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Q&A Topics

Fertility


Yesheen (dr.) Singh Medical Doctor View profile



Dear R



Thank you for your question. PCOS is a challenging disease to manage in the western medicine model of health care, where most doctors rely on synthetic hormones to regulate periods and fertility drugs like Fermotid or insulin receptor modifier drugs like Metformin. These all attempt to treat the symptoms of PCOS but don't do anything to heal the underlying imbalance. Sometimes the work and a woman with PCOS will fall pregnant but the underlying inflammatory disease process continues and simply chooses another avenue to display itself. The rate of successful pregnancy on the combination of Provera and Fermotid is unpredictable but the general consensus is a success rate of around 20% depending on the complexity of the underlying pathology.



I would recommend completing your course of medication since you have already begun it. I would not advocate using any other form of therapy in conjunction as they may adversly affect the medication. But if you come to the end of your course and are still not pregnant then contact me via www.healthnation.co.za if you would like to try an alternate approach to rebalancing your underlying oestrogen:progesterone imbalance and thus improving your chances of falling pregnant.



Many thanks and warm regards

Yesheen Singh


Yesheen (dr.) Singh Medical Doctor View profile

Dear V



Thank you for your question. There are many reasons why you are experiencing difficulty falling pregnant, too many to discuss in this forum. I would recommend firstly trying to have intercourse with an approved lubricant because hair cream often contains many harmful substances that negatively affect the vagina and cervix making them less receptive to sperm. If this does not work after two to three months I would recommend seeking help, either from your local GP, your gynaecologist or from myself, via www.healthnation.co.za. Secondary infertility is a complex issue and needs a proper history and clinical exam to ellicit the cause. It is only once the cause is known that a solution can be suggested.



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear J



Thank you for your question. There is no quick answer to your question because the reason for you inability to ovulate can be due to so many factors. It could be related to obesity, ovarian cysts, prescription medication, high levels of stress, etc, and the reason will need to be ellicited during an in-depth consultation. It is only once the reason is know that we can suggest a treatment option. If you would like to discuss this further please contact me at www.healthnation.co.za



Many thanks and warm regards

Yesheen Singh

Yesheen (dr.) Singh Medical Doctor View profile

Dear C



Thank you for your question. I have to say that without having a look at the reports of your special investigations it will be difficult for me to offer an opinion. There are indeed cases where, due to previous infections or trauma, genetic defects or anatomical aberations, the womb is found to be less than hospitable to hosting a gestating fetus. But these are few and far between. If you would like to consult me in person and bring the reports along you are welcome to contact me through www.healthnation.co.za



Womb transplants are not commonly performed because of the highly vascular nature of the uterus. In true cases where the womb is indeed found to be inhospitable then your options would be surrogacy or adoption. Some researchers have tried extra-uterine pregnancies but this is VERY dangerous and not advisable.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear P



Thank you for your question. The only person who will be able to tell you more on your cycle is yourself. My recommendation is to begin a menstrual cycle where you make a daily note of any activity and detail what occurs. Over time you will begin to see a pattern emerge which will help you know more about how your own body works. Each woman's cycle is unique so don't compare your's to anyone elses.



With regards to trying to fall pregnant the first thing I would advise is to put yourself onto a good pregnant-mom multivitamin with high doses of Omega 3 fatty acids, Folate, Iron and Vitamin B12. Other than that I would say that until you have been trying regularly (i.e. unprotected intercouse at least three-four times per week) for a minimum of twelve months there is not much else we can recommend. Any special investigations into fertility issues should only be begun if ample opportunity has been given to nature to work her magic.



There is very little association between the time of your cycle and the ability to fall pregnant so please don't worry about picking the "ideal time" to have intercourse. Sperm and ovums can still dance the conception dance days, even weeks, after ovulation. So remember - 3-4 times every week of unprotected intercouse when both you and your partner are in a suitable frame of mind for a year. Forcing one another to desperately have sex is only going to increase your levels of stress hormones in your body and make it more difficult to fall pregnant.



Many thanks and warm regards

Yesheen SIngh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear N



Thank you for your question. The use of Acnetane is usually accompanied by a big red warning sign that you should be on tight contraceptive control because of the large possibilities of having fetal deformities if you fall pregnant while on the meds. This hasn't changed.



With regards to your future risk though, I usually advise at least a further year of stringent contraceptive use after the acnetane is stopped before your begin trying to start a family. Usually this is enough time for the body to clear out the last remaining particles of the drug from your system and for your liver to return to a normal level of functioning. If you give your body this time then there should be no increase in your risk of fetal abnormalities when compared to other women of your age.



I have not heard of a change in your ability to fall pregnant after using a course of acnetane.



Many thanks and warm regards

Yesheen Singh

HealthNation

Yesheen (dr.) Singh Medical Doctor View profile

Dear Z

Thank you for your question. The time it will take for you to fall pregnant after stopping Nuristerate depends on you own individual metabolism. We usually recommend trying for up to 12 months from the last dose before seeking help for possible infertility issues.

Warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear L

Thank you for your question. Unfortunately I do not have a clinical profile from you as to why your ova are of poor quality. This is a problem that you must liase directly with the fertility clinic which is treating you, as they will have a detailed file on you. The cause of the problem needs to be looked at, prior to me advising you. I suggest that you contact your gynaecologist directly, or alternatively make an appointment to see me please.

Kind regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear L



Thank you for your question. Duphaston, also known as dydrogesterone, is a form of synthetic progesterone. While I am not a fan of any form of synthetic hormone supplementation I can understand your intention behind your use of it. The reasons for infertility can be quite complex, ranging from anatomical to hormonal changes. From your use of duphaston I am assuming that your's lie more in the latter. Hormonal imbalances can occur at many levels in the sex hormone production pathway, and it is in understanding where in the cascade the imbalance lies that the solution can be found.



Without a proper consult with you to ellicit the true complexities of your case I can only offer limited advice. My advice would be to ensure as smooth a pathway of oestrogen and progesterone through your body as possible, from production to excretion and ellimination. Ensure that you aren't exposed to xeno-oestrogens that confuse the body - if so remove the source and consider a focused detox. Ensure that you are passing stool regularly, at least twice daily - if not add in some psyllium husk nightly. Ensure that your stress levels do not contribute towards the endocrine imbalance - if so either consider using an adaptogen or modifying your response to stress. Ensure that the food you eat contribute towards a balanced sex hormone pathway - cut out beef, lamb, and most other forms of animal protein where the livestock may be contaminated by hormones in the farming process. There are a couple of other more specific supplements I could recommend but these would depend on your history and endocrine imbalance.



If you would like to make an appointment please contact me via www.healthnation.co.za



Many thanks and warm regards

Yesheen Singh

Felicia Rubin Pharmacist View profile

Dear Nompi,

Thank you for your question re Nur-Isterate, which sometimes does have a long term effect in the body.

However, most important , are you having a regular monthly cycle ?

Once we have established your cycle & perhaps a blood test to establish your hormone profile, you will certainly have some answers.

Please feel free to contact me for further discussion.

Am resident in Kloof (021 4875441) or email: felicia@wellnesswarehouse.com.

Kind regards

Yours in Health

Felicia Rubin (Senior Pharmacist & Integrated Health Practitioner)

Angela Lombard Nursing Practitioner View profile

Dear J

Many thanks for your question.

In all honesty, I suggest that you make an appointment to see your gynaecologist so that he or she can assess and examine you fully, and also determine whether you are ovulating properly. Your doctor should also do a breast examination and Pap (cervical) smear, if not already done annually.

Once the basics have been done and checked, you are welcome to keep me updated with your progress from this appointment, and e-mail me with your results, or alternatively make an appointment to see me with your results and I will advise you further. But please do the above first.

You are still young enough with time on your side to make your dream come true. Potential medical conditions need to be ruled out as well.

Sometimes it takes a little longer for some women to fall pregnant, than others, but don't lose heart, just have lots of patience. Please make an appointment to see your gynaecologist soon.

Please always refer back to your previous e-mail, so that I am able to follow you up effectively.

Lots of good luck to you!

Warmest regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear N

Thank you for your question. It can take anything from a couple of days to a whole year before you are able to fall pregnant once stopping an oral contraceptive. It depends very much on your body's ability to clear out the remnants of the synthetic oestrogen in your system and it's ability to bounce back into a normal rhythm that supports a viable pregnancy.

If you are serious about falling pregnant and bringing a new life into this world then I would recommend stopping the contraceptive for at least 12 months, using a good vitamin supplement, eating a healthy nutritious diet that minimises red meat, sugars and simple flours, exercising and most importantly - forgetting about trying to fall pregnant. Stressing about it negatively impacts on your ability to fall pregnant.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Dear C

A warm welcome to our Wellness Warehouse website!

I recommend that you make an appointment to see your GP and gynaecologist and ask them to consult each other so as to pull your body back into rhythm, especially as you are a diabetic and on Eltroxin medication for your thyroid. You do need to be under their supervision. It is not sufficiently adequate to manage you from a website without seeing you as well.

Your GP will be able to repeat your blood pressure as you are currently now. A fasting glucose test to be done in the morning, and a haemoglobin finger prick test to be done to check for your iron levels, or even for blood to be taken and sent away to a pathology laboratory. It would be advisable to get better first and pull your body back into sync, before falling pregnant. You will need to be monitored by your GP and gynae due to your diabetes and thyroid condition please.

If you were in Cape Town, I could consult and monitor you from our Well Clinic, and then refer you when necessary. The above needs to be done to determine the cause of your signs and symptoms. You need to be a little patient for that wished for pregnancy, and in the interim be guided by your doctors in person, who will diagnostically resolve the dizziness (could be due to a low haemoglobin, compounded by insulin resistance, and a possible low BP).

