ovulation and then rise in the two to three days afterwards. Basal body temperature really spikes about 12 to 24 hours after ovulation, so while this might not help in identifying whether you’re still ovulating, it can show that you have just ovulated. Tracking your basal body temperature from month to month can help better determine when you will ovulate across multiple cycles. The way to get the best BBT measurement is to use an oral thermometer first thing in the morning.
• Cervical fluid is the vaginal fluid produced by your cervix. The characteristics of this fluid change throughout the different phases of the menstrual cycle, which means that checking your cervical fluid can help tell you when you’re ovulating. During ovulation, cervical fluid is at its most liquidy, clear, and sticky, which reduces the vagina’s acidity to help sperm cells travel to the egg. When it comes to cervical fluid, you don’t need any fancy equipment to help determine if ovulation is occurring – you’ll just want to be observant, stay on the lookout for any changes, and, if you’re up for it, feel the fluid to determine what stage it’s in.
• Luteinizing hormone, which surges before ovulation, is the most definitive indicator of fertility. You can measure your LH levels with an ovulation test, which is a simple urine test that you can take at home. Ovulation usually occurs about 24 to 48 hours after LH levels are detectable by the test.

Track your ovulation cycle

Ovulation is amazing, and so is your body – it definitely has a lot to tell you if you know how to listen. Tracking all three of these important signs is a great way to get a stronger sense of when you’re ovulating and when you’re most fertile.

Read more

•5 signs you might be ovulating

•What is anovulation?

Sources

• Mayo Clinic Staff. “Menstrual cycle: What’s normal, what’s not.” Mayo Clinic. Mayo Foundation for Medical Education and Research, May 11 2016. Retrieved July 13 2017. mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menstrual-cycle/art-20047186
• PB Miller, MR Soules. “The usefulness of a urinary LH kit for ovulation prediction during menstrual cycles of normal women.” Obstetrics & Gynecology. 87(1):13-7. January 1996. Retrieved July 13 2017. ncbi.nlm.nih.gov/pubmed/8532248.
• José María Murcia-Lora, María Luisa Esparza-Encina. “The Fertile Window and Biomarkers: A Review and Analysis of Normal Ovulation Cycles.” Persona y Bioética. 15(2): 133-148. December 2011. Retrieved July 13 2017. scielo.org.co/pdf/pebi/v15n2/en_v15n2a04.pdf
• •AC Pearlstone, ES Surrey. “The temporal relation between the urine LH surge and sonographic evidence of ovulation: determinants and clinical significance.” Obstetrics & Gynecology. 83(2):184-8. February 1994. Retrieved July 13 2017. ncbi.nlm.nih.gov/pubmed/8290179.
• JB Stanford, GL White, H Hatasaka. “Timing intercourse to achieve pregnancy: current evidence.” Obstetrics & Gynecology. 100(6):1333-41. December 2002. Retrieved July 13 2017. ncbi.nlm.nih.gov/pubmed/12468181.
• Landon Trost, M.D. “How long do sperm live after ejaculation?” MayoClinic. Mayo Foundation for Medical Education and Research, May 1 2015. Retrieved July 13 2017. mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/pregnancy/faq-20058504.