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Ok! I am calling it. It is time we all stop using the word infertility to describe fertility struggles.
I work with and speak with so many women who have been trying to conceive with zero success. But these women are not necessarily “infertile”.
So in this podcast episode, I want to make something really clear. While 1 in 6 couples may struggle to conceive, 1 in 6 couples are NOT infertile.
Don’t let the label of “infertile” stick unless you have definitive proof!
I say this with SO much love but it’s something lots of people need to hear. Please know that I’m not in any way trying to lessen your experiences, to say you’re not struggling and that it’s not sometimes incredibly hard and painful when you’re trying to conceive. Trust me, it’s the ones who are struggling who are reaching out and sharing their experiences and working with me.
So this is what I recommend instead, and a lot of this is about changing your mindset and your way of thinking about infertility.
👉 Instead of describing yourself as infertile or experiencing infertility, describe yourself as experiencing sub-fertility.
👉 Be realistic about your timelines. Instead of expecting to get pregnant at your first go of baby-making, or panicking when it doesn’t happen straight away, understand that on average it takes couples 6-12 months to get pregnant. You can certainly speed up the process by understanding your fertile window and timing sex for around ovulation, but it’s still not a first-try guarantee.
👉 Instead of feeling lost, confused and defeated at the label, take it as a sign that while your fertility may not be optimal right now, there are simple changes you can make to optimise ovulation and boost your chances of conceiving naturally.
👉 Instead of panicking at the prospect of IVF, get informed about your fertile window and ovulation and make sure you have the timing right first! These are the conversations nobody is having.
This is the episode that has been cycling around and around in my brain for over a year now. It’s something that needs to be said and no one else is saying it. The conversations that I’m having with women every single day is really opening my eyes to how prevalent this problem is becoming and it’s something that I’m very passionate about.
There is no single, clear answer for when trying becomes infertility. A couple is clinically considered infertile if conception has not occurred within the first 12 months of trying. A more accurate definition from the WHO is a disease of the reproductive system defined by a failure to achieve a clinical pregnancy after 12 months or more of regular, unprotected sexual intercourse. Some doctors recommend investigation after 6-12 months if nothing has happened yet, especially if the woman is over 35 years.
Too often there are 2 groups of people who are bunched together in this category of infertile – those who are sterile and those who are sub-fertile. Only 2-4% of couples are “sterile”, or truly infertile, which means there is zero chance of conceiving naturally. You are considered sub-fertile if you have been trying unsuccessfully to conceive for more than a year. This is also known as delayed child-bearing. If you have been TTC for more than 12 months with no success, it indicates that something is likely going on in the background that is a barrier to pregnancy, but it does not mean you are infertile. Most people are not infertile. Most people will have reduced fertility for any number of reasons, it’s a matter of working out what’s contributing to this and moving through a list of potential lifestyle factors to address it. We should not be jumping straight to IVF without exploring those lifestyle factors first.
I strongly dislike and never use the word infertility. I refer to couples with fertility struggles who have had no success after 12 months as sub-fertile. So let’s change our thinking about this word right now and I encourage you not to use it either.
Infertility sounds definitive, absolute, final. No way to ever change this.
Subfertility, isn’t so final. It’s less than optimal, so let’s make some changes to make it more optimal. Your fertility is a marker of your current health status, so subfertility is a sign that things can very likely be improved with the right tools and support. Like I said, it’s a matter of working out what’s contributing to this sub-fertility and moving through our list of factors to address it.
It’s a label nobody wants applied to them. And it’s a label that is being thrown around too loosely right now. I speak with perfectly healthy women who are in the process of conceiving or preparing to conceive, and they are so incredibly stressed out and worried that they are infertile when they’ve been trying for a month or two. WhileI do think speaking out about how common it can be to have difficulty conceiving is very important, and that it’s fantastic that people are more comfortable sharing their experiences and talking about what was once a taboo subject. It’s not black and white – people with a large audience and following, celebrities and so on, are sharing their struggles and this is helping women to feel less alone in their struggles, to recognise and appreciate just how common fertility struggles are. It’s now 1 in 6 couples that are struggling to conceive. The next step is to raise awareness about why they might be struggling to conceive. And that the lack of fertility education young women are actually getting in the first place. I’m not saying it’s not important to talk about, I’m not saying it’s not a reality. But it’s causing so many women to genuinely think they have no chance of conceiving and that their only option is IVF when that simply isn’t the case.
Unless we go actively looking for it, we don’t have access to realistic timeframes for conception. You can be completely confident in identifying ovulation, know you’re getting the timing right, be in peak physical health and it’s totally normal for it to take 6 months. If you don’t have the timing right, if you’re not having sex in your fertile window, it doesn’t matter if you try for 6 months, 1 year, 5 years, your chances of conceiving outside of your fertile window are zero.
We all have someone in our lives who got pregnant instantly. A friend, a sister, someone who doesn’t have to do anything and pops out these healthy babies without a second thought. So we have one group of women who secretly expect to get pregnant their first try. Even if they don’t admit it to themselves or anyone else, that’s ok, they officially start trying and then it’s like oh – it didn’t work. And then we have another group of women on the opposite end of the spectrum who have no reason to worry and they are going in from the start almost expecting to struggle. And when males partners know even less than we do, they do nothing to ease our minds or help us to have realistic expectations.
So we start to Google. We end up on forums and chat groups where other women share their experiences and this completely skews our perception of what is normal. And the very worst thing we can to women at an already hugely vulnerable time is to suddenly and without warning slap a label of infertile on them. It’s hard enough that it’s not happening. It’s hard enough that you now have to start down this path of investigating further, seeing a specialist, getting extra testing, and every time you pick up the phone to make an appointment, the label is already firmly attached. You’re making appointments for your infertility. The word is suddenly being thrown around constantly and you don’t identify with it. You haven’t processed it. So even if you have no definitive answers, you’re going to believe you’re infertile pretty fast.
