Dear Ovia, My husband and I have been trying for a third kid for the last year and a half. He wants to stop trying and says it’s taking away from us appreciating the beautiful babies we do have. But I’ve always dreamed of a big family and I don’t feel ready to give that up. 

First of all, secondary infertility isn’t something we talk about enough — and I hope this answer helps you know for certain that you’re not alone! 

So many families hesitate to talk about fertility struggles. And when you’re already parents you may feel the social pressure to just be grateful for the kiddos you have (which I am sure you are!). I’m here to tell you that feeling like there is an empty seat at your family’s table is a valid feeling whether you have 0, 1, 2, 3 or 9 children. The tough part is that you’re both having valid feelings — and they’re not the same. There may be middle ground in taking a break from TTC for a period of time or continuing to try for “X” number of months before starting a break. 

At the end of the day, it sounds like expanding your family is something that would make you both happy if it could happen with the wave of a wand. So, try to focus your conversations with him around the challenges of the journey (the process of TTC), rather than the destination (the decision to have another baby).

In any case, you need an ongoing and open dialogue, but it can be hard to find a good and private time to talk (especially when you have other children in the house). It’s common for people to either avoid tough subjects or to bring them up at times that are not conducive to conversation (like when you’re getting into bed). 

If you’re avoiding the conversation or one of you is bringing it up at less-than-ideal times, it’s essential that you create a space where you can both actively listen to each other. Try scheduling some time to talk, that way you can both come to the conversation prepared to share and listen. 

Having a disagreement hanging over your heads makes the whole situation more stressful.

Some tips:

• Avoid talking about it before bed when everyone is tired and sex is on the table. 
• Sometimes a drive is helpful because you have a little bit of emotional distance, can break endless eye contact, and sex is (usually) off the table. 
• Agreeing on how to move forward may take more than one discussion, but it should be simple to make a plan for more chats. Breathe, you’ve got this. 
• Fertility journeys start, pause, and end for a variety of reasons, and it often takes a toll. It’s always okay to look for more support from family, friends, or professionals. 

More from this series

• Dear Ovia, My partner isn’t sure if he wants kids
• Male fertility testing

What you can control

Timing of intercourse or introducing sperm

Making a baby is all about timing and, thankfully, you have control over how often and when you have sex or introduce sperm. Checking your cervical fluid and tracking your basal body temperature can help you know when you are ovulating to maximize your chances of success. For couples TTC through intercourse, the highest rates of pregnancy happen for those who have sex every day or every other day during the fertile window, which is the day of ovulation plus the 5 days beforehand. 

Your health

Having a healthy body is important overall, and it’s no different for baby making. This goes for your partner too. Having healthy habits such as eating nutritious food and integrating movement into your day can help prime your body for when you finally do get that positive test. Cutting down on alcohol and caffeine, avoiding smoking, and taking a folic acid supplement can help in your efforts to get pregnant.

Your mindset

It’s common to feel sad or frustrated when you’ve been TTC for a while with no results. Even if it’s taking a little longer than expected, with practice you can aspects of how you think about the situation. Staying relaxed and having a positive attitude can help make the process a little easier. And if you just rolled your eyes, we hear you. There are some specific things you can do to improve your mindset like talking to a therapist and setting boundaries around work. Even spending time outside has been shown to increase happiness.

Things you can’t control

How long it will take

Although it would be nice to have a crystal ball and know exactly when conception will happen, unfortunately there’s just no way to know for sure. Studies show that most couples (about 84%) will get pregnant within their first year of trying. This is reassuring, but of course, every person is different. Some may get pregnant on their first try while others may take 6 months or more.

Your fertility

Having a condition that affects fertility is not your fault. About 12% of women ages 15- 44  have difficulty getting pregnant or carrying a pregnancy to term. And even though it’s common, struggling to conceive can feel extremely isolating. It’s essential that you have a support system and/or a professional to speak with. 

When your friends get pregnant before you

When you’ve been TTC with no luck, hearing of a friend’s pregnancy can be bittersweet. Of course, you’re happy for your friend, but you may also feel a sense of sadness. Acknowledging your feelings, focusing on self-care, and remaining optimistically realistic can all be helpful in moving forward.

Reviewed by the Ovia Health Clinical Team

Sources

Mayo Clinic Staff. “How to get pregnant.” Mayo Clinic. Mayo Clinic. October 5, 2019. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/how-to-get-pregnant/art-20047611.

