Pregnancy

Freaking Out About Your Fertility

Dear Amy,

I don’t have kids, but I’m one of those people who, when I’m interested in something, I study it to death. My sister is the opposite. So, I’m used to getting questions about randomness from her and often having the answer. Last night, she told me she and her fiance are trying to get pregnant. Awesome! She very much wanted to have kids before the magical “30” deadline, and I thought this was probably on the way, so I’m not surprised.

She is freaking out. She wants to have kids…it’s not that. She’s freaking out because she’s been trying actively for a month and she didn’t get pregnant. She thinks she’s infertile! She informed me that she and her fiance had been using the rhythm method for contraception before that and that she thought there would be a couple of slip-ups and that would be that, but as I talked to her, it’s clear that she has some wild misconceptions about how this whole thing works.

I tried to clear up some of these–I let her know that age 30 isn’t some magic On/Off switch for fertility, and she wouldn’t suddenly go from yes to no on the kids front at that time. I gave her the usual numbers about how even completely healthy early 20s people have about a 20% chance of getting pregnant in any given month of active trying, and that doesn’t even count the really high levels of miscarriages before a pregnancy can even be detected. She still wants to know if she should start looking for a fertility specialist. I told her that a good specialist probably wouldn’t even see her (at age 29) unless she had had a history of miscarriages or a year of unsuccessful, active trying, and that at the very least, she should wait a good 6 months before she considers seeking one out, and I don’t think I made things worse, but I am out of ideas to tell her.

I know that some people will ask, was she looking to vent or did she actually seek out advice, and she explicitly asked for advice from her wiser big sister, but she’s just not willing to accept an answer that boils down to “have patience, it doesn’t always happen on a whim”.

Stuck Big Sister

Oof, yes, she needs to calm waaaaaayyyyy down. That said, the two worst words you can tell a trying-to-conceive (TTC) person — no matter what point they are in the game — are “just relax.”

An OB/GYN is a better place to start

Everything you told her so far is 100% accurate, including the general guidelines for getting referred to a fertility specialist. She clearly wants SOMEONE to take her worries seriously, but I can’t imagine her getting a response from a specialist-with-a-months’-long-waitlist other than a baffled, “why are you here and wasting both of our time? go home, have more sex, call me if nothing happens in a year.”

Her regular OB/GYN, on the other hand, would be an appropriate person to see, as plenty of women like to get an exam and clean bill of sexual health before they start trying. And an OB/GYN is more than qualified to handle her early fertility concerns and give her practical guidance about timing, charting, etc.

Additional Resources

Your sister — most likely — has many, many fertile years ahead of her, and it sounds like she needs some basic education/information as to how to make the most of them. Both for the active TTC periods (as you said kids, plural) and for the times when she really would prefer NOT to be pregnant (i.e. when a rhythm method “slip up” is not something she’s okay with). Her OB/GYN would be a good first start, if mostly to reinforce your wisdom that no, it’s not time to panic just yet. If you want to continue to put her mind at ease (while also empowering her with accurate, ACTIONABLE information), I’d suggest getting her a copy of Taking Charge of Your Fertility or The Impatient Woman’s Guide to Getting Pregnant. Or both, along with a basel body temperature thermometer so she can starting charting her cycles more accurately.

Given her successful use of the rhythm method, she might be more in tune with her cycles and ovulation than a lot of women are, so some of the information in these books won’t be all that new. (Though it sounds maybe more like she just got really lucky, as she’s interpreting her “success” with “I must just be infertile because I wasn’t really expecting it to work.”) But the books will back up the information you gave her — that a perfectly healthy, fertile woman still won’t necessarily conceive the very first month of trying. And you can also tell her that the first thing any fertility specialist would have her do ANYWAY is take her temperature and fill out a chart for a couple months, just to get a baseline on ovulation and cycle length. She can go ahead and do that herself, with the books or the TCOYF site as a guide.

Listen don’t just give advice

All this said, it’s also entirely possible that your sister might just need more listening right now and less “I HAVE THE ANSWERS AND CAN FIX THIS!!” Like, obviously it’s good to present her with facts that both reassure and empower her, but on the other hand, when you want to be pregnant and get that negative test at the end of the month… Man, it really can do a number on you. It’s very easy to slip into worst-case scenario thinking, to feel like EVERYONE IN THE WORLD is pregnant and you aren’t, it’s never ever going to happen, etc. So in between the good big sisterly advice, be sure you’re also there for her as just a good big sister. Lots of hugs, acknowledgment of her disappointment, a glass of wine to drown her not-this-month sorrows. I hope it all happens quickly for her, though, and you can go from Stuck Big Sister to Super Proud Aunt!

