Question:

I am 39 years old and have polycystic ovaries, endometriosis and cysts in the thyroid. How can I fall pregnant without IVF?

Answer:

It certainly sounds as though you have a lot going on and it is essential that you see a suitably qualified practitioner with advanced fertility training to assist you as best as possible.

Most importantly it is not impossible to conceive naturally. The human body is designed to conceive when it is at its healthiest to protect the genetic information that is passed onto the next generation. You do have a few issues that are against you with respect to natural conception; however, it is not impossible but would require you to make a number of health changes and work closely with a practitioner.

As we age, our gametes (eggs and sperm) age as well. The fact remains that the older your eggs are, your risk of successful conception (either with IVF or naturally) reduces. What happens is that any underlying tendencies or health deficiencies exacerbate over time. For example, your thyroid may have caused you to have weight stabilisation issues in your twenties and early thirties; however, your thyroid symptoms would likely advance in your late thirties and are expected to advance further in your forties and beyond. Through the ageing process everything progresses this has a negative impact on one's fertility.

What you need to focus on is what has caused these health deficiencies and remedy them as soon as possible for your long-term fertility and general health.

If I review your health symptoms individually:

Polycystic ovaries will need to be correctly diagnosed and you need to determine the hormonal pattern associated. That means there is a hormonal imbalance (FSH to LH) or are there high androgens (testosterone, SHBG) or are the ovaries simply polycystic with no hormonal influence. Are you at your healthiest weight? Weight is one of the most positive modulating treatments we have to regulate polycystic ovaries (if indicated). Additionally, weight stabilisation has significant positive effects on improving fertility and increasing the chance of natural conception. At all times though, please don't focus on losing weight if you don't need to!

As for endometriosis, simple recommendations are again tricky as this is a really complicated condition and everyone presents differently. For example, you could have stage one endometriosis whereby simple dietary modification — avoidance of dairy products (cow's milk especially), soy products, caffeine and sugar — has all been shown to produce dramatic improvements in symptoms for endometriosis sufferers. If, however, you've been classed as having stage two to four endometriosis, I suspect that higher treatment protocols will be required.

As for thyroid cysts, it's another tricky one to comment on as I'd need to know your thyroid profile and what symptoms you have.

My suggestion is to see someone about this. From a self-empowered perspective, adopt general preconception healthcare principles (I have a few great articles summarising this on my website) and focus on general health strategies such as exercise, clean diet, clean lifestyle, lovemaking as opposed to baby making and time intercourse effectively.

For more information please visit Leah Hechtman's website.