Ep. 88: Should we try medicated cycles?
Caitlin:
Welcome to the Woven Well Podcast. I'm your host, Caitlin Estes. I'm a certified fertility care practitioner with a master of divinity degree. Each episode will cover a topic that helps educate and empower you in your fertility while honoring the deep connection your fertility has with your faith. Let's get started.
Caitlin:
Welcome back to the Woven Well Podcast. Today's episode is meant for couples who are discerning whether they should use medicated cycles in an effort to grow their families. So whether that's you or you have friends or family that may be in that boat or you just want to be knowledgeable about the topic, I'm glad you're here and I'm looking forward to sharing about what medicated cycles are, who they're for, and whether you should consider pursuing them or not. First, I want to address those who are actively trying to decide if a medicated cycle should be their next step as they try to grow their families. If a doctor has recommended a medicated cycle, it's likely because you've been given some sort of diagnosis related to infertility, whether it's specific or simply unexplained or very early on in the process. But being told that you have infertility is a really difficult thing to hear.
Caitlin:
I just want to acknowledge that up front. It stirs up a lot of emotions and a lot of fears about the future. In fact, I've had couples who are afraid to even try to get pregnant because they don't want to find out that they're infertile. So it is definitely an overwhelming and sometimes all consuming experience, and there are a lot of different reasons that a couple may be dealing with infertility. We aren't going to address any of those specifically in this episode, although we do have previous episodes that talk about this if you're interested in those. But I do want to just briefly speak to those who are told they are infertile because they haven't gotten pregnant after 12 months of trying. This is technically the basic definition for infertility, but it is so general and not at all helpful. It doesn't address if the couple is actually intimate on days of fertility or if she's even successfully ovulating during that time, or many, many other scenarios.
Caitlin:
I have actually had clients who were told to try to conceive for 12 months, come back if they didn't, but she never had a period during those 12 months when she came back to the doctor's office after 12 months of no menstruation at all. What she was told was this means she was infertile. It's a term that feels very permanent. Infertility sounds like something that you're going to live with for the rest of your life, but infertility is not really a diagnosis as much as it is a symptom symptoms point to an underlying diagnosis. The why behind something is that is happening. So knowing that you haven't conceived after 12 months, that doesn't give you any hint as to why that's the case. That process takes a little bit of investigation, but for some of you hitting the 12 month Mark May be the point at which you're offered a medicated cycle.
Caitlin:
So it's important to know about that. Now, what is a medicated cycle? So every menstrual cycle has a few main events. You have the follicular phase when the follicles containing eggs are growing and producing estrogen throughout the body. You have ovulation when the mature follicle releases an egg, and then you have the luteal phase when the lining of the uterus prepares to welcome a fertilized egg for implantation. A medicated cycle is when each of these events are supported or caused by medications or supplemental hormones. So it's common for a medicated cycle to consist of injections or medications at the end of your period to increase the number and growth of follicles during the follicular phase, and then a trigger shot of HCG at the point in which the medical staff would like that mature egg to ovulate and sometimes even progesterone support post peak to support implantation.
Caitlin:
For many OBGYNs who may not have the experience or interest in investigating the nuance of the delay in conception, this is often their first recommendation to do a medicated cycle, and I don't want to put them down for wanting to try this first. I think it's understandable that a first step may be to strengthen a natural cycle to see if that's all it takes. A medicated cycle really can be a great choice for those who need hormonal support or those who simply have a hard time releasing that egg. So examples may be chronically deficient hormones, PCOS or LUF syndrome, which stands for luteinized, unruptured follicle. While working to improve these underlying conditions to improve overall health and reproductive health, medicated cycles may be the best way to provide direct support to a specific cycle to increase the possibility of pregnancy.
Caitlin:
So medicated cycles do not treat any conditions. They do not change anything about your long-term health or your body or your cycles, but they do provide direct support during the cycle. You're on medications and such to increase your chances of a healthy ovulation and potentially conception. Now, another reason many like to try a medicated cycle is because they don't come with any blatant moral or ethical concerns. A medicated cycle is supporting the natural functions of a healthy reproductive cycle. It's not preventing you from being able to do what your body should naturally do, and it's not trying to bypass that natural system. So unlike IUIs or IVF, there's no Christian denomination that I know of that has any issues with supporting hormones and triggering ovulation for a natural conception. Fertilization would still happen through fertility focused intercourse around ovulation, and everybody can get behind that.
