You’re ready to start a family, but after a few months of trying you still haven’t seen those two pink lines on a home pregnancy test. If you have been having unprotected sex for a few cycles without conceiving, you may be feeling like you want to do something about it—something that you can do right now without having to wait until the “right time.” Here’s one action you can take: Stock up your fertility medicine cabinet.
Ovulation Predictor Kits
Ovulation predictor kits (OPKs) are a relatively easy way to gauge your most fertile days. They range in technology from simple chemical test strips to electronic devices that monitor and record several fertility signs in your saliva, in your urine, or on your skin.
Standard OPKs: OPKs measure the presence of luteinizing hormone (LH) in your urine. The amount of LH in your system peaks 12 to 48 hours prior to ovulation. These kits pinpoint the LH surge, helping you anticipate your most fertile time an average of 36 hours in advance. Most kits contain five or six sticks, so time your testing window carefully based on the length of your cycle. Women with longer or irregular cycles may not find their fertile window with one kit on the first try. Costs range from $12 to $30 per pack.
Saliva Ferning Tests: These tests use a small microscope to examine the amount and appearance of sodium in your saliva. The test works by placing a bit of saliva on a slide and checking for any visual changes in the sample. When you approach your fertile time, the appearance of the salivary sodium “ferns,” thus indicating that ovulation is approaching. While these kits are relatively inexpensive, some people find it difficult to assess ferning. Costs range from $25 to $40.
OV-Watch Fertility Predictors: These wristwatch-sized, mini-computers monitor the level of chloride ions on your skin. A surge in chloride ions appears 24 hours prior to an estrogen surge, and two days prior to the LH surge, thus providing you with five days notice before ovulation. You wear the watch only at night, and no saliva or urine tests are required. The product includes a sensor good for one month of use, so additional sensors must be purchased separately. $150 for a starter kit, $40 for additional monthly sensors.
Clearblue Easy Fertility Monitors: These electronic devices use urine OPKs to measure both luteinizing hormone and estrogen. Since estrogen peaks a few days prior to the LH surge, monitoring both hormones provides several days’ warning prior to ovulation. Offering a wider “window of opportunity” can help couples feel less pressure to perform on demand.
The computer records your personal information from month to month, and clearly indicates when you are in a low, high, or peak fertility phase. This is particularly useful for women with irregular menstrual cycles.
Each kit comes with a three-month supply of 30 test sticks, and additional sticks must be purchased in increments of 30, making this device one of the more expensive options available. $180 for the monitor, plus $50 for each additional 30-stick pack.
OvaCue Fertility Monitors: These monitors measure the amount of electrolytes in your saliva to identify what the manufacturer calls “Cue Peak,” an event that indicates your prime fertility a few days prior to your LH surge. These sophisticated monitors record the fluctuation of electrolytes with a spoon-sized sensor you insert in your mouth every morning.
With the addition of the optional vaginal sensor, you can confirm that ovulation did, in fact, occur that month, a feature no other kit on the market offers. While this monitor is the priciest, particularly with the addition of the vaginal sensor, it does not require any additional monthly maintenance costs. $300 for the kit, $100 for an additional vaginal sensor.
At-Home Semen Analysis Kits
Many men dislike going to the doctor and may put off asking a physician for a male fertility workup. To address the need for privacy, pharmacies now sell at-home semen analysis kits. An at-home semen analysis test, such as FertilMARQ Babystart, can detect whether the concentration of sperm meets the 20 million sperm-per-milliliter thresholds set by the World Health Organization (WHO) for male fertility.
While this test is an accurate measure of sperm count in a particular specimen, sperm concentrations can vary greatly from sample to sample. When couples are tested for infertility in a medical setting, men with low concentration are often asked to repeat the test two to three times before their doctor diagnoses low-sperm count. In addition, these over-the-counter tests cannot identify other powerful factors that affect male fertility, such as motility (percentage of active sperm in a sample), velocity (movement of sperm in a straight line), or morphology (shape and size of sperm). The most advanced semen screening reproductive endocrinologists offer also examines the genetic quality and total volume of sperm per ejaculate. Consequently, a passing grade on an at-home semen test cannot guarantee fertility.
The good news is that a low-sperm count on an at-home test may convince your doctor to order more sophisticated tests that can pinpoint when and if you need medical intervention.
Herbal medicines appeal to some couples trying to conceive because natural products are perceived to be less invasive and to have fewer side-effects. Why not take blue cohosh, which is purported to regulate menstrual cycles? A few drops sound harmless, right? The answer is maybe, maybe not. Blue cohosh may increase the incidence of uterine contractions, a phenomenon that could interfere with implantation of a fertilized embryo or otherwise complicate an established pregnancy. Some studies have also shown serious heart and thyroid problems in infants whose mothers took blue cohosh to induce labor.
While practitioners of holistic Traditional Chinese Medicine (TCM)—a system of medicine that treats the whole person and not just the illness—use herbs frequently with much self-reported success, the use of herbs to enhance fertility is controversial according to Western medicinal standards.
Dr. Alison Zimon, MD, a reproductive endocrinologist at Harvard Medical School, says that there is “just not good data on whether these herbs are effective.” Dr. Zimon adds that “Even if some good data were available, the real fear is not knowing if these herbs and the other ingredients in these remedies could cause harm.” If you have already taken herbs, tell your physician right away. Many herbs reputed to increase conception rates (for example Chasteberry and Ginseng) can actually harm fetal development if taken in high doses.
Couples who want to optimize their systems for babymaking may wonder if specially designed fertility-blend multivitamins might help speed up the process. Many of these products are simply multivitamins with additional herbals, which have not been scientifically proven to increase fertility. “We have to remember that reproduction is a natural process,” says Dr. Robert Oates, MD, associate professor of Urology at Boston University School of Medicine. “Our Western diet is better than at any time in human history. It’s quite likely that we as a species are not so nutritionally dependent that a supplement would make the difference in our fertility, or we would never have reproduced.”
Given that these supplements are expensive, Dr. Oates, like most experts, recommends that both partners get as healthy as possible with a good multivitamin, regular moderate exercise, and a balanced diet instead of buying products specifically marketed for fertility purposes. One individual supplement, however, has a demonstrated positive impact on female reproduction: folic acid. An additional 400 mcg of folic acid for at least three months prior to conception is key to maintaining a healthy pregnancy and reducing the risk of neural tube defects in a developing fetus.
Having frequent intercourse on a babymaking schedule can hurt your libido, causing vaginal dryness in some women. Many works around this issue by using commercially available lubricants, which unfortunately have a pH level that creates a hostile environment for sperm. Some lubricants, such as Pre-Seed, advertise a sperm-friendly environment, but make sure to check the label for FDA warnings about the effect of your personal lubricant on actual conception rates.
The Hidden Ingredient: Patience
While the desire to have a baby is personal, infertility is a $3 billion-dollar-a-year industry complicated by leading-edge science, folk wisdom, difficult restrictions on research, a lack of regulations, and dubious marketing claims. Before dipping into your wallet to buy a faster route to conception, it’s worth noting that the vast majority of would-be parents do attain a pregnancy without medical intervention within a year of their first attempt. Quitting smoking, maintaining optimal health, and talking to your doctor about a preconception checklist will enhance your chances of conceiving speedily. And stocking your fertility medicine cabinet wisely won’t hurt.