Photo source: Depositphotos/3dmentat

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Noodle

7 years ago

Amalah recommended the exact two books I was going to recommend! Have her get on the fertility friend app – it’s great for Type A people who want to conceive. Also, by collecting all the data (temp, fluids, etc) she’ll be able to figure out within a few months whether she might have some sort of identifiable fertility issue, in which case she wouldn’t need to wait a whole year to see a fertility doc. All the tracking can be a little crazy-making, but I took comfort in knowing that if there was going to be an issue with conceiving,… Read more »

Liz Miller

I’m on the other end of this process, nearly 48 and my periods are departing, but I highly recommend Pink Pad as a tracker.

Alison

Yes, yes, yes to using a tracking app (or just ovulation test strips and a calendar). It was using that method of tracking my period and ovulation that I realized 6 months into TTC that I DID have ovulation problems that were preventing me from getting pregnant. And I wish I had hightailed it to a specialist at that point (no referrals needed with my insurance) instead of letting my obgyn at the time mess around with clomid and ZERO blood tests/ultrasounds because that wasted another 8 months before I finally discovered that clomid was causing big cysts on my… Read more »

Ann

I know that it can take up to a year of activity trying to get pregnant. Expecaly, if birth control was used before hand. However, there has been this rumor that if at any time you don’t use birth control you’ll get pregnant. Which makes people run to the doctor fearing something is wrong with them.

Reply to Ann

I think the issue is the different mindset for when you are trying to avoid pregnancy vs. when you are trying to get pregnant. The author of Taking Charge of Your Fertility discusses this a bit. She tells the story of a woman who never got her period, and her doctor told her she still needed to be on birth control when she didn’t want to be pregnant because she could get pregnant. When she was ready to conceive, she went off birth control and continued to not have periods, and didn’t get pregnant. What she didn’t realize was that… Read more »

Vickie

Anyone considering a pregnancy should be on good prenatal vitamins well in advance. (My personal opinion is anyone in childbearing years having sex should always be on prenatals.)

Caroline

Reply to Vickie

unless they would not continue with a pregnancy, then sure.

Myriam

no need for the whole vitamins! that’s a receipe for expensive pee! 😉 However, folate is essential. You can get it on its own, and it’s cheaper than multivitamins.

Reply to Myriam

Prenatals are often available for free. Check local pharmacies. Ours are free. And they are one pill. I have two girls with health issues and their doctor recommended prenatals as a means of increasing the quality of their vitamins in a much simpler and cheaper format. That was several years ago, they are still on them. Will stay on them. We did not notice a pee difference in switching vitamins. HUGE cost difference, we are saving a lot of money. And so much easier. Prenatals (for pregnant women) are often prescribed with stool softener. We do not get that type.… Read more »

I don’t think you got my point. I am saying that the only vitamin that needs to be generally recommended to women waiting to become pregnant is folate, which you can get by itself, for cheaper than a prenatal or “regular” multivitamins. For most people, you already consume enough vitamins and minerals on a “normal” diet, so you just end up peeing the excess. Your pee would not look or smell differently. There are also conditions or situations where taking a multi/prenatal would be recommended, but I would leave that decision to your doctor. http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/prenatal-vitamins/faq-20057922

Holli

Prenatal vitamins contain the highest dose of iron available OTC in multivitamins, as well as a lot of other fat-soluble compounds that won’t be peed out, meaning all those extra vitamins stick around in your body at best sitting idle, and at worse making you sick. There’s no reason to be taking vitamins for two when you’re not supporting a baby, preparing to support a baby or nursing a baby. You run a good risk of overdosing yourself with vitamins. You should talk to your doctor before deciding on a vitmin or if you need a vitamin. Some people eat… Read more »

Noone

I was in a similar situation (although Inat least did try for 6 months, first.) I was 33, and had never been the most careful about birth control (with my boyfriend/husband we’d used the pullout method for the whole 7 years we were together), and had never ever had a scare. I always had a sneaking feeling something might be wrong, though – who’s that careless and goes that long without a scare? So after 6 months of trying (and I only waited that long so the doctors wouldn’t think I’m crazy) sure enough, it turned out I had uterine… Read more »

CKD1

Reply to Noone

Very true! I think the reason people are suggesting the more aggressive tracking/education is because a lot of women actually don’t know a lot about fertility and the mechanics of getting pregnant (I met an actual adult woman who didn’t realize it was a quality vs quantity game, so to speak: she just thought lots of sex = baby, and hadn’t the slightest clue about her cycle and how that came into play.) Not saying OP’s sister is that…uninformed, but a little research might help her solve the mystery of why no “oops” yet.