“Trying to get pregnant.” National Health Service. NHS. December 2, 2020. https://www.nhs.uk/pregnancy/trying-for-a-baby/trying-to-get-pregnant/.

“How long does it usually take to get pregnant?” National Health Service. NHS. September 4, 2018. https://www.nhs.uk/pregnancy/trying-for-a-baby/how-long-it-takes-to-get-pregnant/.

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. 

What’s a miscarriage and what to do about it

Common physical symptoms of miscarriage include abdominal cramping, abdominal pain, lower back pain, and vaginal bleeding, which can range from spotting to heavy. Many of these symptoms can occur for other reasons during early pregnancy, so it’s best not to jump to conclusions. However, never hesitate to contact your healthcare provider if you are feeling something that doesn’t feel normal. Being familiar with these symptoms will help you know when you should take the following steps.

Call a provider

A healthcare provider can perform certain tests that confirm whether or not somebody is experiencing a miscarriage. The earlier these results come in, the faster the provider can treat whatever is going on, whether it’s a miscarriage or something else. These tests might include a pelvic exam, a blood test, or an ultrasound.

Ask a friend or family member for a ride

It’s unsafe for anyone to drive if they’ve been bleeding extensively. After the appointment, it also might not be safe to drive oneself home, depending on any procedures or medications performed or prescribed. Having a driver will make the situation much more manageable.

Notice the amount and duration of bleeding or spotting

Being able to describe the amount of vaginal bleeding a woman has experienced could be helpful for the provider to form a diagnosis. Bleeding that increases or stays bright red over time might indicate a problem, so if possible, women should try to notice these details and report them to their provider.

Having a miscarriage (or a miscarriage scare) can be so shocking and stressful that it’s understandable if women can’t remember to do certain things while it’s happening. This is completely understandable, but if possible, it can be beneficial for women to ask their provider if they think she should try to save any fetal tissue during the miscarriage. This might sound surprising, but fetal tissue that comes out with vaginal bleeding can be tested in a lab to help identify if there was a particular cause of the miscarriage. While not all women will be able to differentiate between vaginal bleeding and fetal tissue, if possible, it is helpful to save any of this tissue in a clean container and bring it with you to your appointment.

Think about comfort and cleanliness

Many may need need pads or panty liners to control the bleeding during a miscarriage. Tampons should not be used during a miscarriage, as they increase the risk of infection. They might also want to get bed liners for the bleeding, or a hot water pad for cramps. A provider might prescribe pain medication if the cramping or pressure is intense.

Moving forward after a miscarriage diagnosis

It’s often recommended that women abstain from sexual intercourse for a period of time after a miscarriage, usually anywhere from two to four weeks. When the bleeding stops, blood will be drawn to determine when the levels of pregnancy hormones return to zero. This helps her provider know when the miscarriage is complete.

Once a provider confirms that the miscarriage is safely complete, the healing process can begin. There’s no right or wrong way to grieve; there’s also no set date for when to start feeling better after a pregnancy loss. What’s most important is that she feels safe to grieve however she feels most comfortable, and also, that she has the support of friends, family, and her provider to help her through this difficult time.

Thinking about the possibility of miscarriage is difficult, but pregnant women can benefit from knowing the warning signs of certain situations that may happen during pregnancy. Just like fire drills and CPR training are valuable, knowing what to do during a possible miscarriage helps women get faster treatment if the situation ever arises.

Sources

• OBOS Pregnancy and Birth Contributors. “Miscarriage in the first trimester.” OurBodiesOurselves. Our Bodies Ourselves, Apr 9 2014. Web.
• “Miscarriage.” PlannedParenthood. Planned Parenthood Federation of America, Inc., 2016. Web.
• Mayo Clinic Staff. “Miscarriage: Symptoms and Causes.” MayoClinic. Mayo Foundation for Medical Education and Research, Jul 20 2016. Web.
• Robin Elise Weiss. “I’m having a miscarriage: What to do if you’re having a miscarriage.” VeryWell. About Inc., Jun 8 2016. Web.

Should you try to conceive again after pregnancy loss?

To determine how ready you are to start trying again, ask yourself some questions about how you’re feeling and what you want. Some of these questions could be:

• How is my emotional health? Could I benefit from counseling?
• Have I talked to my healthcare provider about whether my body is physically ready for another pregnancy?
• Does my partner also want to keep trying?
• Right now, could I handle the emotions associated with trying to conceive (TTC)?
• If your next pregnancy will be considered high risk: Am I well enough right now to handle any stress that could accompany the next pregnancy?