I do hope that you feel better soon. You are more than welcome to ask for further assistance.

Warmest regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear M

Thank you for your question. What you are experiencing is termed secondary infertility - you have been able to fall pregnant in the past and successfully carry a baby to term but for some reason you are unable to do so now.

One of the causes may be the recent use of a contraceptive. We usually allow a twelve month period after the last dose of contraceptive before making the diagnosis of infertility because even though the contraceptive weans itself out of your body by month three it often takes up to twelve months for your body's own hormonal cycle to kick in and successfully support a conception. Having a monthly cycle does not necessarily equate to ovulating every month.

Another reason may be the antiretrovirals you are on - they have been known to affect many different systems including the hormonal/reproductive system. Depending on the drug there is a possibility that you will find it challenging to fall pregnant or that if you do the fetus will be malformed and spontaneously abort because of the inherent mechanism of the drug.

I would firstly ask you to be thankful for the two healthy kids you do have, and secondly relax and give it some more time. If after twelve months of no contraceptive use you are still finding it difficult to conceive then please approach you local clinic for a referral to the nearest public infertility clinic.

Many thanks and warm regards

Yesheen

Angela Lombard Nursing Practitioner View profile

Hi Bahlaole

Thank you for your query. The PREGNACARE MULTIVITAMIN product is a good product. This needs to be taken as x1 tablet every day after breakfast. A good omega supplement is also essential so as to ensure that your baby will develop healthy brain and nerve tissue. It also ensures healthy muscle co-ordination. I recommend MUM OMEGA by Equazen as x1 capsule every evening after supper. In addition, I also recommend for the mum to be, FERTILITY FOR WOMEN by Viridian as x1 - 2 capsules daily after food, preferably after breakfast.

And for you as the dad of baby, so as to ensure good quality sperm and motility, FERTILITY FOR MEN by Viridian, to be taken as x2 capsules after breakfast every morning.

Always drink the above with water, when swallowing medication.

All the best of luck to you both!

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Trying

Many thanks for your query. I sincerely apologise for my late reply as I have been away on leave.

You can actually count 10/11 as your first day of bleeding for your menses as it is so close to the hour for the following day. You seem to have a 30 to 31 day cycle. This may be how it is for you usually, or it could be due to your nutritional status or even stress. Do keep a daily record. Try and chill, do try not to stress as this can often impede conception.

There are some interesting guidelines out there about conceiving baby girls and boys. From my obstetric experience I can tell you that a predominantly dairy intake is supposed to encourage the conception of a girl. A predominantly salty diet can result in a baby boy. But don't forget that it is the father of the baby who genetically determines the sex of the baby due to the different mix of chromosones. The alkalinity of the vagina mucosa assists in the female sex of the baby as well. An acidic mucosa tends to lean more towards a male conception. I suggest that you balance your acid and alkaline levels generally. DR VOGEL'S ALKALINE POWDER taken as x1 dessertspoon (10 mls) a day will assist you with this.

Your guideline given is accurate for intercourse 2 - 3 days prior to ovulation. If you wanted a boy, then carry on and have intercourse for each of the 3 days after ovulation. More frequent intercourse, is supposed to increase the chances of a male conception as the genetic material transported in the head of a sperm needs to be in more abundance to survive and win its swim to the ovum!

You can include the day of ovulation for conception, but then depending on the few above mentioned factors there would also be the small possibility of a baby boy. Also remember the dad's genetic role in determining the sex of the baby!

Aim for a healthy baby first of all, and should your little one be a girl, take it as a bonus!

So sorry this is late - perhaps you would like to pose a new question as to how you are now? All the same, everything of the very best to you, relax and enjoy, before your prescious bundle arrives.

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear T

Many thanks for your query. Your clinical profile is one which I would require you to see me for with your pathology results. Your doctor has advised you correctly so far. There is very little that I can do without having seen those hormonal levels. There are an increasing number of women with hormonal imbalances, so you are not alone with this problem.

You are welcome to make an appointment to see me to assist you further. Take care now.

Warmest regards

Angela

Yesheen (dr.) Singh Medical Doctor View profile

Dear T

Thank you for your follow-up question. You may indeed be on the right track here with your suspicions regarding the after effects of pelvic injury. The scar tissue within your pelvis as a result of the healing process may be negatively impacting on your ovaries, the blood supply to the ovaries or even the fallopian tubes. This in turn may reduce your ability to ovulate or to conceive. The only way to make certain that all is well is for a contrast study of your uterus and fallopian tubes, called a retrograde hysterosalpingography, which your GP or gynaecologist can arrange if indicated.

Many thanks and warm regards

Yesheen

Gabriell (dr.) Prinsloo Medical Doctor View profile

Hi

Fertility treatment is complex and everything that you take will have an impact on the process. Because of this it is important to stick with only one Dr/plan of action at a time. So instead of answering I suggest that you rather ask your fertility Dr about the Staminogro as s/he will know how it will fit in with your specific plan.

