67. Why Fertility Takes Time: A Step-by-Step Approach to Conception

Join Dr. Monica Minjeur as she discusses setting realistic timelines for pregnancy when facing fertility challenges. Hear the story of Amanda, who navigated unexplained infertility, multiple failed IVF attempts, and the importance of identifying root causes through cycle charting and medical evaluation. Dr. Minjeur highlights a step-by-step approach to improve health and promote fertility, emphasizing patience and setting realistic expectations. Tune in for valuable insights on achieving pregnancy naturally with the help of Restorative Reproductive Medicine.

Transcript

Monica: 0:02

Welcome back to cycle wisdom, where we empower women to restore natural menstrual cycles, to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you're listening today. On today's episode, I'll be sharing ways to manage your expectations when trying to become pregnant. This information is so critical to making sure that you don't quit too early, because sometimes it can take much longer than women expect. I will discuss how to best utilize your time and resources in a way that works towards finding and treating the root cause of fertility concerns while improving your overall health and well being in the meantime. So, as always, let's get started with a patient story about a past client of mine who we'll call Amanda. Now, Amanda came to see me after five years of primary infertility, meaning she had never been pregnant before. She had gone on to see her OB doctor who referred her on to IVF after a diagnosis of unexplained infertility. Amanda and her husband went through four rounds of IVF, none of which resulted in a successful pregnancy. When Amanda came to see me, she had actually been taking a pause with everything for the past 6 or 7 months, and then a friend of hers referred her on for additional evaluation. So as is often the case, at Amanda's first visit, we talked about charting instruction, and got her to work on charting her cycles, looking at her daily biomarkers of observations, of her cervical mucus, of her basal body temperature, and other signs that might help her to identify when her fertile window was. After just a couple of months of charting, we were able to identify that she was actually having anovulatory cycles, or at least cycles that were much more challenging to identify when she was ovulating. So at the first medical visit that I saw her, we ordered a bunch of labs as well as made some supplement recommendations specific to her particular charting pattern that was identified. When I saw her back for her second visit about a month later, we identified five new diagnoses that could be playing a role. Now this was huge because previously Amanda had been given a diagnosis of unexplained infertility, but now we had at least five different things that were going on that could help to identify what was happening from a hormonal standpoint. At that second medical visit, I also recommended evaluating male factor in order to get her husband some additional testing done that we would work on simultaneously evaluating. We also planned for another lab recheck and found that after that second medical visit when we started her on her medications and some supplements, that her hormones were improving and we made some additional adjustments at that time. By the time it came for her third medical visit, which was about four months into treatment. realized that she still had a lot of different life stressors going on, and she was very frustrated that she wasn't pregnant by this point in time. So, as is so commonly the case, I gave the reminders that it can take more than six months, even with normal cycles and hormones, to happen. And unfortunately, by the month after that point in time, she called and let us know she was done with treatment, she stopped all her medications and all of her supplements, and unfortunately, Never contacted us again and honestly to this day I don't really know what became of Amanda if she was ever able to get pregnant if she was ever able to go on and establish a family in some other way and Really? This just highlights a couple of points and that's why this is so important Is that Amanda's story is very very common and I want you to think of Amanda's story Not as that she gave up But that there was a lot of other factors that were playing a role here that just became incredibly overwhelming. And so I think this is really important as we look at mindset going into trying to achieve a pregnancy and I want to give a realistic expectation as far as timeline today so that going into this you can kind of understand What am I getting into? What is the appropriate time that this may take in order to try and get pregnant? Many of us know someone in our lives who maybe wasn't necessarily trying to get pregnant and it just happened really easily for them. So maybe your co worker stopped taking the pill and was pregnant the very next month. Or maybe your friend just looks at her husband the right way and they get pregnant. Or your sister says, I wasn't even trying and she was able to get pregnant, but you have been desperately trying. You've been reading all the books. You've listened to all the podcasts. You're eating organic foods. You're taking your daily vitamins. You're following all the rules. And yet you can't seem to will your body into having that positive pregnancy test. Now, maybe you've seen a healthcare professional to get advice or have been told that everything is normal with your labs. Perhaps you've even been referred on to IVF saying that's your only option or that's the next best step or that's the quickest way to get the result that you're looking for. And I'm here to tell you today that IVF is not a quick fix for everyone. It's not your only option. And it oftentimes does not work to address the root cause issues that will help you to get and stay pregnant. And because of these reasons, it's important to understand what the alternatives are, as well as what this timeline can look like. So, in general, what I tell most women when I start working with them is that this is likely going to take at least 12 to 18 months, sometimes up to 24 months or more. Now, oftentimes we're able to get lucky and it doesn't take that full time, which is great. And we celebrate and we have a great time, you know, being successful with a pregnancy prior to that 12 months mark. But for many women, it takes a long time in order to kind of make sure everything is balanced and make sure we have a good understanding of exactly what's going on. So in general, what we look at is that we always are going to start with charting your cycles. Again, this is so critical to be able to identify what's happening, what's your current baseline, and where do we have areas that may need to improve. So for most women, I like to see charting at least four to six weeks, ideally closer to that six to eight week mark, where we've got a good baseline to understand what's happening and what biomarkers are you observing on a daily basis. At that point in time, we start with phase one of medical evaluation. And this phase typically lasts one to two months, and during this time frame, we are ordering lab work, sometimes checking ultrasounds or other evaluations in order to really get a good sense for what's going on. What is the root cause? What are the other factors that are playing a role with what's going on with your particular unique situation? Once we have those diagnoses in place, we enter into phase two. And during this time frame, we are treating and adjusting. And so for many women, this time frame can last anywhere from two to four months and really just trying to make sure that what we have diagnosed, that we have an adequate way to treat, that we're making sure that your treatment and your medications are working well for you. We also are looking to make sure that you aren't having any side effects or negative impacts