Compare all of that to someone who explains to you that you have sub-fertility. Your fertility is not optimal right now, which is affecting your ability to conceive. But let’s talk about how to optimise things. Do you understand your menstrual cycle and ovulation? Can you confidently identify your fertile window to make sure you’ve got the timing right? Have you explored lilfestyle factors that could positively impact your hormone balance and ovulation, which can maximise your chances of conceiving?
That is the conversation that is missing between trying and struggling to conceive and the label of infertility and discussion of IVF.
I’m a realist. I’m not living in a fairyland where I think everyone will be able to conceive naturally just by following my advice. But it sure as hell maximises your chances. It gives you back control, it reassures you that you have explored every possible conservative measure, you’ve eliminated every potential cause for your struggles.
I feel like the best and worst diagnosis that anyone can give you is of unexplained infertility. It’s the worst in that it gives you no answers. It’s the too hard basket. It makes you feel out of control, nobody can explain what is happening, or why things aren’t happening. I interpret this diagnosis to be “we don’t know what’s wrong, we don’t have any more tests we can do, so let’s just slap on the label and move on with IVF because that might work”.
I’ve said before that IVF is wonderful technology and it’s incredible to be able to give couples the chance to have children that otherwise could not. But it’s also a multi billion dollar business that will get you signed up without actually sitting you down and teaching you the basics. And that’s why I do what I do. Because every couple deserves the opportunity to explore all of their options before going down that path.
And a lot of medical professions just don’t know about this stuff. We go to our GPs and they refer on. They look at numbers and make definitive statements like your partners sperm count is too low. You’ll never conceive. Without any kind of discussion about possible causes of low sperm counts, how most of them are temporary, how they can be improved with simple lifestyle changes.
About 1/3 of the time, fertility problems are unexplained. This is an incredibly frustrating diagnosis, but also one that gives the most hope, in my opinion. Because if there is no obvious explanation as to why pregnancy isn’t happening, then we just need to find the problem and correct it. The most common cause here is usually mistimed intercourse. This can more often than not, in the absence of any other problems, be the reason why you haven’t yet conceived. And that’s where understanding ovulation and making a few lifestyle changes can have enormous effects.
If it’s not mistimed intercourse, the next most common fertility problems are issues with ovulation and these are most often cases where no definite cause is found. This is when you get your diagnosis of unexplained infertility. Lifestyle changes related to diet, exercise and reducing stress have all been found to significantly improve fertility. One Harvard study found that a preconception protocol was associated with lowering the risk of fertility struggles by 69%. That’s really significant. And nobody is talking about it.
We need to change our thinking.
Just because it’s been over 12 months and you’re not pregnant, doesn’t mean you’re infertile. Unless you have evidence to prove otherwise, you are sub-fertile. By learning to identify ovulation, by making some small and simple, but hugely impactful lifestyle changes that optimise ovulation and drastically improve your chances of conceiving – by 69% according to that Harvard study.
Unexplained infertility can be a positive. It means we can’t find anything definitively wrong that could be preventing you from conceiving. This means you are not sterile. This means you are sub-fertile and this means that there is hope.
Change the language you use around fertility. Think about what fertility is. It’s not just about getting pregnant. It’s your potential to conceive if and when the timing is right for you. A fertile body is the highest state of health, a body in optimal condition, and your hormones are the very first point of disruption when the body is under some form of stress. And hormone disruption will impact ovulation and your menstrual cycle. And if you don’t understand ovulation and your menstrual cycle then you’d never know it was impacted. So when you think about fertility as a state of health, and an indicator of your current health status, then it’s easier to think about how this can be improved with the right support, tools and guidance.
Think about the basics we as a society now take for granted – people first language. You are not an infertile person. You are a person with fertility challenges. And challenges are challenges. They’re hard, but they’re not impossible.
This episode subject is the one I have spent the most time thinking about over the past year. I’m very fortunate that I conceived after three cycles, and I know that that is a drop in the bucket compared to many women who reach out to me and many women who are listening to the podcast. I hear your stories first hand, and I hear the stories of people in my own life and it’s upsetting, and it’s frustrating because that middle step between trying and the label of infertility is not happening and it’s a simple conversation. It’s some education, and it can absolutely make the world of difference and save a lot of couples, not only a lot of money, but a lot of stress and heartache.
And so, whether or not, you are struggling to conceive, whether or not you’re preparing to conceive, and you’re not officially trying yet, change your thinking and change the way you use these words because words have power and we need to take away the power of some of these words or our own sanity and peace of mind, so I encourage you not to use the word infertility. I encourage you to use the word subfertility unless you have been specifically tested and told that you are sterile which is only 2-4% of the population. I encourage you to think about fertility beyond making babies think about it as a state of health, the same way that your menstrual cycle is an indicator of your health, and if your fertility and your menstrual cycle are telling you that your health is sub optimal, then there are absolutely things that can be done to improve your situation which will hopefully has the potential to significantly improve your chances of conceiving, the first step you’ve already made the first step by listening to this podcast and learning about your body The next step is making sure you have the right support and guidance if you need it.
So next time you are having a hard time, when you’re not getting answers and you’re feeling completely overwhelmed with what to do next…know you are not alone. I feel your frustration too. There are tough parts about preconception and trying to conceive, no doubt about that. And sometimes, getting pregnant is hard.
But look instead at the huge OPPORTUNITIES that still exist – if nobody is giving you a clear reason as to why things aren’t happening, see that as a positive. See that as an opportunity to dive into your cycle and fertile window, to explore what changes you can make to optimise your fertility. Because it may be sub-optimal, but it’s not a complete write-off.
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