Give this program a few cycles chance. If you are not happy with your Dr, go to a different fertility expert or use a different approach.

I am sure that you know this, but just in case: it is important that both you and your partner are completely healthy and relaxed. The more stressed either partner is the more difficult it is to conceive. So relax as much as you are able (I know it is easier to say than do) and do things that are fun together.

Good luck!

Warm regards

Gabriell

Megan (dr.) Jones Homeopath View profile

Hi Jesse,

I agree with you about not putting more artificial hormones into your body to correct issues caused by artificial hormones in the first place.

Firstly, I suggest you give your liver some additional support in metabolising the hormones that need to still be cleared from your system, especially if you plan to conceive soon. Milk thistle is a very gentle liver restorer and detoxifier. I suggest Solgar's Milk Thistle or Holistix Milk Thistle.

I would advise you take a herb such as Agnus Castus to bring your hormones back into balance. Agnus Castus helps to normalise female sex hormones. It is indicated for painful periods, PMS and infertility. It is a very effective treatment and has even been known to stimulate the release of multiple eggs from the ovary, resulting in multiple births. I suggest Solgar's Agnus Castus.

Warm wishes, Dr. Megan Jones, Registered Homoeopath

Angela Lombard Nursing Practitioner View profile

Dear J

Thank you for your query. I always recommend a 90 day (3 month) supplementation programme for preconception so as to assist a woman in preparing her body for a healthy pregnancy.

The two most important products that should always be considered, are a good quality multivitamin which contains folic acid, e.g. CHELA-PREG by Arctic Health - to be taken as x1 tablet daily after breakfast. Or alternatively, PREGNAVIT M by Georen Pharmaceuticals, the same dosage.

The second most important product should be an omega supplement, e.g. MUM OMEGA by Equazen. This is taken as x1 capsule daily after food, morning or evening.

These 2 products will assist in providing your baby with healthy brain tissue and nervous system. They can be taken before conception, during pregnancy and post delivery.

I note that you have been on Nur-Isterate for 10 years without a break. It takes the body at least 6 months to release all the chemical components from all the systems of the body after the consistent usage, like this, of the two month contraceptive injection. Sometimes it can take a little bit longer, but perserverance wins in the end.

All the best of luck with your plans!

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear Jessicah

Thank you for your query and for giving a detailed contraceptive history. It is great that all your diagnostic tests came back healthy.

Your doctor has advised you correctly. The contraceptive pill in your particular instance, will help to trigger your hormonal cycle once again. I fully understand you not wanting to take the pill and the reasons thereof etc. However, for you it should pull your cycle back to normality - you need only take it for 2-3 months in order for regular menses to return. I also recommend a good quality multivitamin like VITA-LIFE by Amipro - take x2 capsules, twice a day after breakfast and supper, or x1 capsule three times a day after meals. This multivitamin will assist in replacing the mineral loss of your sceletal structure caused by taking contraceptives, including the contraceptive injection. Alternatively, the MULTIVITAMIN+MINERAL FOR WOMEN by Foodstate as x2 capsules after breakfast, is also excellent.

Otherwise, your answer is to sit it out longer and wait for your hormonal cycle to right itself on its own. Still take a multivitamin as suggested, eat a well balanced and healthy nutritional eating plan, drink 2 - 3 litres of filtered water daily, and do regular and gentle exercise.

The Well Clinic does a wellness assessment which could assist you in determining that you are healthy - this non-invasive medical checkup covers blood pressure, a measurement of height, weight, girth and a BMI (body mass index), a glucose test, total cholesterol screening, and haemoglobin. This service does require you to make an appointment please.

Good luck!

Warm regards

Angela

Angela Lombard Nursing Practitioner View profile

Dear H

Thank you for your query. The hCG range of 46 is perfectly normal and indicates an early pregnancy. The approximate hCG range for one week of gestation is between 5 - 50 IU/L. I hope that your pregnancy is a happy occurrence as I would like to wish you heartiest congratulations! How exciting for you!

Warmest regards

Angela

Angela Lombard Nursing Practitioner View profile

Many thanks for your query. A good approach is to allocate at least 3 months for vitamin supplementation (i.e. 90 days) to be taken prior to falling pregnant. This will really assist your body in preparing for a healthy conception. Once your prescious cargo is on board, you can continue as such and even after the delivery of baby. There are numerous supplements for this purpose.

