Fertility Expert Answers Questions From Youtube
All right, it’s Q&A time. That’s right. This is one of the favorite episodes that I love to record, which is taking your questions that you’ve posted and answering them live right here For all of you on Fertility TV. We’re going to be getting into some of the most popular questions that you guys have asked, all about fertility, your menstrual cycles, getting pregnant, everything having to do with helping you get pregnant.
So these first three questions I’m going to kind of group together because they kind of piggyback on one another, and these have to do with menstrual cycles. And so the first one says, Casey asked, “Can you talk about how to get my period back?” Or, the period back, in her case? And Tay says, or asks, “Thank you Dr. Sklar, for the information. I currently don’t have a cycle.” We want to get that back. “What are your recommendations for how to go about doing the labs?” This is a little bit different.
And then the last one is how to get periods started, and I’m going to add at the end of that, again. So all of this really ties in together. First thing is, obviously we want to have a regular menstrual cycle, without a regular menstrual cycle, we don’t ovulate regularly, and without knowing when we’re ovulating, then you know it’s difficult for us to time intercourse appropriately and get pregnant, or at least have a chance of conceiving. So we want to make sure that you are menstruating and having a regular cycle.
If you’ve gone months without it, we need to figure out why. The first thing I like to say about this is, often I find that big stressors impact your menstrual cycle. And so my first question typically is, “Well, what did you do, or what changed when your cycles disappeared?” And I’d like to go back at least two or three months prior to that to see what may have contributed to that. Did you start new supplements, something that might impact your hormones? Did you start medication? Was there a big stressful event that happened?
Those are all things that you need to be mindful of when we’re looking to get our cycles back. Without understanding why they went away, it’s hard to make the necessary changes to bring them back. Which brings me to that second question is, well, what about doing labs when we don’t have a cycle? So I want to make sure that if you’re not having a cycle, we need to look at your hormones so that we can also understand what needs to be supported. So part of the puzzle that needs to be figured out to get those results is looking at your lab work, but to do your lab work, normally I say you need to do those at certain times of your cycle. This is the exception.
This is when I want you to just go ahead and do the labs whenever they are. Let’s get that information back. Let’s start to support those areas that need to be supported. And then later on when your cycle’s back, we can retest those hormones at the right cycle day. So hopefully that helps to answer that group of questions, and at least gets you moving in the right direction.
The next question that I want to answer is from Deborah, and she says, “I would love more videos or information about implantation failure. I feel like this is my issue. 10 early miscarriages, four kids, two after 40. I do all the right things, both hubs and I are healthy weight, active, lots of supplements, healthy diet, labs are great for our age. So even if I did IUI and IVF, still might not work if implantation isn’t happening.”
I want to agree with her first on that last point. If there’s an issue with implantation or those issues that are contributing to a miscarriage or all those miscarriages, because 10 is a lot, are not addressed and figured out, then going through with an IUI or an IVF is pointless in my opinion. You’re just kind of wasting time and money. So I would not recommend that.
I do appreciate her thought process here about implantation failure. I think that can be something that definitely needs to be looked at. There’s lots of reasons that could contribute to implantation failure. We want to look for infections in the uterus, maybe any abnormalities in the uterine cavity, maybe an autoimmune issue, maybe a blood clotting variable. Those are some of the big things that come to mind.
Now, we could maybe potentially start to rule out some of those things because she’s had four children,
even with all the multiple miscarriages.
I kind of break this down into two separate areas. So if those miscarriages all happened after at least having one child, then there are things that can arise after a pregnancy that can make it more difficult for subsequent pregnancies to maintain and have early losses. And that’s where I start to think of, did something happen during the first pregnancy, or is there anything going on with her thyroid, which is a common issue that happens postpartum and with secondary fertility issues. And then also I start to think of immune issues. I’m not saying blood clotting variables can’t be a concern here, but those are the things that I start to think of.
When we’re looking at other reasons for implantation failures, we do want to look and rule out any infections inside the uterus. So this is where we might want to dig deeper. She might want to do an ALICE or an EMMA test, or an EFT, or even a microbiome analysis of the uterine and vaginal microbiome. Those are all reasonable things to look at and to start to rule out. But I typically say you’re going to need more guidance and support here, so you’re going to start to want to work with someone who can help support you and look at the whole history, gather all your full information and really guide you and point you in the right direction in terms of steps one, two, and three. Hopefully that was helpful, Deborah.
Before I get into the next question, I do want to remind you all that if you’ve got questions about what I’m commenting on, post those below. If these spark other questions for you, go ahead and post those below as well and I’ll do the best I can to answer them. So Amber asks, she says, “Hello. Are you able to work with couples where not only does the female have low AMH and autoimmune, but also the male is shooting blanks and trying to take medication to stimulate it?” The answer is yes. We work with both men and women in my hope coaching program. That is something that is really important, actually, even if she didn’t mention anything about her husband or partner, we would evaluate everybody, both sides of the equation to make sure that everything is taken care of, looked at properly, and that we are confident that everyone is performing on a reproductive level appropriately.
