Posts By: Brendan
Clomid (aka Clomifene Citrate) is one of the most common ‘fertility’ drugs in the world and often the first choice of doctors looking to help their patients ovulate ‘better’.
It’s often used in a sort of “shur try it and see” approach.
Ask anyone on the street how it works and anyone who even knows about it will say something like “doesn’t it make you ovulate?”.
Yes…indeed. But how?
It’s a class of drug called a SERM, or a Selective Estrogen Receptor Modifier, in that it ‘modifies’ certain (or select) estrogen receptors, those being the ones in your hypothalamus!
It’s your brain that dictates how much estrogen your body should produce at any given moment. It does this by first tasting the blood to see how much estrogen is already in it. (Like a good chef tastes for salt!). Specifically, it’s the hypothalamus part of your brain that does the tasting. There are estrogen ‘taste buds’ on your hypothalamus, otherwise called estrogen receptors.
Clomid blocks these taste buds so that your brain can no longer accurately tell how much estrogen is in your blood.
The result of this is that the signal to stop producing estrogen doesn’t fire, or in technical terms the Pituitary gland does not get the signal to cut back on the amount of Follicle Stimulating Hormone (FSH) it is pumping out…so it continues to pump it out…and pump it out…and pump it out until the levels of FSH rise much higher than normal in the body.
FSH rises because Clomid has blocked it’s ‘off-switch’!
Soon after taking a few high doses of Clomid, the ovaries become bathe in FSH which hyper stimulates the follicles in the ovary to grow and attempt to ripen.
You could say it forces the ovaries to ripen some eggs!
For some people this is ‘job done’ ovulation happens, pregnancy follows, but for others it doesn’t work at all. Often Clomid is used in advance of IVF to help produce a cluster of eggs that can be harvested, tested and fertilised with a sperm in a petri dish. Again, for some it works fine, for many it doesn’t.
Why does it not work sometimes?
There is no easy answer to this, but the general answer is that women who are availing of this treatment are already dealing with underlying dysfunctions in their bodies, however the dysfunctions are different for different women. They may all have issues ovulating, but the causes for this are very varied.
To give just one example – let’s say a woman was having trouble ovulating because, out of a multitude of possible reasons, she was chronically tired – and so her cortisol production was compromised. Cortisol is necessary for many functions in the body but if your levels are lower or higher than you need them to be, then certain functions will be affected. One of these functions is egg maturation because you need a certain degree of cortisol to produce a viable egg.
But if you are low on that hormone then forcing your follicles to mature eggs is not going to fix that. Clomid cannot fix that problem!
Another issue with force-ripening eggs is that you may not have the nutritional raw materials to produce a healthy egg, this may be the reason for failed ovulation in the first place. In this case Clomid may well succeed in making your ovary produce a clutch of eggs, but that doesn’t mean they will be healthy or capable of sustaining fertilisation or pregnancy.
The bottom line is Clomid works for some, but in my world the best solution is to address the underlying issues first. If that doesn’t work then Clomid may be a viable tool to get you over the hump! (No pun intended!)
Regardless of your religious faith it’s true to say that one of the biggest benefits of spirituality and religion is that it connects us to something bigger than ourselves.
The idea that we surrender to God seems, at least on paper, to be an expression of weakness. It’s as if we have so little faith in ourselves (to cope with whatever we are facing) that we must give up any notions of our own strength and just let God take care of it all for us.
On the other hand, the idea of ‘surrendering’ in the face of complexity is a realistic acknowledgement that life is bigger than us and that try as we might we don’t actually have total control over what happens. There’s a self-evident reality to this, and yet we spend a lot of energy resisting it.
Many elite solider outfits are trained to accept death before a big mission. This is a similar idea, and it actually increases the odds of success and survival!
Surrendering control is a tacit acknowledgment that we are mortal, that we are limited and that we really do need help solving big problems, yet the very act of facing big problems with the intention of solving them (and thus making the world a better place) is an expression of our innate greatness as human beings.