It really is all about you

Once you are medically cleared, there’s no right or wrong time to be ready to TTC after a miscarriage. Every woman is different in how she handles the experience, so it’s up to you to determine if you’re emotionally and physically capable of TTC again. There’s nothing wrong with wanting to wait a little longer, but there’s also nothing wrong with being ready to try again earlier than you first expected.

Research suggests that pregnancy after miscarriage might be healthier if women wait less than a year to conceive again. According to Mayo Clinic, women who got pregnant again within six months of a miscarriage actually had fewer complications in their next pregnancy than did women who waited more than six months to conceive. You might not be ready to try again so soon, and that’s perfectly fine. But if you are ready, and your provider has given the go-ahead, know that it’s safe to do so.

What you’ll need

If you decide that you’re ready to try again, you’ll want to ensure that you’re physically and emotionally prepared for anything that comes your way while TTC. It’s a good idea to have all of the following in place.

• An exam from your healthcare provider: He or she will assess if you’re physically healthy and ready to try for another pregnancy.
• Support from a partner, friends, family, or a support group: You may find yourself needing people who can help you through this experience, whether they’re providing a listening ear or a ride to your provider’s office.
• Healthy lifestyle choices: Most miscarriages can’t be prevented, and a big part of healing involves understanding that the loss was no one’s fault. But taking precautions to reduce the risk of another miscarriage is always a good idea; this means not smoking, limiting caffeine and alcohol intake during pregnancy, maintaining a healthy weight and taking prenatal vitamins while TTC.

Staying positive and hopeful

Most miscarriages are followed by perfectly healthy pregnancies. This being said, many women are still nervous about trying to conceive again after a pregnancy loss. As you consider and possibly move forward to start trying again for a pregnancy, take some time each day to remind yourself of your own strength, and to focus on all the love and support that you have in your life right now.

Sources

• Felicia Nash. “Pregnancy after preterm birth or loss.” HandtoHold. Hand to Hold, 2012. Web.
• “Getting pregnant: When is the best time for a miscarriage?” MayoClinic. Mayo Foundation for Medical Education and Research, Mar 17 2016. Web.
• Chaunie Marie Brusie. “Tips for Conceiving After a Miscarriage.” Parents. Meredith Corporation, 2013. Web.

Things to consider about sex after a miscarriage

Individuals and couples who have experienced a miscarriage often report feelings of hesitancy towards resuming sexual activity, for both physical and emotional reasons. What is most important is that you take care of yourself, and keep the lines of communication open.

What factors influence when someone can start having sex again?

Sex after miscarriage is a very personal and individualized situation. That being said, there are some physical and mental factors that most people will want to take into consideration after experiencing any kind of pregnancy loss.

• Physical factors:

After a pregnancy loss, women are generally advised to maintain ‘pelvic rest’, including no tampon use or sexual activity, for two weeks after miscarriage. This is partially due to the fact that the cervix and uterus are more dilated in the weeks following a miscarriage, which makes infection more likely. A pelvic exam from a provider is the best way to know for sure if you’re medically ready to have sex again. Sexual activity can typically be resumed after this time. However, a healthcare provider may give different recommendations about when it’s safe to resume sexual activity based on their assessment and your experience.

• Emotional factors:

Many people don’t feel quite ready to start having sex again for some time after a miscarriage. This is very normal. Open, honest conversation between partners should be encouraged in order to remain connected and work through these feelings.

Your healthcare provider is a valuable resource to help you determine when it is safe to resume sexual activity and, if you’re ready, to try and conceive again if that is something you want. Your provider will base their recommendation on multiple factors including the type of loss, the gestational age at the time of loss, and the your personal experience.

When does the menstrual cycle return?

You may ovulate as soon as two weeks after a miscarriage, but it is also normal for ovulation to take longer to resume.  Healthcare providers usually recommend waiting at least one menstrual cycle before trying to conceive again, and that people not try to conceive until they feel emotionally healed. These recommendations may be different for those who have had more than one miscarriage. As always, it’s a good idea to ask your healthcare provider for their opinion about when it’s safe to start trying again. In the meantime add a safe method of protection, if that’s necessary for you, until you’re cleared.

