Almost every person or every couple would like to conceive naturally if they possibly could do so. In this episode, Dr. Sonya Jessup talks about the importance of understanding fertility both in men and women, available natural fertility treatments in the market, and tips for couples who want to get pregnant.
Dr Jessup is an experienced Fertility Specialist and Gynaecologist at Demeter Fertility, who has studied and worked in Reproductive Medicine for the past decade. She provides a thorough and personalised assessment of a patient’s situation and can quickly organise and perform any procedures, tests or surgery they may need. Dr Jessup has been through IVF herself and works to create a happy, low stress, sustainable approach to fertility treatments.
Wayne Bucklar: You’re listening to Health Professional Radio. My name is Wayne Bucklar and today my guest is Dr. Sonya Jessup. She’s a fertility specialist and gynecologist at Demeter Fertility and she’s here to talk to us because it’s Natural Fertility Awareness Week and we’re going to talk about her work and some interesting stories and expert commentary about fertility. Dr. Jessup, welcome to the show.
Dr. Sonya Jessup: Thank you very much.
Wayne: Now for a experienced fertility specialist and you’ve been through IVF yourself, tell us why Natural Fertility Awareness Week is important.
Dr. Jessup: I feel almost every person or every couple would like to conceive naturally if they possibly could do so, so it’s an important thing for all of us to consider women are these days having a lot of IVF and different treatments because they’re trying to conceive later in life and people have more medical conditions as well as they get older. But in terms of natural fertility if people are aware when they’re young what can maximize their fertility as they get older and then are aware of how fertility works when they do start trying, they can make sure that they conceive as quickly as possible when they want to conceive and often they don’t need to go to IVF in the more advanced treatment.
Wayne: Do many couples underestimate how long it takes to fall pregnant?
Dr. Jessup: Most people do. The stage that we tend to use other people are completely fertile having sex usually over a year 80% of those couples will get pregnant within one year and 90% by 18 months. So in general most people do to conceive within a relatively normal frame of time, the problem occurs if people are getting older. At the age of 38 if you want three children you haven’t got the luxury of trying 18 months to conceive naturally, so that’s where we run into problems where women get older. Conversely however, if you’re 26 and you have been trying for over a year with your partner to get pregnant, there probably is something going on that needs to be addressed because young people should get pregnant really quickly.
Wayne: Now I’m well past the age of having to worry about conception but in my younger days, it was always just something that happened well automatically and maybe inconveniently. What are your top tips for conceiving naturally?
Dr. Jessup: My top tips when couples decide that they actually want to get pregnant, often they’ll stop whatever contraception they have been using. The key for me is just understanding when in the month is the fertile time and it’s a basic thing but many people don’t understand when it is and they spend a lot of money on ovulation detection kits or other bits and pieces where if they just had a good understanding, there wouldn’t be a need to all of that. So what I tell my patients is a regular cycle or normal cycle – which isn’t normal everyone obviously – it’s 28 days. So from the first day of your period being Day One to the last day when you get your period, that’s the 28-day cycle. Now the last half of the cycle is always fixed so for a person in a 28-day cycle, in two weeks or fourteen days before they release an egg and then 14 days to when they get a period. So the last bit is fixed so if the female let’s say they have a 30-day cycle, not a 28-day cycle, instead of releasing an egg on Day 14, they release an egg on Day 16 so it’s always two weeks from when you release an egg to when you get a period. So that’s very useful, you can say when you’ve got a period, “I ovulated two weeks ago.” That’s great but you need to be able to figure out proactively when you’re going to release an egg and not be able to work it up retrospectively. So for people with a regular cycle, it’s pretty easy to do. It doesn’t really matter if your cycle is every 26 days or every 28 days or every 32 days, you can work out if you’re going to a 32 day cycle instead of releasing an egg on day 14 as somebody with a 28-day cycle does you will release an egg four days later which will be Day 18 so if you know what day you release an egg and we know that the egg survives for about 12 hours then the very best day to have sex to try to get pregnant is the day before you release an egg. So if you use those basic guidelines, somebody with a regular cycle they can also add into that and they can look for cervical mucus, big watery round about that time but you can pretty much pinpoint when you should be having sex to get pregnant. So yeah,if you’ve got a regular cycle it’s a relatively easy thing to sort out. The problems come in if you don’t have a regular cycle, so you have a cycle that sometimes shorter, sometimes longer sometimes too much and that’s where it gets complicated.
