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GETTING PREGNANT & STAYING PREGNANT By Dr. John R. Lee
There’s no
question that more women than ever are having problems conceiving, and that
more women are being required to become familiar with the complex issues of
infertility in order to become pregnant. The other increasingly common problem
of pregnancy is miscarriage: one in three pregnancies in the U.S. ends in miscarriage.
SOME POSSIBLE
CAUSES OF THE INABILITY TO CONCEIVE
Some of the more
common underlying causes of the inability to conceive (excluding problems with
the sperm) could include the following:
1. Mechanical obstructions (blocked Fallopian tubes)
2. Hormone problems (e.g. hypothyroidism, estrogen dominance)
3. Primary ovary failure (ovaries fail to develop)
4. Secondary ovarian failure (e.g. after years of birth control pills)
5. Improper timing of intercourse ( the presumption that ovulation only
occurs at day 12 to 14 days of the menstrual cycle is erroneous)
6. Toxicity (fertility rates inversely correlate with fluoride exposure for
example)
7. Genetic (Turner’s Syndrome for example)
8. Stress (stress-induced anovulatory - non-ovulating periods are common)
9. Nutritional (anorexia starvation routinely limits fertility)
The list of
possible causes of infertility is actually much longer than this. Achieving
successful pregnancy is a precarious thing; experts think that one-third of all
fertilized eggs fail to survive.
One of the keys to
improving your odds of getting pregnant is a good hormonal balance. To help you
understand how your hormones may be affecting you either negatively or
positively, I want to tell you a little bit about your eggs, follicles and
cycles, and why you may be having trouble conceiving.
Popping An Egg
A molecular
biologist friend of mine refers to ovulation as
“popping an egg.” This is a good metaphor for ovulation. A combination
of hormonal and chemical messages in the brain and the ovary, all need to
coordinate and coalesce at the right moments in the menstrual cycle in order
for an ovarian follicle to get the message to mature and “pop” out of the
ovary, where it releases the egg into the fallopian tube.
Ovulation is the first requirement for pregnancy, but we can’t take it for
granted, even in young women. As reported by Peter Ellison of Harvard, at study
of 19 presumably healthy premenopausal women with a mean age of 29 found that
six of them, or 31 percent, failed to ovulate at any time during
their menstrual cycle.
When women do
ovulate, it doesn’t necessarily occur within the narrow time boundaries
dictated by traditional medicine. The advent of the saliva hormone assay has
significantly broadened our understanding of the timing of ovulation. When
salivary testing is done throughout a woman’s menstrual cycle, several stunning
observations can be made.
For example,
ovulation in a healthy women occurs within a much broader window during the the
menstrual cycle, most commonly from day 5 to day 15, rather than from day 12 to
14, as most textbooks indicate.
Salivary testing
also reveals that the ovulatory surge of progesterone that occurs after
ovulation is lasting for only two to four days in some women, rather than the
normal 10 to 12. This means that something is wrong, because adequate
progesterone levels are crucial for proper implantation of the egg in the
endometrium (the uterine lining) as well as for the survival of the fertilized
egg. A fall in progesterone after only two to four days would eliminate the
implantation or survival of any fertilized egg.
The Life and Times
of Your Follicles
Strange as it
might seem, ovaries and testes are formed early in the life of the embryo. By
the third week, more than 500,000 follicles are being formed in the embryo’s
ovary, and each follicle supposedly contains an ovum (egg) awaiting full
development after puberty. (In males, the equivalent case concerns Sertoli
cells in the testes.) Any of these follicles,
upon ovulation, becomes the corpus luteum that produces the progesterone
necessary for the survival of the fertilized egg.
Exposure to
pesticides or other petrochemical xenobiotics (environmental substances with
hormonal effects) during the embryonic period is particularly damaging to the
development of ovaries. (For details, read Our Stolen Future by Theo Colborn et
al.) That is, the mother may not show toxic effects to minute doses of these
toxins, but the embryo is exquisitely sensitive to them. If the embryo is
female, her ovarian follicles may be damaged.