Long-term grief

It’s normal to experience a shift in mood, or strain in a relationship after a miscarriage. While short- and medium-term grief and sadness are expected, if you’re experiencing grief or depression lasting for months and it’s impacting your  ability to perform daily activities, seek the help of a specialist. There are many options to get the help you need. This could be a therapist, a psychiatrist, a support group, or a combination of them; the most important thing is that you feel comfortable talking to your healthcare provider about how you’re feeling and any concerns you may have. Sexual activity after loss might be emotionally or physically difficult at first, but as long as both partners are respectful of one another and understand where each other are at in the healing process, things will get easier over time.

Sources

• “When can I resume sex after a miscarriage or pregnancy loss?” UTMBHealth. The University of Texas Medical Branch at Galveston, 2016. Web.
• “How soon can couples have sex again after a miscarriage?” ISSM. International Society for Sexual Medicine, 2016. Web.
• “Getting pregnant: when is the best time to get pregnant after a miscarriage?” MayoClinic. Mayo Foundation for Medical Education and Research, May 17 2016. Web.

Here are the TTC acronyms you should know about

AF:

Aunt Flow. Your period.

Thanks for the invite, but my Aunt Flow’s in town. I’m gonna go home and treat her to some wine and reruns.

BBT:

Basal Body Temperature. BBT may spike right before ovulation, so many women track it to help them pinpoint their ovulation.

The very first thing I did this morning was grab my thermometer and take my BBT.

BCP:

Birth Control Pills.

In almost no time after I stopped taking BCP, I was pregnant.

BD:

Baby Dance. Sexual intercourse, usually done on the most fertile days of your cycle. (Can also mean baby dust, which is a phrase you use to wish someone good luck.)

My ovulation test is positive, which makes me want to dance – the BD, that is!

BFN/BFP:

Big Fat Negative/Big Fat Positive (on your pregnancy test).

Every time I buy a pregnancy test, I think about how it could be the one to show the BFP.

BOB:

Baby on the Brain!

I’m having a hard time shopping with BOB. All I can think about is tiny socks and pacifiers, which makes it impossible to keep track of my grocery list.

CD:

Cycle Day. A specific day in your menstrual cycle (or fertility treatment cycle). To track it, start by counting from the first day of your last menstrual cycle.

It varies each cycle, but normally I ovulate on CD 13, or 13 days after the first day of my period.

CM or CF:

Cervical Mucus or Cervical Fluid. Changes in cervical fluid indicate that a woman is at different stages of her cycle.

At the most fertile point of each cycle, my CM is clear and super stretchy.

CP:

Chemical pregnancy. A very early miscarriage.

My doctor recommended that I put off trying again until one cycle after my last CP.

DD:

Darling daughter. A daughter you already have.

DH, DD, and I go on vacation next week.

DH:

Dear husband.

I’m 42 and DH is 43.

DPO:

Days Past Ovulation, or Cycle Date Post Ovulation.

By 7DPO of the TWW, I’m already wondering if every little cramp is a sign of pregnancy.

DS:

Darling son.

It’s a challenge to care for DD and DS while also TTC.

ENDO:

Endometriosis. A chronic disease in which tissue that is supposed to grow in the uterus grows outside of it. Millions of women experience this condition and it can affect fertility.

After getting diagnosed with ENDO, I was able to find a huge and supportive online community of other women who had the same condition.

EWCM:

Egg White Cervical Mucus. When your cervical mucus looks like egg whites, it may mean that you’re at your most fertile point.

Nothing is as exciting as seeing EWCM when TTC!

FMU:

First Morning Urine. Most pregnancy tests require that women take them the very first time they pee in the morning. In the morning, urine typically has the highest concentration of Human Chorionic Gonadotropin, or hCG, an early pregnancy hormone.

I tested with FMU and got a faint BFP.

FP:

Follicular Phase. The phase of the menstrual cycle when follicles mature in the ovary. This phase begins on day 1 of your period, and ends with ovulation.

I’m so excited to try and get pregnant, I just want my FP to be over!

hCG:

Human Chorionic Gonadotropin. A hormone produced during early pregnancy that helps the baby grow.

I had a positive test, which means there was enough hCG in my urine to detect a pregnancy.

HPT:

Home Pregnancy Test. A pregnancy test that you can take at home. This morning my HPT showed a BFP – but I’m going to my doctor’s to take a blood test to confirm.