We have it in us to do amazingly complicated things, to overcome deep problems and to leave a mark on history that would not have been left had we not risen to the occasion.
And yet surrendering, an act that seems so weak, is the beginning of our real power.
“I can’t reach the branch Dad” says my 10-year-old daughter, “can you lift me up?”
… … “There you go” … and off she climbs fearlessly into a massive tree!
You’re facing infertility but you realise suddenly that you don’t know much about it, or about how to fix it, or about the options available to you.
You decide to go and check out your options, so you start looking – but where exactly?
Do you go to the doctor first? Why?
Dr Google is always available and will certainly provide you with many choices, but now the real problem arises – the problem of choice!
This supplement or some of them? This clinic or that? This book or one of those?
It’s head wrecking having so may choices, but there is a biological counterpart to this too.
It takes A LOT of energy to make decisions. Many people are now suffering from decision fatigue which is affecting the quality of their lives.
Deep in our core body there are millions of decisions being made every moment that require a lot of energy to carry out. The number of these decisions increases exponentially if you dial in other issues such as – nutrient deficiencies, cellular damage, inflammation, a medical condition or a basic functional issue like constipation. As the level of internal decisions multiplies so to does the level of energy required by the body to make these decisions.
Eventually the body reaches decision fatigue. One symptom of this is infertility – it’s the body dealing with issues in the now, thus unable to make decisions about the future.
My program “return to fertility” helps you get your body to a place where it needs to make less sub-conscious decisions, but to get on to that program you need to make one big conscious one.
The chances of success on any route you take are slim enough, that’s a hard reality, but all your options carry greater rates of success once you get your body to a place where it needs to make less decisions. This is the key to success, alas most of you will soldier on making one separate decision after the next and increasing the level of internal (sub-conscious) decisions your body must make just to keep you going!
The most effective decisions you can make are those that minimise the number of future decisions you will have to make!
I use the analogy of the map and the compass regularly with my clients, so it’s not surprise that Seth’s Blog inspired me today.
It’s the essence of understanding how the program ‘Return To Fertility’ is successful.
A constant theme in the program is that of bring your inner guidance system back online or fixing the ‘offset’ in your compass. This literally means getting your thoughts and goals straight, getting your hormone system balanced and functioning normally and being able to read your gut instincts more effectively.
But what about the Map? What about the terrain you are attempting to navigate?
This comes in two forms: 1 is your body and its internal terrain, and 2 is the field of infertility and how you need to navigate your way through it to find the best options so that you achieve your dream of having children.
You literally have to steer your body through unknown or incompletely understood situations before it arrives at a place where it is aligned and ready to become pregnant.
There are lots of elements to line up for this to work.
The terrain you are crossing needs to be figured out as you go, and your course corrected as you get feedback that you are going in the wrong direction. But the key to this is to get your inner compass working well so that you can realise when you are going in the wrong direction and when you are going in the right one.
The confusing part for many people is realising that your right direction is not the same as someone else’s right direction. Another way to say that is the map is not the same for everyone!
Thus, the key to is all is the compass.
As Seth says…
“Happy endings come from an understanding of the compass, not the presence of a useful map.
If you’ve got the wrong map, the right compass will get you home if you know how to use it.”
I couldn’t agree more!
Being infertile is a tough place to be.
You might need to get several different aspects of yourself working better before your fertility comes ‘back online’, but you may not know what those things are.
It’s pretty much a universally true phenomena with my clients that something about their world view is part of the mix of ‘stuff’ that needs to be fixed before they can restore fertility.
That’s a weird thought though, isn’t it!
Our worldviews hold such a powerful grip on us, they pretty much dictate our decisions, and our direction in life, they even create much of our personality – so much so that it’s often impossible to know where ‘we’ start, and our worldview ends. It seems like we are one and the same, but we are not.