These effects have
serious consequences. Damaged or dysfunctional follicles will not be able to
pop and egg or produce sufficient progesterone later in life. The incidence of
progesterone deficiency among women aged 35 in the industrialized world is
about 50percent. Treatment with progesterone is helpful but not necessarily
curative for this condition. Dysfunctional follicles, which cause progesterone
deficiency, lead to ovarian cysts. These cysts will usually clear up after
proper progesterone levels are restored, but the ovary still may not be able to
produce a viable egg. It is also follicle dysfunction which causes many early
miscarriages.
WHAT YOU CAN DO
ABOUT MISCARRIAGE
I am going to give you some simple solutions you can try at home that may
help prevent a miscarriage. Although there’s nothing we can do about a follicle
that can’t pop an egg, miscarriages caused by “luteal phase failure” , in
which the follicles ovulate normally but fail to continue their progesterone
production at levels necessary for successful implantation of the fertilized
egg and development of the embryo, can be prevented by progesterone treatment.
I encounter women with this problem all the time.
At one of my talk,
a woman told me she was having difficulty having a baby. She has a
four-year-old son, and has been pregnant several times since then, but each
pregnancy resulted in an early miscarriage. Repeated early miscarriages are
often caused by luteal phase failure. The problem is common and is occurring in
younger and younger women, probably because of embryonic exposure to
xeno-biotics. These women do not have trouble getting pregnant: their problem
is getting the embryo to survive and not miscarry.
What should they
do? They need to increase and maintain their progesterone levels to the point
where they can support their pregnancy, and they can do this by supplementing
with progesterone. Normally when an egg is fertilized, this sends chemical
messages that cause the follicle to increase its production of progesterone to
30 to 40 mg per day, double or triple what it made during the luteal phase of
the monthly cycle when the woman was not pregnant. The level of progesterone
increases gradually until well into the third month of pregnancy. By that time,
the placenta is well developed and is producing progressively more progesterone
within the uterus. By the third trimester (the final three months of the
pregnancy) progesterone production reaches 300 to 350 mg per day, more than 20
times higher than normal.
Correcting Luteul
Phase Failure
When supplementing
progesterone for luteal phase failure, conventional physicians often use
injectable progesterone or vaginal progesterone suppositories in doses of
several hundred mg. Per day. They give so much in order to produce serum levels
of progesterone similar to levels in the early pregnancy. But serum levels of
progesterone are misleading. Most conventional physicians do not know that 90
percent of bioavailable progesterone is carried by red blood cells and not in
the blood serum. Progesterone in the blood serum is protein-bound and less than
10 percent is bioavailable. Because of this simple task of understanding,
conventional medicine routinely gives excessive doses of progesterone to
patients with luteal phase failure in order to raise serum progesterone levels.
As a result, the success rates for this approach are usually less than 30
percent.
It is much more
effective to supplement with transdermal natural progesterone, which is carried
in a bioavailable fashion by the red blood cells after absorption. Progesterone
creams can easily supply the proper dose of 30 to 40 mg per day, or more if
needed. The creams I usually recommend provide 450 to 500 mg of progesterone
per ounce. One-quarter teaspoon of cream supplies about 20 mg. This dose can be
applied at bedtime and in the morning to provide 40 mg. Per day. For this use,
I recommend avoiding creams with wild yam (diosgenin), herbs or other active
ingredients.
As soon as
pregnancy is confirmed by a blood test, a woman at risk for miscarriage should
start using a progesterone cream that supplies that dosage. (Women who are
already using progesterone cream should simply continue if they become
pregnant, and increase the does.) After the first month of pregnancy, the dose
can be increased gradually to 60 to 80 mg per day. After the third month of
pregnancy, progesterone production, in the placenta increases so much that, in
theory, supplemental progesterone becomes less important. However, most of my
patients felt more comfortable continuing the cream throughout pregnancy, and
stopping one week before their expected delivery date.
At that time the
baby triggers its own delivery by excreting cortisol in its urine. This reduces
progesterone’s uterine effect, and allows uterine contraction. In the mother’s
body, the steep fall in progesterone that occurs with delivery stimulates the
production of the hormone prolactin, which stimulates the production of milk.
Women who suffer from post partum depression often find relief when they use a
little bit of natural progesterone cream.
Thus it’s clear why progesterone is the progestational hormone: its
presence at the proper time and in the proper amounts is essential to
conceiving and maintaining a healthy pregnancy.
Alles over natuurlijk progesteron:
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