The following are quality supplements you can consider :

A good multivitamin is always a must e.g. The VIRIDIAN PREGNANCY COMPLEX, taken as x2 capsules daily after breakfast. This product is free of gluten, wheat, lactose, added sugar, salt, yeast, preservatives and artificial colourings. Suitable for vegetarians. (In the Viridian range no bovine products are used, nor is any testing done on animals). Other alternative examples of quality multivitamins are CHELA-PREG by Arctic, and can be taken as x1 tablet daily after food. PREGNAVIT M by Georen Pharmaceuticals (Pty) Ltd is another alternative, and can be taken as x2 capsules daily after food, preferably breakfast. Don’t take your supplements on an empty tummy - your body will only absorb about 20% of the supplement and the rest will literaly pass right through you! Only one of the above need be taken for a multivitamin. These supplements contain folic acid which is essential for well developed brain tissue and prevents neural tube defects.

An omega supplement is essential. I always recommend MUMOMEGA Pregnancy by Arctic, and can be taken as x1 capsule daily . MEGA OMEGA by The Real Thing company, is an excellent alternative, and again only x1 capsule daily. An omega supplement will provide your baby with essential nutrients for healthy nerve and muscle tissue.

All of the above named products are stocked by our Wellness Warehouse stores.

When eating, it is important to remember that you are not eating for two (!), but in essence to eat correctly with a well balanced nutritional eating plan. Eat small meals often, don’t skip meals etc. Do eat your 7-9 vegetables (including salads) a day, 3-4 fruits a day (unless diabetic), drink at least 2 litres of water a day, and do gentle exercise like walking and swimming. Your dark green leafy vegetables like spinach, brocolli and green beans contain iron. The herb rocket, is loaded with iron and can be eaten on sandwiches, in salads and soups - my personal favourite! Vegetables and fruits contain natural antioxidants which support the immune system and among other things, help to eliminate toxins and chemicals from the body. If you are able to visit our food markets and cafe, you can only benefit from the healthy variety and quality available. Steer clear of too much of the ‘white’ foods like white bread, pastries, white sugar.

All of the above, with a good dose of patience added, can surely make it happen! Oh, and don’t forget to destress - vitally important in order for a pregnancy to happen.

All the best of luck! Warm regards, Angela, Nursing Practitioner.

.

Angela Lombard Nursing Practitioner View profile

Many thanks for your query. Yes indeed, our primary health care clinic does provide a family planning service at our Kloof Clinic in Cape Town. Please ensure that an appointment is made, so as to provide you with quality time. A 20 - 30 minute time slot is allocated for this type of request. The contact number is 021-4875420, and request the clinic. Alternatively, you can contact the clinic directly on 021-4875435 between the hours of 09h00 - 16h00, Monday to Friday. With kind regards, Angela, Nursing Practitioner.

Hi There,
I wanted to ask you how does one use an ovulation test kit.
I have been off Yazmin for just over 2months. I’ve been on contracetives for years (since 18years now 27) with healthy breaks between. I would like to try for a baby this year. I was very stressed out in the beginning as my body was constantly showing signs of pregnancy and the tests always came back negative. I think now after 2 months and two healthy 3-5 day periods my body feels a bit more stable and not so crazy befor a period is due. I’m also afraid that i’m not ovulating how do i know when is a good time to use the kits as they are quite expensive to constantly buy and waste. I had my last period on the 30th of Jan 22 days after the other period. My period last for 3-5 days. I have had a check in Oct, a scan of my ovaries and the Doctor was very pleased with the healthy bits although i was still on Yazmin then. Since then am off like i said for 2months at most and have picked up 2kg since Dec. I am not over wieght for my height and age, 27 years, 55.5kg. Should i book for a gynea appointment and what all must i ask her to look for? What do you recommend? I just personally want to know that my body is healthy and working well for one less thing to worry about so if it happens it happens to a healthy body you know. I am taking all the right vitamins and folic acid in prep for the day i concieve. So far its been a bit sad as friends have fallen pregnant 1month after stopping the pill and i’m going on month 3. Although i know we are all different, i am becomming less stressed out about it and have joined a gym and other hobbies to curb my stress involving conception.

Thank you Nurse Angela.

Angela Lombard Nursing Practitioner View profile

There are numerous ovulation kits on the market - I am aware of 10 that are currently advertised on the internet. As you have not mentioned the name and make of the specific ovulation kit which you have currently been using, I suggest that you go back to the instruction booklet/leaflet and follow the guidelines carefully. These kits are designed to be simple. Many questions have already been answered on this website about pre-conception, fertility, ovulation and pregnancy - I suggest that you check under “women’s health” on the Wellness Warehouse website at www.wellnesswarehouse.com It is great that you are eating correctly and taking your vitamins (i.e. a folic acid and iron supplement and a good omega supplement?). You also need to drink sufficient water, do gentle exercise, and de stress. Should you be in the geographical area of Cape Town or Claremont, I suggest that you make an appointment to see me so that I can do a wellness assessment for you, which is our own non-invasive medical check-up consisting of a blood pressure, height, body mass (weight), body mass index, a glucose test, a total cholesterol screen, and a haemoglobin (to check iron levels in the blood). A visual assessment is done at the same time.