IUI:

Intrauterine Insemination. A specific kind of fertility treatment where sperm is placed directly into a woman’s uterus during ovulation.

After 2 years of TTC, we’ve decided to try IUI.

IVF:

In Vitro Fertilization. A procedure in which an egg is fertilized in a lab and then implanted.

We went through several rounds of IVF before getting a BFP.

LMP:

Last Menstrual Period. The first day of your last period.

I started my LMP on June 6th.

LPD:

Luteal Phase Defect. If the corpus luteum didn’t form properly, a luteal phase defect may occur, causing a short luteal phase. This can make it hard for a woman to get pregnant.

I’ve been really accurate with my charting, because I suspect I might have LPD and I want to have a lot of information to show my provider.

LSC:

Low Sperm Count. Commonly the cause of male infertility.

A semen analysis showed that my partner has an LSC.

M/C:

Miscarriage.

I got my first BFP a year ago, which ended in a really upsetting MC.

MF:

Male Factor Infertility.

To help with the MF issues, we found an infertility counselor who was covered by our insurance.

NTNP:

Not trying for pregnancy, not preventing pregnancy.

I just stopped taking BCP, so I guess that we’re NTNP.

O or OV:

Ovulation.

I O’ed on CD15 and BD on days 13 and 15.

OPK or OPT:

Ovulation Predictor Kit or Ovulation Predictor Test. These tests tell you when your body has a surge of luteinizing hormone (LH), which indicates the onset of ovulation.

I just got a positive OPK, which means BD as soon as possible!

PCO, PCOS, or PCOD:

Polycystic Ovaries, Polycystic Ovary Syndrome, or Polycystic Ovary Syndrome Disease. A condition in which a woman’s levels of estrogen and progesterone are unbalanced. Women with PCOS develop cysts on their ovaries, and the condition can cause infertility.

My doctor thinks I have PCOS, so I’m waiting to hear back about my blood work.

POAS:

Pee On Stick. Taking a pregnancy test (peeing on a stick), usually at home.

I’m 7DPO and it’s so hard to wait to POAS!

RE:

Reproductive Endocrinologist. A type of fertility specialist.

I’m meeting with an RE tomorrow to go over my fertility test results.

SA:

Semen Analysis. This is a test that providers can use to determine the quality and quantity of a man’s sperm.

The results of his SA show he has low sperm count, low motility, and poor morphology.

SO:

 Significant other.

My SO and I have decided that next month we’ll start TTC.

TWW or 2WW: Two Week Wait. The time period between when you ovulate and can take a pregnancy test.

 just started my TWW and I need to find some ways to distract myself!

TTC:

Trying to Conceive.

I haven’t decided who I want to tell that we’re TTC.

U/S:

Ultrasound.

Our first U/S is scheduled for the end of the month.

How to manage anxiety when trying to conceive

It’s normal feel a little anxiety during this time, but too much can impede on your ability to be excited and hopeful about the possibility of pregnancy – which is why you started trying in the first place! Recognizing when it’s time to address and treat your anxiety can help you start feeling better and more in control of your TTC experience.

Common signs of TTC anxiety

While the term “TTC anxiety” isn’t an official medical condition, anxiety around TTC is a very real thing. According to the American Psychological Association, the emotional ups and downs of trying for a baby pose a challenge for many women and their families.

It isn’t always easy to know what anxiety symptoms require further treatment, so it helps to be at least a little familiar with the common signs of anxiety while TTC.

• Feeling overwhelmed when you see other people getting pregnant
• Blaming yourself or feeling low self-esteem
• Relationship problems
• Sexual dysfunction, loss of interest in sex
• Isolating yourself from friends or family
• Excessive worrying or ruminating thoughts
• Getting overly caught up in the details of TTC
• Neglecting your own health because your body isn’t ‘cooperating’
• Having anxiety or panic attacks

Things you can do

The frustration and worry that women feel when TTC are very real. This said, there are healthy ways to manage these troublesome feelings. Here are some things that you can do if you’re feeling like your anxiety is taking over your TTC experience.