Wayne: That’s when we’ve got a healthy couple and things are all I guess normal. Are there issues that affect fertility in both men and women outside of that kind of normal spectrum?
Dr. Jessup: Obviously, there are. So for example, it’s not all about the woman so the man’s sperm count has to be alright. So in general we advocate people to lead healthy lifestyles, don’t do too much alcohol or anything drug wise or anything. In Australia we see a lot of men going to the gym taking steroids for muscle development, now has an impact on sperm so it’s important for anyone who’s taking anything like that to proactively stop those medications about three months before they want to get pregnant. With regard to women, the other thing is making sure that going forward you’ve maximized your fertility when you were young and that includes things like trying not to get STDs particularly chlamydia which is well known to block fallopian tubes. If you do know that there’s a family history of endometriosis, try and minimize the endometriosis which often means things like going on the contraceptive pill and running the pill together to decrease the amount of bleeds which are known to flare up endometriosis. A lot of women feel that the pill will decrease their fertility going forward, it won’t and especially with women with endometriosis it may in fact improve their fertility so that when they stop the pill you’ve got a higher chance of conceiving naturally.
Wayne: You’re listening to Health Professional Radio, I’m in conversation with Dr. Sonya Jessup of the Demeter Fertility and we’re talking about falling pregnant because it’s Natural Fertility Awareness Week. Sonya what about people who are a bit older? Is fertility in your 40s a viable period?
Dr. Jessup: You can still conceive naturally in your 40s. The problem is if you are an optimist and you try and conceive naturally and you do so, that’s the best outcome but if you were a pessimist and thought, “It might take me awhile to conceive.” If you start trying at 41, at 40 and then try naturally and at 41 you realized you haven’t conceived your fertility has gone down dramatically between the ages of 40 and 41. So I always say to people when you are older trying to conceive do the tests first to make sure that you actually have a realistic chance of conceiving naturally. So do the sperm test, make sure it’s not normal. Flush the fallopian tube, make sure that the tubes are open. Even coming from monitoring so that you know that you’re having sex at the right time so you’re making the most of every single month, giving yourself the best chances of conceiving naturally because it’s a shame when I see people who have tried naturally between 40 and 42, by the time they come in to see me that their natural egg count is so low that it’s hard to get pregnant even with IVF, so that’s that’s the concern. I think if you’re trying in your late 30s you’re well advised to see a fertility specialist and make sure that there’s nothing obvious that that’s preventing that natural fertility because if you knew that the sperm count was very low or the tubes were blocked, you would not sort waste that time conceiving naturally. You would go straight to IVF and try and get a baby while it was still possible and fairly easier to do so.
Wayne: Now short of IVF, are they natural fertility treatments available?
Dr. Jessup: Yes, there are. A lot of my patients who maybe they’ve had a baby and they are saying, “Look, it’s three years. I have the same partner and nothing else seems to have changed but we haven’t got pregnant.” Often with those patients, I’ll bring them in and flush the fallopian tube. Sometimes just with a bubbly water solution and other times with Lipiodol which is an oil poppy seed iodine rich substance and although we know that anything can flush the tubes whether it’s water or oil or whatever, people seem to get pregnant a lot more easily after a Lipiodol flush and it appears that there may be other factors. Maybe it’s having an immunological response or do something differently. The number of patients I have who can see within a month, either that month or the month after of flushing the tubes with Lipiodol is really quite extraordinary.
Wayne: It actually sounds like quite a pleasant beauty treatment, doesn’t it? Having a flush with poppy seed oil, it sounds like something quite pleasant.
