Will This Affect My Fertility?

Can you supplement cyclical progesterone with an over-the-counter preparation?

In a normal cycle, progesterone is secreted to adequate levels when there's been a decent ovulation. (That's why your temperature spikes after ovulation if you're tracking your fertility with basal body temperature.) Treating low progesterone after a faulty ovulation is only wishful thinking. It won't help a bad egg. In the rare case in which there's been an adequate ovulation but low progesterone, then progesterone will be useful to stabilize the implantation bed of the uterus for the fertilized egg. Repeated miscarriages may support this concern, but only a doctor trained for this can distinguish between the two instances of low progesterone.

Another thing to consider is that over-the-counter remedies aren't considered pharmaceutical-grade, and therefore they're understudied, unregulated, and somewhat unreliable. For something as important as conception, physician supervision of FDA-approved and FDA-scrutinized hormones are necessary. Especially if there's a problem with ovulation.

Dr. DiLeo says, "Infertility can often have many causes at the same time. Know what you're dealing with before throwing good money at it. For instance, what if your husband has prostatitis? This could affect the sperm count, dooming you to continued infertility while you're paying through the nose for progesterone creams sold by persons who may have no biochemistry background at all."

It's well known that smoking is bad for your heart, lungs, skin, and oral health. But what about your reproductive system?

Again we'll repeat the mantra: Act as if you were pregnant when trying to conceive. Quit smoking!

But for the nitty-gritty, consider this. The American Society of Reproductive Medicine says:

Virtually all scientific studies support the conclusion that smoking has an adverse impact on fertility. The prevalence of infertility is higher, and the time it takes to conceive is longer, in smokers compared to nonsmokers. Active smoking by either partner has adverse effects, and the impact of passive cigarette smoke exposure is only slightly smaller than for active smoking. Research indicates that cigarette smoking is harmful to a woman's ovaries, and the degree of harm is dependent upon the amount and the period of time a woman smokes. Smoking appears to accelerate the loss of eggs and reproductive function and may advance the time of menopause by several years.

Components in cigarette smoke have been shown to interfere with the ability of cells in the ovary to make estrogen and to cause a woman's eggs (oocytes) to be more prone to genetic abnormalities. Smoking is strongly associated with an increased risk of spontaneous miscarriage and possibly ectopic pregnancy as well. Pregnant smokers are more likely to have low birth weight babies and premature birth. The incidence of sudden infant death syndrome (SIDS) also increases in households where someone smokes.

Will the dietary estrogen in soy interfere with fertility?

According to Dr. DiLeo, soy is a source of isoflavones, which supply natural estrogen. If you consume enough, it is theoretically possible to overlay your normal cyclic hormonal fluctuations with a steady stream of dietary hormones and if this effect were strong enough it could disrupt ovulation and hinder fertility.