An accurate though simplistic way to conceptualise a worldview is as a frame of mind and emotions that colour how we carry on in the world, meaning how we interpret and react to everything that happens to us. Our worldview is like a lens through which we see life.
Grow up in crime-alley and you will be more likely to tense up whenever a stranger walks up to you – but grow up in the Hamptons and your interpretation of strangers is much different.
If you think of worldviews as something that gets created in our minds by virtue of the experiences we have which get loaded on to one side of a scales or the other such that positive experiences tip the scales one way and negative experiences tip it the other way, then how your internal scales are leaning at any given moment in your life, is based on the overall weight of the combined negative and positive experiences you’ve had in life.
Simplistically put, some people are predominantly negative in outlook due to a list of negatively interpreted experiences that get place on one side of the scales, whereas others are predominantly positive in outlook due to a list of positively interpreted experiences that load the other side of the scales.
A negative outlook makes it more likely you will shy away from challenges in favour of creating a predictable life, whereas a positive outlook allows you to have the juice to take on new challenges, thus you will more likely create a life of variety.
The key though is to realise that it is our interpretation of what happens that matters – not the event itself, but there is unfortunately, circular issues afoot here – a negative worldview makes it more likely we will interpret new events negatively, so it becomes self-reinforcing.
This is a huge problem, and if you are facing infertility the last thing you want is a negative worldview because this is wired directly to your hormonal system. If you see the world negatively your hormones will have no choice but to take on a defensive posture (as does your physical body often), and this posture is anti-fertility in nature.
I would go so far as to say that you cannot fix a fertility problem if your mind is coloured by a negative worldview.
To solve the problem, you must first identify what your worldview is by asking yourself if it is defensive, on alert, or in some way causing you to generally see things negatively or stress-fully. Then you must create a new picture in your mind, or a new feeling in your heart of the future you want, then you must conjure up that picture or feeling so regularly that it becomes familiar to your nervous system.
After you ‘familiarise’ your system with this new future idea of yourself, you do it again with a new picture or feeling that you desire to make real. This could be you playing with a new baby on the carpet and loving it, or it might be imagining yourself with a pregnant bump, but it could be whatever you want. Doing this will eventually familiarise your nervous system with the good life you want and allow you to melt away barriers that prevent you from achieving it. If you are following what I am saying here, you will realise that many of the barriers preventing you from getting pregnant are internal. They are related to your beliefs and to unexamined assumptions you hold that are related to your worldview and which cause you to veer off the path of truth – so to speak!
I’ve just summarised an incredibly powerful book for you that has nothing to do with getting pregnant but could just carry the day for you if you have the courage to put it into action!
Life provokes people to continually take on more.
Jobs, relationships, families, hobbies, sports, community activities, social engagements, overtime, church work, extra study, following the news, social media, back to college, moving up the ladder, home building, political activism, environmental concerns, fitness regimes…and on and on it goes.
We start out with some idea of what we want in mind, but eventually Mission Creep sets in and we find ourselves over-committed, not where we really want to be in life and unclear what our path should be, but worst of all we don’t even know it’s happened.
This describes a lot of my clients. Good people, with a strong work ethic and a can-do attitude – doing too much of something and not enough of another.
Sometimes you have to hit a wall before you realise you were not looking where you were going.
Sometimes cancer is that wall, sometimes it’s a broken relationship, and sometimes it’s infertility.
How hard you hit it depends on your level of self-awareness, and the actions you take on a regular basis.
We only have so much energy and we don’t know how much time we have.
Tune into your body, focus on your mission, resist the forces that cause it to creep off track, save your energy for what really matters to you.
The Wall is coming.
I learned a lot from “The Road Less Travelled”, by M. Scott Peck.
I learned that no matter what path you take it will be hard, and that once you come to terms with this life gets a lot better – despite being hard. Coming to terms with this reality is one of the best things I ever did, though it took me a long time. I’m a slow learner!