Caitlin:
So if these scenarios both health-wise and other describe you, it really may be a great option for you. But if you're already growing strong, mature follicles and successfully ovulating, it may not do for you what you hope it will. If your follicles are growing to a healthy size, you may not need follicular support. If you're successfully ovulating, you won't benefit from a trigger shot. And if your progesterone is strong supplementing it isn't accomplishing anything. So while some doctors may just start you out with a medicated cycle, I'd like to recommend that you start with a little investigation instead. And one reason for this is that any type of treatment is going to take a lot out of you. That includes medical cycles, right? Mentally, emotionally, physically, even financially. You want to make sure that any treatment you're pursuing is worth it and it's actually a accomplishing something.
Caitlin:
So are you growing healthy follicles? Are you ovulating on your own? Figuring these things out first, and my favorite way to do that is through a follicular ultrasound series. This series uses a vaginal ultrasound to watch the growth of your follicles during the follicular phase and then check it once again after ovulation has occurred, to ensure that ovulation really did happen successfully. You can see a lot of stuff through this series. How large was the follicle? Was it large and healthy enough to ovulate and possibly be fertilized? Was there more than one? Were there any organic issues like a mass or a cyst getting in the way when all signs pointed to ovulation, was there still an egg stuck in the ovary or was it successful in ovulating? You can learn so much from a series of ultrasounds like this instead of just one or maybe even two at some point in your cycle.
Caitlin:
That's why it's one of my favorite ways to find out. So if you are successfully ovulating a healthy egg, then it may make the most sense to skip medicated cycles and put your focus on figuring out why conception isn't happening so that you can make the most out of your treatments and out of your time. There are so many amazing factors that go into a pregnancy. The whole process is truly miraculous. Ovulation is just one, it's a major one. It has to happen, but still it's just one other things worth investigating. Is your husband producing healthy sperm? Can the egg and sperm physically meet? Can an embryo implant in the lining? Does your body attack pregnancies? So there are all these really good questions to ask to see what else could be hindering conception besides ovulation. Now, we're not going to talk about those today, but we do have more specifics about this in our free infertility resource guide on our website at woven fertility.com/resources.
Caitlin:
It will definitely be linked in the show notes as well. Something that I really appreciate about most restorative reproductive OBGYNs is that these are the questions they're asking. They're not going to jump to a treatment before knowing what they're treating. They're going to spend the time up front listening to your experience, looking at your charting and investigating why conception hasn't happened. The easiest scenario, maybe you weren't actually using days of fertility for intercourse. You'd be amazed at how often something like that can happen. So it really does make a difference to know when you are fertile or infertile and charting your cycles through something like the Creighton Method system, which is what we teach at Woven Natural Fertility Care can show you that on a daily basis. It can also point out very clearly if you are producing enough cervical mucus, whether your lining is sufficient for implantation or if you possibly have an infection or an inflammation that could prevent pregnancy.
Caitlin:
Creighton can reveal so much valuable information. It's also the charting method that is used by restorative reproductive OBGYNs to get to that root cause of infertility. So with charting, they could see at a glance what the strengths and weaknesses of your cycle are. They can identify initial struggles to conception. They can even see how effective their treatment plans are by whether or not your body responds accordingly. Perhaps the best news is, unlike General OBGYNs, they won't make you wait a year before pursuing treatment. So if you're not getting pregnant after six months of using days of fertility, it's time to start investigating why. Then when they see what's going on and why they're going to tailor a specific treatment plan to you, long before you've been trying to conceive for 12 months. Now, could that treatment include a medicated cycle? For sure it could. There is nothing wrong with a medicated cycle, like I mentioned.
Caitlin:
It is a great approach and can be the support that you need in order to conceive. The key though, is to first take the time to identify what that need really is and address it directly. I know the journey is not easy, and if you are walking this road and trying to figure out if a medicated cycle is for you, then I know that you are walking through a challenging time both in and outside the doctor's office. We want to provide as many resources that we can to you, okay? We serve all women, all couples, but at woven natural fertility care, we have a special heart for couples who are trying to conceive and we want to provide you with practical resources for advocating and getting to the root cause of that issue, or even emotional and spiritual support. We want to provide that because we know it's difficult to walk this journey of balancing medicine, theology, life challenges, all sorts of things together.
Caitlin:
So I would love to talk with you about your situation and offer any of that support that I can. So I don't know if you know, but you can schedule a consultation even if you don't already work with woven. So you do not have to be a client in order to schedule a consultation. You can go to our website@wovenfertility.com and book one of these to share about your menstrual or medical background, your spiritual struggles through your fertility journey, or anything else that you'd like to discuss with us. I would love to sit and talk with you. As always, thanks for listening. As we continue to explore together what it means to be woven well.