Issue link: https://cp.revolio.com/i/855118
Abby's Magazine - Volume 5 Issue 4 | Page 37 Q In your experience, what are the most common factors that make concep on difficult? A Most common include: • High levels of stress leading to cor sol imbalances • Thyroid problems, especially hypothyroid and Hashimoto's • PCOS • Metabolic syndrome, pre-diabetes, diabetes • Microbiome disrup on leading to changes in the vaginal microbiome • MTHFR gene c changes • Certain gene c blood disorders • Factors in the partner, i.e., low sperm count or poor mo lity Q Are there other important things to do before trying to get pregnant? A All women should be on methylfolate, the most absorbable form of folate. Folic acid, the synthe c version of folate, taken by women before and in early pregnancy has undoubtedly reduced neural tube defects in the US. We need more than we get just from dietary folate, and neither dietary folate or folic acid are highly absorbable by women with the MTHFR gene c pa ern (which occurs in anywhere from 7 percent to 40 percent of the popula on, depending on which gene varia on you're looking at). To get enough to protect a baby, 400 mcg methylfolate should be taken star ng ideally three months before concep on and then con nued through the pregnancy. Women with a known MTHFR gene muta on may want to take up to 800 mcg or more daily. I also recommend that all women start both a general mul vitamin and a probio c before concep on. The former to make sure you're ge ng all the nutrients you need, including iodine, which women in the US are o en low in and which is essen al for healthy thyroid func on. The la er because a healthy microbiome can prevent miscarriage, urinary tract infec ons (which can lead to excessive an bio c use in pregnancy), preterm labor, and other prenatal problems. Also, probio cs have been shown to help protect babies from developing allergies and asthma, especially if there is a cesarean (which occurs in 34 percent of pregnancies in the US). If a woman has had a history of miscarriage or trouble ge ng pregnant, or knows she has Hashimoto's or elevated thyroid (TPO) an bodies, I also recommend ge ng a full thyroid lab panel. If an bodies are high, I recommend star ng 200 mcg of selenium daily, which has been shown to prevent prenatal and postpartum thyroid problems. Finally, I also recommend women find natural alterna ves to medica ons they are on, whenever possible and safe for you to do so, to minimize poten al medica on exposure. For example, one in six women is on an an depressant, some of which may not be op mal for a baby's development. Most women regularly take Tylenol for minor pain like headaches, but Tylenol has been shown to increase behavioral risks for babies later on. Q How long do you recommend people try to conceive before they seek out help from a specialist? A Since 90 percent of women will get pregnant naturally within a year of trying, and most of those who don't will get pregnant within two years, I go for the long game and encourage women to try for about a year-and-a-half or so before they go for interven on. (Women who have been on the pill may find it takes a year just to get a normal cycle back once they discon nue it). It's reasonable a er about eighteen months of trying naturally to at least get a fer lity work-up to make sure everything is normal with both partners. The excep ons to wai ng that long: if there is a known fer lity problem that just can't be overcome naturally, or if a woman's age when she's trying pushes her to the edge of her comfort zone in wai ng. That said, I've been the midwife for women having their first births at forty- four, so it's partly on an individual basis/choice, because it can happen naturally at almost any (fer le) age. Aviva Romm, M.D. is a Manha an-based integra ve women and children's physician, and author of The Adrenal Thyroid Revolu on. Romm did her medical training and internship in Internal Medicine at Yale School of Medicine and her residency in Family Medicine with Obstetrics at Tu s Family Medicine Residency. She's also a midwife and herbalist, and a graduate of the University of Arizona Integra ve Medicine Residency program. The views expressed in this ar cle intend to highlight alterna ve studies and induce conversa on. They are the views of the author and are for informa onal purposes only. This ar cle is not, nor is it intended to be, a subs tute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.