So yes, these are things we can address, AMH, autoimmune issues and male factor or sperm quality are all things that are in our wheelhouse and something that we support on a regular basis and have seen really positive results as well. So yes, Amber, that is something that we do. If any of you, including Amber, want more support and want to find out more about my coaching program, you can use the link in the description below to apply, talk to one of my team members to see how we can support you, and if you’re a right fit for my program.
Okay, question number four. I think it’s number four. Britney asked, “What are your thoughts on PRP?” I’ve done a lot of different videos on PRP, in general, I think really positively about it. I think there’s a lot of positive aspects to it, but with everything, there’s a couple of things that we need to take into account. One is who’s doing the PRP? What kind of provider, what sort of experience do they have? What kind of results do they normally get?
I would rather be working with a clinic that does a lot of PRP. The other piece is, we think of PRP as one type of procedure, and I think of them as four or five because there’s variations to them. So depending on where you’re going, what sort of variation do they offer and which one’s best suited for you, which also should be factored into what kind of results you’re going to get. And, do you qualify? Are your hormones, your cycles, are these appropriate for the given circumstance?
I also want to mention with PRP, it’s not just about ovarian PRP, it could also be uterine PRP. There was a question about implantation earlier, and if there’s anything going on inside the uterine cavity, PRP may be something to consider as well, depending on what that situation is, to help with the endometrial lining and hopefully helping with implantation. So in general, I like PRP, but we do need to make sure we’re working with the right team, the right provider to make sure we’re getting the right kind of PRP for our situation. We can even take that a step further, which I won’t go into in this video, but there’s even stem cell treatments, which we can’t do in the United States. True stem cell, cultured stem cell, but may be appropriate for some of you watching as well.
All right, question number five. This one’s a little bit long, so stick with me here. She says, “Dr. Sklar, love your content. It has been so educational.” You’re welcome. I’m glad it has been. That’s the point. “Can you explain what may cause delays in a cycle? Soon to be 36, I have been tracking my cycle for about two months to get more familiar with it. Cycle usually varies between 30 to 33 days. This month I noticed I got my LH peak on day 19, but my BBT didn’t peak until day 24, five days later. It was a slow progressive rise in temp. Is there anything I can do to bring ovulation closer to day 14? Should I be concerned about ovulating later in a cycle? Should I test hormones just in case?”
So I’m going to go backwards here. Should I test hormones just in case? If you haven’t had your hormones tested, you know me, if you watched any of my videos, I believe you should have your hormones tested. So yes, so let’s make sure you get your hormones tested. If you haven’t, that’s essential. The other point that I want to bring up here is if your cycles are normally 30 to 33 days, and now your cycles are longer, this one cycle, I don’t know that I would worry too much about it. That can happen for a lot of reasons.
I know it’s typically concerning when something changes in this fashion, but I’m not one to jump at one little shift and change everything I’m doing for that reason. So I like to let this cycle be, make sure we have a bleed, see what the length is. Then at that point, let’s see what happens the next cycle. If the next cycle replicates this one, it’s also later than you normally have. So in your case, longer than 30, 33 days by a considerable amount, I’m not saying by just 34 or five days. Then I do think there’s something to be looked at here and evaluated.
There’s lots of reasons why a cycle can shift. One is stress. Two is, many of you might not realize it, but women can cycle together. And if you’re spending a lot of time with women that are on a different cycle than yours and their hormones are a bit, let’s just say stronger than yours, they can pull you to cycle with them. So those are just two reasons why. And medication, other variables. So I would say let’s just see what happens next cycle before we jump to conclusions, and then decide what actions need to be taken. With that being said, again, if you haven’t had your labs done, I suggest getting those tested.
Okay. So as you can see, there’s a lot of nuance and details to these questions, based on each one of you as an individual, and I hope you could recognize that, there aren’t just these grandiose blanket statements that can be made that can answer everyone’s fertility questions. Each one requires a little bit more detail and nuance, and that’s just the tip of the iceberg when we start to address these fertility issues.
Diving deep into your fertility is something that I hope all of you want and actually why you’re here watching. And more importantly, I also hope that’s why you’re here, to find the root cause of what’s contributing to your fertility struggles and why you’re asking these really important questions. So if you want more information on how I can support you, how you can dive deeper and get to the root cause of your fertility struggles, then again, I want to invite you to apply, to join my Hope Coaching program, speak to a member of my team who can really understand your situation and learn and determine if our program is good and well suited for you.
So if you want to do that, use that link just below. If you like this video, give me a thumbs up. If you’re not already a subscriber to my YouTube channel, please subscribe by hitting that bell and getting notified when I put out another video for all of you. I also want to leave you with a video on the top things that you can avoid when you’re trying to conceive, to help you start to take the next steps on
your fertility journey. You can get that link, again, below as well. And until the next video, stay fertile.