Each woman is a unique individual, and falling pregnant can happen easily for some, and then it can take longer for others. This is a time when being patient can really be tested!

It may be a good thing for you to book an appointment to see your gynaecologist, depending on when you last had a check-up with a specialist of this nature. I do encourage all clients to consider having an annual pap smear (cervical smear) so as to rule out any potential problems. A cervical smear procedure can also be booked at our Well Clinics.

You are welcome to telephone me about any further queries you may have, or if you remain confused with the ovulation kit you are using, on telephone numbers 021-4875420/6737200 from Monday to Friday, between the hours of 09h00 - 16h00.

Kind regards, Sister Angela Lombard, Nursing Practitioner.

Gabriell (dr.) Prinsloo Medical Doctor View profile

It is great that your body is adjusting so well to being off the pill and your hormones are finding their natural balance so fast. While getting ready to conceive, it is important to stay relaxed, to exercise gently and to get enough sleep, and continue to take your vitamins!

Ovulation occurs around day 14 of the cycle (measured from the first day of your period). Eggs are viable for about 24 hours while sperm can live for up to 5 days. So there is a fertile period of about 5 days in the middle of the cycle.

Certain body changes take place when you are ovulating.

You may notice a series of lower abdominal cramps or twinges, usually on one side of the abdomen, that occur at ovulation.

Your body temperature will change at ovulation as a result of the change in hormones. Basal body temperature reaches its lowest at ovulation and then increases immediately by about 0.2 ° C. It will then continue to increase for a couple days afterwards. The small increase at ovulation is similar to the general fluctuations; however you will know when ovulation is in retrospect after seeing the large increase over the following days. You can buy a special thermometer that measures basal body temperature. This is measured first thing in the morning before sitting up or talking, after at least about 5 hours of sleep.

Your cervix and cervical mucous also changes at ovulation. Before ovulation there may be very little mucous production, while just before and at ovulation there are larger volumes of thicker, stretchy, slippery mucous. In addition before ovulation the cervix is low, hard and closed, while at ovulation it softens, pulls up and opens slightly. You can check this by feeling the cervix with one or two fingers.

However all of these changes need to be recorded over a few months to see the pattern, and then they only give a general guide as to when ovulation occurs.

Ovulation kits can be very useful. As your cycle is about 25 to 27 days and seems to be regular, then it is most likely that you are ovulating sometime between day 12 and day 14. I would suggest start using the ovulation kit a couple days before the predicted date and continue daily until you get a positive result. The other option would be to track your body changes over a few months using the other methods and then to use the ovulation kit to see exactly when you are ovulating.

Good luck!

Kind Regards

Dr Gabriell Prinsloo

Angela Lombard Nursing Practitioner View profile

Thank you for your query. The Clomid tablet is the most commonly prescribed fertility medication. Clomid should always be commenced on the 5th day of your hormonal cycle. An initial course of Clomid consists of a 50 mg tablet to be taken daily for 5 days. It is preferable to take each of these tablets at the same time, each day. Your gynaecologist would have taken a careful medical history from you, as there are a number of medical conditions which do not warrant the use of Clomid. Having a missed period, tender breasts with a negative pregnancy test could be one of two things, namely, that your pregnancy test was done too early before a two week gestation time span, or it is that ovulation has not taken place and yet there is still an overload of hormones in the systems due to taking Clomid, hence your signs and symptoms. Your signs and symptoms mentioned would be graded as being mild side effects of taking Clomid. Feeling dizzy warrants you having your blood pressure checked, preferably on the left arm as this is the cardiac side and is an accurate reflection, and a simple glucose test (blood sugar) done by means of the finger prick method with you having having fasted (nothing to eat or drink, except water and any medication you are on from 22h00 the previous evening) - try and do this at a pharmacy clinic first thing in the morning. Try and do this before you contact me so as to give me your results, if possible. You are very welcome to ‘phone me by all means. I am currently based at the Kloof Clinic at our Cape Town store on a Monday, Tuesday, Thursday and Friday from 09h00 - 16h00 on telephone number 021-4875420; and at the Cavendish Clinic in Claremont on a Wednesday from 09h00 - 16h00 on telephone number 021-6737200/7210. I look forward to helping you further! Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Thank you for your query. In total you have had 10 months plus of the 2 contraceptive intramuscular injections. With you having had the last injection administration in October 2009, you will have had 4 months of being off this medication. Either contraceptive injection can take between 3 - 6 months, given your particular case history, for the chemical components of the contraceptives to be released from the different systems of the body. I suggest that you give yourself a further 2 months to help release all chemical component buildup, thereby giving yourself a time span of 6 months which will then also help to re-establish a hormonal pattern and menstrual cycle. There are most definitely a number of supplements that you can take for preconception, which should also be taken during pregnancy and post delivery of a baby.

Many questions have already been answered on our panel website - replies to questions can be sourced under ‘women’s health’ on the Wellness question and answer panel.