and that the issues that we're trying to improve are actually improving not only from a lab standpoint, but also from a symptom standpoint. Once we make sure that everything is just right, meaning your charts look great, your hormone levels look good, and if needed that we have evaluated any other anatomic concerns like endometriosis or blocked tubes by surgical evaluation, Then we enter into phase three and during phase three is kind of this optimization and observing and really the idea is we want to take some of the intensity off and, and really this is going to be a mix of trying to just settle into everything that we've been doing from a medication and a supplement standpoint, continuing to work on decreasing your stress levels and just kind of enjoying life. sitting back and relaxing throughout the fertile window, utilizing that time to try and conceive during those observation periods, but realizing that sometimes it just can take some time. And what we know from many years of evaluating this process is that most pregnancies are achieved during that third phase around five to eight cycles in, although some can take 12 to 18 months or more. Um, And so if we back that up completely from the very first time that we have an interaction from starting charting for many women, this can be at least five to eight months or more until we get that pregnancy during that fertile time. So why does it take so long? A lot of women when they come to see us, they want to be pregnant yesterday or two years ago or five years ago. And there's a lot of different things that can come into play with this. One of those is that we're oftentimes correcting underlying hormone imbalances or health concerns. And for many women, they have been placed on oral contraceptive pills or an IUD or other medications that ended up masking the symptoms of those underlying hormone imbalances. And so it can take some time in order to reverse the effects or the impacts of those hormones that were in their body. And for some women it takes a while even to just get a cycle back to seeing regular ovulation happening. And so we need to get kind of back to whatever that baseline is. As well as work additionally in order to correct those underlying concerns that were going on. Reminder that even in couples with normal fertility, it can take up to 6 months or sometimes a little bit more until they see that positive pregnancy test. For example, we know that with each cycle in a couple with normal fertility, they're only going to get pregnant about 25 30 percent of the time if they're targeting that fertile window. Now, certainly if there are subsequent cycles in which they're utilizing that fertile window in order to try and conceive, they are able to then utilize that over time and it adds up over the course of six months that over 90 percent of couples are typically pregnant within that six months. So, if you take that on the flip side and say I'm somebody that came in, I have irregular cycles, I have a hormone imbalance, perhaps my partner has some issues as well with counts or motility. Now we add all of those factors in and we realize we're not dealing with a couple with normal fertility. we have to take and adjust and get all of those pieces into place and corrected, which can take some time. And so realizing that sometimes we just need to be patient with that. Sometimes we need to set realistic expectations. And most importantly, we need to manage the anxiety that can come with that, knowing that it does take a little bit longer time. But in the meantime, we are correcting all of those underlying health conditions. Which not only helps to improve your cycles, but also helps to improve your fertility and improves your long term health so that we are correcting any underlying health conditions that may be impacting that pregnancy as well. I think one of the most challenging things that we deal with when we are looking at fertility concerns is that we can't make any promises. In fact, there is nothing from a conventional medication standpoint or artificial reproductive technologies, whether that's IUI or IVF, nothing can actually give you that 100 percent promise that you're going to walk out with a baby at the end of this. And I think that's unfortunately an expectation that is not made really clear, especially when it comes to these artificial reproductive technologies. Now we know that the data is getting better. We know that the science is getting better. But the reality is, is that each individual cycle of IVF does not have 100 percent chance of getting pregnant. Nor does it have 100 percent chance of actually carrying that baby to term. Um, on the flip side, if we look at things from a restorative reproductive medicine lens, we know that overall our numbers are at least equal to, if not better than IVF numbers. And we promise to find answers to keep searching until we have that root cause for the infertility, which helps to improve your health along the way. Another promise that I do always make to my patients is that we're promised to have a better understanding of your cycle. To help you know and empower you to identify when am I ovulating, when is my fertile window, and when is the optimal time in order to try and conceive. We also promise better health, taking into account all of your hormonal issues, medical concerns, lifestyle changes, and especially your mental health along this process. We know that for many women and couples that are going through infertility, that the mental health component can play a huge role on this. It can be a major stress on your relationship, on your body, on your finances, on your social situations, on who you hang out with for friends and how you interact with family. And really, we promise to walk with you every step along the way throughout this because everybody's journey is different. If you get to a point of where you decide, look, I'm not interested in continuing on this path of restorative reproductive medicine. I don't think like artificial reproductive technologies are the right answer for me. There are ways that we can walk with you to help build your family in other ways, like fostering or adoption, or for some people working through the process of deciding that they aren't going to have children that live in their home, but perhaps having children in a different sense of the word. So I hope this has been somewhat helpful in understanding some of the timeline, some of the why, realizing that this is not just a quick fix situation, that restorative reproductive medicine can take some time, but really once we're able to crack the code, We're able to identify what your unique situations are. It really helps us to be able to get on the right track and to help kind of settle into not panicking or feeling like you have to continue to be on this search for where can I find my answers. So imagine if you had the resilience to find the true root cause of your fertility concerns. by knowing that it may take up to one to two years to get things back on track and get your fertility figured out depending upon your unique situation. Imagine the difference it would be to work with our team through our stepwise approach to get you on the track more efficiently to improve your health and promote fertility. If you're ready to work with our elite team of healthcare professionals, go to our website, radiantclinic. com, to schedule a free discovery call with me, and learn more about our package based pricing for comprehensive care. We are currently able to see people for in person appointments in our Cedar Rapids, Iowa clinic, telehealth visit if you live in the states of Iowa, Illinois, or Minnesota. Thank you so much for listening to this episode. Please share this podcast with someone in your life who would benefit from our services. Remember to subscribe to this podcast for more empowering content that I look forward to sharing with you on our next episode of cycle wisdom.