• Make time to do more things that you like: It’s easy to focus on the serious stuff when you’re TTC. Doing things that you enjoy will boost your mood and help you unwind.
• Learn relaxation techniques: Deep breathing and meditation are just some of the ways you can help your body physically de-stress. These techniques can take only a few minutes, and are clinically proven to help reduce symptoms of anxiety.
• Focus on other projects: There are probably at least a handful of things that you could put your attention towards. Working on these things might help distract you from the stresses of TTC.
• Find (and repeat) a fertility mantra: It’s possible that mantras can help you manage difficult emotions. One study, published in the Journal of American Nursing, found that women who repeated a spiritual or meaningful phrase to themselves whenever they were stressed felt that it helped them manage unwanted thoughts and emotions. So if you have a phrase that is particularly comforting to you, try repeating it when you feel overwhelmed.
• Reach out to your support system: Support systems can’t be overstated in a journey to get pregnant. Talking to your partner, family, or trusted friends about your experiences can ease some of the burden off of your shoulders, and make you feel less like you’re going through these things alone.

Reaching out to a professional

Of course, for many women, treating anxiety is difficult or not possible to do on their own. It might be in your best interest to see a professional, who can help you start one-on-one or group talk therapy. Support groups can be especially helpful and there are usually at least a few local support groups for women who are TTC. Your provider can help refer you to someone whose specializes in this kind of anxiety.

Seeking therapy for anxiety is completely normal, especially if you’re struggling with infertility. And it can equip you with long-term skills to help manage anxiety.

Anxiety while trying to conceive: Final thoughts

How effective are condoms?

While condoms are helpful and protect the user from some STDIs and getting pregnant, condoms aren’t a cure-all. There are infections that condoms don’t always protect against even when they work perfectly.

Pubic lice

Other things that fall under the heading of STIs are scarier and more dangerous, but there’s nothing that sounds worse than pubic lice. And unfortunately, they’re one of those things that using a condom won’t necessarily protect you from, since they can spread through non-genital skin-to-skin contact, and even, in rare cases, through very infested clothing and bedclothes. Mutually monogamous sexual relationships and good personal hygiene from your sexual partner along with condom use can help reduce the chances of catching them.

Herpes

Genital herpes can be passed along through skin-to-skin contact outside of the genital area a condom covers, and can be caught from sexual partners who don’t have any visible sores and therefore may not know they’ve been infected. Condoms and monogamous sexual relationships are still the best way to avoid herpes, as well as open communication with sexual partners.

HPV

HPV, or the human papilloma virus, can lie dormant for years, but it can also cause genital warts or certain kinds of cancer, most often cervical cancer. It can infect and then be passed on through parts of the skin that aren’t covered by condoms, and using a condom definitely lowers risk. HPV vaccines also exist and provide a much better chance of avoiding contracting HPV than condoms alone.

Syphilis

Like HPV and herpes, syphilis can be caught and passed on through skin-on-skin contact either in the genital area, which condoms protect against, and in the area around it, which condoms do not. This means condoms are still a good idea, but they’re no guarantee against syphilis.

Reviewed by the Ovia Health Clinical Team

The fertility talk

The conversation can feel like you’re making an accusation when, really, all you want to do is improve your odds as much as you can. According to the World Health Organization, 40% of the problems couples have trying to conceive can be traced back to male fertility, and roughly 20% of men have a low sperm count, so it’s a good idea to work on boosting his sperm count at the same time that you’re trying to maximize your fertility.

Animals, vegetables, minerals

Just like with your body, what he’s eating plays a huge part in his fertility. In fact, both of your bodies will benefit from adding a lot of the same nutrients to your diets, which means that improving what you eat is something you can work on together. Not having enough folic acid, omega-3 fatty acids or vitamins A, C, D, E or B12, zinc or selenium could all hurt his sperm, as well as your egg health. Antioxidants found in fruits may also help both of you. A balanced diet and a multivitamin can go a long way!

Baby-making sex, hold the drugs, your call on the rock ‘n roll

A 2003 study shows that smoking cigarettes can cause damage to sperm, and a Danish study suggests drinking alcohol on a regular basis can decrease sperm, which makes the combination of the two not a great one for fertility. Illegal drugs can also interfere with fertility, on top of their other health risks. You should let him know these facts if you think they may be contributing to the difficulty conceiving.

De-stress to impress

A recent study in the journal Fertility and Sterility suggests that stress can lead to a lower sperm count. Some doctors recommend adopting a regular but moderate exercise routine to keep stress low and body healthy, but the road to less stress can start with something as simple as daily deep breathing.

Having the “talk” to your partner about his fertility can seem a scary prospect, but it doesn’t have to be. If a baby is something you both want, then you need to be comfortable communicating your concerns in order to improve your chances.