You should consider taking a vitamin supplement with iron along with an omega supplement. At Wellness Warehouse our practitioners treat holistically, but by all means you are fully entitled to consult your gynaecologist.

Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Well done for persevering so far! It is important that your infection clears up completely, otherwise your immune system will be compromised. You do not mention the name of the pills your doctor prescribed, but I am sure that he/she would have prescribed medication for you that would be ‘safe’ should you fall pregnant at this time, so that there would be no danger for a potential pregnancy. Please try and be patient with yourself and relax as much as possible - once you relax, and not try so hard every time miracles can happen. You are welcome to make a time to see me so that we can reassess the whole situation for you from a holistic viewpoint, namely to look at you physically and nutritionally. Your gynaecologist’s advice has been correct so far with the approach he has taken. All the very best of luck! Kind regards, Angela, Nursing Practitioner.


Angela Lombard Nursing Practitioner View profile

I do hope that you feel more like your old self soon - however,
with the surgical procedures you have undergone most recently, you do
need to be a little patient in waiting for your body to recover, prior
to conception. After the DNC (dillutage and
curretage) you need to allow your body up to 6 weeks to recover, as in
allowing your hormonal cycle to settle down and to start regulating
again. During these 6 weeks and thereafter you can continue taking the supplements I previously recommended. Don’t feel down hearted should conception not take place before another 3 months - concentrate on preparing your body for a healthy conception and thereby healthy pregnancy. It is not unusual for a woman to wait for 6 months or even for up to a year. Just concentrate on obtaining your health back! All the very best of luck! I would love to know when it happens - take care now. Kind regards, Angela, Nursing Practitioner.

Reena Sukdev Homeopath View profile

Taking a probiotic is always useful and in fact can prevent and reduce the chances of allergies in babies. There are many good probiotics on the market. I would recommend either Amipro Ultra Flora or Udo’s Probiotics. Remember, yoghurt is also an enjoyable way to top up with probiotics. Fertility requires a comprehensive approach. Providing a strong nutritional foundation is one aspect. Viridian makes a comprehensive nutraceutical formula for men and for women to optimise fertility. One could also include herbs to assist. Vitex Agnus Castus could assist females, whilst a combination of Saw Palmetto and Ginseng will be useful in males. We have a comprehensive range of Chinese herbal formulas which will be useful as well. Be prepared to deal with the emotional side as well. Anxiety could be a major obstacle. Taking products such as Serenegan will be useful if this is an issue. Having a strong bonded relationship should also ease the matter and make for a more balanced preparation of pregnancy. All the best.

Regards

Reena (Homoeopath)

Sean (dr.) Gomes Medical Doctor View profile

Conception is different for every women and there are no fixed rules. Typically after having been on oral contraceptives for a prolonged time, one needs to leave at least 6 months for the normal cycle to return and for ovulation to occur on a regular basis. It is also important that you maintain a healthy lifestyle with a healthy diet, exercise and manageable levels of stress. Should you not fall pregnant after a 6 month period after being off all contraceptives it may be worth visiting your doctor to perform some hormonal tests to ensure that you are ovulating adequately. Kind regards and good luck. Dr Sean Gomes

Felicia Rubin Pharmacist View profile

I would most definitely recommend taking the supplements in the morning after breakfast. However Staminogro, is often prescribed by medical practitioners, to be taken at night. The reason being is that it contains a large range of amino acids. The Viridian fertility brand is an excellent product & am sure you will feel good taking it after your morning meal. Best wishes & good luck for the future. Regards, Felicia (Pharmacist and Natural Medicine Dispensary Consultant)

Angela Lombard Nursing Practitioner View profile

It
is vital that you consult with your gynaecologist about any query you
have while on his fertility treatment regimen. Your medical specialist
will have a certain approach for handling the symptoms you are
currently experiencing - please liase with him/her directly as
initially implementing a fertility programme requires a specific and
delicate balance of the hormonal system in preparation for conception.
Having spotting so early on with the commencement of Provera is an
indication that your hormonal cycle is out of balance, so you do need
to contact your doctor and inform him about what is currently happening
with you, while on the above prescribed medication. Kind regards,
Angela, Nursing Practitioner.