Once you realise that every action you take is the result of a decision, you come to accept that there is no neutral position to take in life.
If you ‘go’ there will be consequences. If you ‘don’t go’ there will be consequences.
If you hold off deciding because you are afraid to ‘go’ – that’s a decision, you have decided and there will be consequences.
If you decide to ‘go’ because you are afraid to not go, that’s also a decision, albeit a clearer one.
I like the way Jordan Peterson put it – it’s less about being courageous and more about choosing to be afraid of the right things.
If you do nothing different to what you have been doing, what do you think the chances are of solving your fertility problem?
Are you afraid of never having a baby, or are you afraid that you might realise too late that you could have been doing something more to solve the problem?
Are you afraid of the right things?
It’s so frustrating to watch a woman do a whole lot of hard work to prepare her body to have a baby, only to see the guy not step up to the plate and try to solve his own problems, or at the very least do what he can to improve his own health in advance of conception.
I accept that men generally don’t really understand how important the health of their sperm is not only for conception to happen, but to the long-term health of their kids. They are hardly told about it by doctors, who are not told about it in medical school.
To use just one example of published science, it is known that a fathers age at the time of his child’s conception has an influence on longer term outcomes like autism and schizophrenia in the child. To understand this, you have to appreciate that the age is simply a marker for sperm health, or sperm damage, and that ANY sperm damage or ageing that occurs will likely produce similar effects.
Some men’s lack of willingness to play their part in promoting optimal fertility used to bother me no end until I came to understand better why it happens. This really allowed me to help my male clients much better.
This is what I see as being the issue:
It’s a biological fact that men are not as tuned into fertility as much as women are.
One of the most common reasons men give for not being able to complete the work on my fertility program is that they are too busy with their work.
This makes total sense, but it makes better sense to call it as it is and to acknowledge the truth, which is – “Right now I prioritise my work over having a family”.
Every guy has a total right to do this, no question, no judgment. If that’s the truth that’s the truth.
With rights come responsibilities though, exercising ones right to not pursue a family just yet may mean reneging on a previous promise, even if that promise was unspoken. Being in a committed relationship with a women IMPLIES the intent to have kids, unless otherwise agreed.
Also, one may have to read between the lines sometimes. For a guy – not being ready may mean that something has changed in the relationship, but they haven’t said it. If this is the case then so be it, but it needs to come to the surface. It can’t just be that the guy frustrates all efforts to have a baby by not taking positive action hoping the issue will just go away or the clock will run down.
Men know intellectually that a woman can’t wait forever, but they don’t seem to know this intuitively. I didn’t, I thought we could wait until things were more aligned, till we were better prepared, till we had more money or till our minds were in the right place to think about kids. Lucky for me my wife was having none of that.
Serious straight communication is needed here. Couples need to say out straight what their intentions are, what their dreams are, what their fears are. The first two are easy for guys, but the last one is hard. The irony of it is that for most guys (or at least the ones who live with decent women) the very act of sharing your fears will promote a bond of trust and deepen your friendship, it can lift the tide of any relationship and even in itself can free you from false assumptions. Just doing this alone can sometimes resolve infertility issues.
Beating infertility is a team sport. Your job as a man is to have your woman’s back, to make her feel safe and secure – part of this involves being open and honest about your intentions, first to yourself, then to herself.
Dragging your heels is not an expression of male energy, it’s an expression of confused energy. Being clear and decisive and straight up is an expression of male energy because it requires having the guts to deal with things properly, and even with the fallout.
If you don’t want kids just yet – fine – but at least come out straight and say it.
I have never encountered a couple with infertility who had made a decision to try nothing to fix the problem until they got more clarity on the situation.
I’m sure they exist, but every client that uses my program has already gone far down a road of trying things before they find me.
The thing is it would be better on balance to do nothing until you knew more about what the issues were, because good intentions don’t always translate to good outcomes. There are hundreds of possible interventions a couple could try in an effort to solve their problem and get pregnant…and some of them will help, some will be neutral but lots of them will actually make things worse.