Dr. Jessup: Well if the tubes are blocked, it can be a little bit uncomfortable but if they’re open it’s not that uncomfortable. What I used to notice was that when we used to do this treatment routinely 25 years ago say, it was a common thing that people would come in and say “My mum said I just need to come in and have my tubes flushed and I’d get pregnant.” And it was a bit of an old wives tale in those days but in fact we now know that there was something about that poppy seed oil that was doing more than just flushing the tube and in fact some of these women’s moms were correct, it was in fact a fertility treatment that we weren’t quite aware of how good it was at the time.
Wayne: Sonya one of the questions of I guess couples face when they want to get pregnant is when do you say “Oh I need professional help when.” When should people be seeking medical advice?
Dr. Jessup: That differs for different individuals. So there’s some people I see who are young and they say “Look, we’d like to have a baby. It doesn’t have to be at the moment but if it happens sometime in the next 18 months, that would be great.” I say “Brilliant. Well you’ve got your 18 months. You can either do the test now to check out the sperms or you can just enjoy life and take the 18 months with the guidelines and this is when you’re most fertile.” But if somebody’s a bit older, then I don’t say to take that long. After about six months I’d say “If you are not pregnant after six months, you need to come back and we’d really dot the i’s and cross the t’s and make sure that we’re not missing anything.” The other thing is that sometime people who are younger say “I really want to get pregnant now. My best friend’s pregnant, my sister-in-law is pregnant. It’s a bit of a perfect time for me. How do I maximize it?” And in that case I’d also say “Well let’s just do the baseline test, make sure that we’re not missing anything.” And just with some education about the best time to conceive, often people do conceive and they realize that once they’ve had the discussion, “Ah in fact we were doing the wrong thing.” We were trying at the wrong time.” And knowing that fertile times when you’re likely to conceive, it doesn’t mean you can’t have sex at the rest of the months just for fun and have a normal fun life. It just means that you know that you’re getting the best chance in making that fertile window work for you.
Wayne: Do you see people coming in kind of just looking for a personalized assessment and advice about how they should go forward and getting I guess in my mind it’s about getting all the ducks lined up in a row to maximize your chances of conceiving?
Dr. Jessup: More and more I do so. And it really pleases me that we’re being proactive in this approach. So they’re coming and they’re saying “Look my other friend is having this problem or that problem and my mum’s got polycystic ovaries. I just want to know what my fertility might be like going forward. Should I be worried? Do I need to look into it now? Do I have time?” And that’s a perfect opportunity to go through, do a women health check. make sure everything’s fine and get some sensible advice. I usually do an egg timer test and anti-mullerian hormone and say “I’m looking quite a lot of eggs left and everything looks good. You don’t seem to have any endometriosis. I would say you’ve got time so at the moment, you’re fine.” Other times it’s quite low or there are other health issues or we find other things. I say to couples “When you do get pregnant or if you are going to get married soon, don’t leave it too late.” This is a situation that I would advise “If it’s possible or a good situation for you get pregnant early, don’t pay off the house first or do anything else. For you guys that would be better to have kids earlier rather than later.” And for some women, we look at them and say “There’s likely to be an issue. Maybe it would be sensible to freeze some eggs now so that you’ve got some options later on given you’re not in a relationship and there’s no one on the horizon. Let’s be proactive about this.”
Wayne: Dr. Sonya Jessup, a fertility specialist and gynecologist of Demeter Fertility, it’s been lovely having a chat with you today. Thank you for making yourself available .
Dr. Jessup: That’s alright, thank you very much.
Wayne: And if you just joined us on a Health Professional Radio, you can catch up with Dr. Sonya Jessup at the website for Demeter Fertility, it’s demeterfertility.com and you’ll be able there to make contact and get all your questions answered and sorted out. If you’ve just joined us and you’ve missed the start of the interview, if you’ve just come in on the tail end then I have good news, on our website we have a transcript for you. We also have an audio up on YouTube, SoundCloud and iTunes where you can download and listen to the whole interview again. You’ve been listening to Health Professional Radio, my name is Wayne Bucklar.