Sean (dr.) Gomes Medical Doctor View profile

Ginette is the generic contraceptive pill, schedule3, for Diane 35. This is a concentrated pill, and having taken it for 3 years, presumably without a break/rest, would then require your body an adjustment time span of 6 months minimum. But having said this, you may need at least one year in order to allow your body to fall back into sync hormonally. As you have already been on Clomid now on three different occasions, I suggest the following: 1) Hormeel S by Heel is a homeopathic tincture preparation - commence taking this remedy as 10 drops 3 times daily, in a little purified water of 50-100 mls. This remedy may help correct any hormonal in balance. 2) You should also be taking a supplement with folic acid e.g. the Pregnancy Formula by Foodstate, as x2 tablets daily after breakfast. 3) An omega supplement is also essential, like Mum Omega by Equazen. Take x1 capsule after supper at night. Both the Pregnancy Formula and the Mum Omega will ensure that your baby will grow healthy brain and nerve tissue. Clomid is the most commonly used and safest fertility drug - stay with it if you decide to take it again. Do all of the above - should you want to add to the above, I recommend that you take Fertility for Women by Viridian, as x2 capsules after breakfast or supper. Your husband could take the Fertility for Men as x2 capsules after breakfast or supper as well. Persevere, relax, take your supplements, make sure you get enough sleep and drink sufficient water. Try and be patient, and soon you may be asking me to babysit!! You are welcome to contact me for further advice and help. Should this not work, you will also need to visit your fertility doctor again. It is important that both you and your husband are fully assessed in order to find the exact cause of the infertility, should it persist so that you both can be treated. Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Diane 35 is a concentrated schedule 4 contraceptive pill. When this pill was prescribed for you, you were still very much in your formative puberty years. Your hormonal cycle would still have been settling down - your acne must have been quite pronounced to be put on this particular pill at such a young age. Also, it would have been advisable to give your body a rest from taking this pill every year for at least 3 months - this would have been the correct approach in caring for yourself while on Diane 35. As a result of taking Diane 35 for 4 years (I gather without a break) your body has become temporarily resistant to the ovulation process - this has caused an imbalance of the progesterone and oestrogen levels in your body. As a result of this imbalance in your hormonal levels, and with your present clinical profile, you could try the following natural products to assist your body achieve its normal hormonal levels again: Bioharmony by Doctor Patrick Holford has a nutritional supplement which can help put your body back in sync - Take Bio-Agnus Castus as the suggested dosage of x2 capsules, 3 times a day after food. You need to give your body at least 1-2 months on this product. Agnus Castus is also known as the Chaste Tree Berry and is used in supporting female hormonal health. It affects the pituitary gland by sending chemical messages to regulate the hormone balance in the body. Agnus Castus has been proven in clinical nutritional studies to help regulate oestrogen and progesterone and to treat an imbalance in female reproductive health. Bio-Agnus Castus will work iun parallel with your Norprolac medication, and will not interfere with the function of Norprolac. Start doing the above first, in order to regulate your hormonal imbalance, and then you can plan your family. For further advice please feel free to come and see me at either of the WellClinic’s at our Kloof or Cavendish Stores. Good luck! Kind regards, Angela, Nursing Practitioner.

Angela Lombard Nursing Practitioner View profile

Your case profile is a classic example of someone I would like to see for an appointment please. First of all, with you being a diabetic, I must stress to you that you do need to monitor your blood sugar with a routine daily glucose finger prick test, this is with you having expressed the wish to fall pregnant. Should your blood sugar not be within the normal value range (i.e. a maximum of 5.5 mmol/l for someone who does not have diabetes) and is too high or too low, an imbalance will be created and this could inhibit a healthy conception. A correct and healthy nutritional intake is essential along with an adequate water intake. I suggest that you make a time to see me at either of our Well Clinics and have a wellness assessment done - this is a non-invasive medical checkup to assess your blood pressure, body mass index (to ensure that your weight is concurrent with your height - being underweight or overweight can also serve as an inhibitor to falling pregnant), a finger prick glucose test and a total cholesterol screen is also done. Lifestyle change guidelines would also be discussed setting realistic goals for you. You have not mentioned when you stopped having the contraceptive injection or which one it was - both Nur-Isterate (the 2 monthly injection), and Depo Provera or Petogen (the 3 monthly injection) takes 3-6 months to be released from all the systems of the body - having said this, this is a guideline, as each person is a unique individual and you may take longer than the next person etc. Smoking and stress automatically causes undue strain on the body and can inhibit conception. Both blood pressure and blood sugar need to be stable prior to conception, and then carefully monitored on a regular basis once a pregnancy has been established. Nutritional supplementation can be discussed at the clinic appointment, specifically for diabetes, without harming a pregnancy. I look forward to meeting you! Take care and good luck. Kind regards, Angela, Nursing Practitioner.


Please Note:

The Wellness Q & A is for informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your health, you should always consult directly with your healthcare professional. Wellness Warehouse will not be liable for any errors in the Wellness Q & A, or for any actions taken in reliance thereon. The advice on the Wellness Q & A is not comprehensive and does not replace the assessment and advice of your own healthcare professional. Consultation with your healthcare professional is extremely important if you are experiencing persistent or severe symptoms.

Caution:

Consult your doctor, healthcare professional, and/or pharmacist before using any supplements or before making any changes in prescribed medications. If you have a chronic illness or routinely take prescribed or over-the-counter (OTC) medication, or you are pregnant or breastfeeding, it is extremely important to consult your doctor, healthcare professional, and/or pharmacist before taking any new medication. Do not stop taking any prescription medication without consultation and guidance from your doctor.

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