Even a safe bet like cutting out ‘bad food’ can backfire because people classify bad food differently.
Saturated fat is one such case.
Sugar and processed sweet foods you would imagine should be universally good to cut out right? On balance I’d say yes, but some women are underweight and even dropping bad food means dropping calories that help maintain their current weight. Being underweight is a bad idea for fertility, as is being overweight, but the complications are different. Underweight is more associated with infertility than overweight, which in turn is more associated with pregnancy complications!
But what about simple vitamins? Surely a decent multi is a safe bet, right? More often than not I would say yes, but still there are some people who have genetic or metabolic differences that can create problems if they take the wrong form of a vitamin or too much of it.
People can take niacin (vitamin B3) and feel better but soon run into issues with neurotransmitter imbalances that bring on depression.
People can take bog standard folic acid only to end up jittery due to an over production of some compound in the blood.
Why is it all so complicated? To answer this, you must recognise that if you already have infertility it means you are more likely to possess metabolic characteristics different from the norm, therefore you are part of a – let’s say special – cohort of people. You could be statistically ‘normal’ (meaning your key body functions operate within the standard distribution norms), but you are more likely to fall outside this or be on the fringe, and therefore issues like I mention above (plus a dozen others) are more likely to be relevant to you.
To put that in simple terms, a regular person is probably fine doing any of the above things to help fertility, but a person who is infertile is more likely to set themselves back by doing the same things.
You might see this as being dealt a bad hand of cards, but I see it as an invitation to learn and to grow.
I’ve been told by some clients over the years, when they were going through a very difficult dark time and full of fears and doubts that they’d prefer to have a disease like cancer because at least they’d know what is wrong.
But I see it differently. From where I stand, I see people with infertility being more willing to confront it than are people with cancer. The motivation seems different. Many cancer sufferers lie down and die…or give their power over to the medical system (which is a symbolic version of lying down to die), and ultimately, they don’t embrace change and thrive as a result of their experiences. Many do, but most don’t.
It’s different for people with infertility…most of them fight, but more of them are willing to look introspectively and change.
The flip side of this is that more of them will end up making bad decisions based on the endless peddling of simple solutions for infertility.
Are there safe things one can do to help?
Yes, totally. Yoga, walking regularly, relaxing, becoming aware of your breathing, honestly assessing your career to see if it suits you or not. These really do help.
The mirror image of having the right to make your own choices is the acceptance of the consequences of making them, and even more poignantly the consequences of not making choices.
“The Endless” now there’s a whacked-out film!
Good though…full of sub stories and thought-provoking metaphors.
It opens with the statement “The oldest and strongest emotion of all is fear of the unknown”.
This is the fear that keeps us from changing – not from wanting to change – but from actually going on a journey that will change us.
Simple as it sounds the thing that keeps us from changing is familiarity – our attachment to the old familiar feelings of everyday life.
The challenge is deceptively huge. We can’t solve our problems by doing the same thing over and over (the insanity argument!!) so if we are to succeed, we must do things differently, ie we must change.
And here’s the conundrum we all face – we want to change, there’s an impulse inside us all urging us to do it – but we fear the unknown, yet even when we muster up the courage and actually venture into the unknown, we find it near impossible to unshackle ourselves from the loops of our lives with which we’ve become so familiar. Fear & Familiarity – it’s a double whammy!
I wonder if this is what makes it easier for an emigrant to make a better go if it in a foreign country? They are forced to break out of their old patterns, to think new thoughts and do new things!
On the other hand, “wherever you go, there you are”, the same head, with the same habits.
Sometimes it takes catastrophe (or the threat of it) to shake us out of our old familiar habits and into a new way of looking at life.
Funny thing is we now have so many stories from people who have faced the unknown, who have been changed by it, and who are totally grateful for the experience, I wonder why we still fear it?