Eight tips on how to increase your fertility

The month of October is National Infertility Awareness Month. Understandably, we appreciate the opportunity to educate the public on current issues and developments in this field. The 2009 annual meeting of the American Society for Reproductive Medicine will be held in Atlanta from October 18-21. You can follow us on Twitter to see some of the topics that will be discussed by going to #ASRM09 on those days!

I would like to share some tips on how to improve your fertility. This problem affects about 7.3 million women and men in the United States, which represents 15% of couples in their prime reproductive years.

AGE

I want to start with age, because it is one of the greats. Women are born with 1-2 million eggs and at the age of 37 they have 25,000 left. How well it reproduces depends on a number of factors, but one of the most important is the factor of age. The quality of those eggs begins to deteriorate after age 30, and more significantly after age 35, due to poor egg quality. There is no way to change the quality of the egg. Consider trying to start your family sooner rather than later. If that’s not possible, continuing birth control pills could extend the viability of eggs in a woman’s ovaries by putting the ovaries at rest. Seek help for infertility problems early instead of putting it off. If you are over the age of 35, develop a well-defined, aggressive treatment plan with a set schedule. Don’t let your doctor assure you that “everything is fine and you just need to wait it out.” Basically, I advise my patients over the age of 35, if there is no pregnancy after 6 months, see a fertility specialist for a complete and thorough evaluation (which should only take 1-2 months), create a treatment plan in a set amount of time and move through that plan sequentially. For example, if you start with ovulation induction and intercourse, use for 4-6 months, then go to IUI for only 4 attempts, then go to IVF. As time goes on, your chances are getting smaller and smaller, even with IVF.

HEALTH

The key ingredient here is good health and exercise in the years leading up to trying to conceive. It is recommended to exercise for at least 5 hours each week. Good habits start early, but it’s never too late to start! Weight can also affect your ability to get pregnant, in some cases, and being too above or below your ideal BMI (body mass index) can be detrimental. Check the National Institutes of Health website to calculate your BMI: http://www.nhlbisupport.com/bmi/. Try to have an ideal BMI, however, do not postpone pregnancy to lose weight if you are over 35 years old.

diet

A good diet before you begin your efforts to conceive is also important. It makes sense to eat lots of fruits and vegetables, but did you know that dairy products and yogurt have been found to be equally important? A Harvard Medical School study suggests that full-fat, not low-fat, dairy products are responsible for protecting against ovulatory infertility. Another interesting finding has been that folic acid improves ovulation in women and, in men, sperm quality! It can be taken as a multivitamin and found in foods like oranges. Eliminating trans fats in women with diabetes also seems to help. Moderate intake of caffeine and alcohol is also important. Once again, the ideal weight is beneficial. No matter what anyone else says, there are no diets or foods that “enhance” fertility, but a healthy diet can help in general.

TIMED SEXUAL ACTIVITY

Many couples trying to conceive use over-the-counter ovulation kits. However, there are a few things to keep in mind. Most women ovulate 14 days before their next period. For example: If your cycles are 25 days long, you will most likely be ovulating around cycle day 11. Your fertile window would then be CD# 9-13. Those are the days I would recommend having sex. You must stop intercourse at CD #7 and wait until CD #9 to begin. Have sex once a day in those five days, only one ejaculation per day. Start using your ovulation kit on CD #9 (counting back 16 days from the end of your average cycle). Remember, once the egg is released from the ovary, it is only receptive to sperm and can be fertilized for about 12 hours. If you have irregular cycles you may have another problem and need to see a specialist to determine what is going on. But the absolute bottom line over time is this, make it fun NOT scientific! Her husband will become a reluctant participant if he is forced. Don’t tell him, “Honey, it’s my fertile time again, we need to have sex,” he shouldn’t even know. You just need to set the stage for him to get interested, excited and “warmed up”. That way, both of you will enjoy the experience and it won’t be too much of a chore to try.

PATA THE TUXEDO DRESS

Virtually all studies show that smoking impairs fertility. In women, 10 or more cigarettes a day reduces the quality of the egg. Smoking after conception has been linked to miscarriages and ectopic pregnancies. In men who smoke, there is a problem of lower sperm count and lower sperm motility, which means less functionality of sperm. The worst is smoking marijuana. Any chemical that enters your body enters your bloodstream, your cells, and your sperm and/or eggs. This is an absolute no no! The same goes for other forms of recreational drugs, including large amounts of alcohol. My rule of thumb is that if it affects brain cells, it also affects reproductive cells.

RELAX

Couples trying to conceive can get stressed, especially if they’ve been trying for more than a few years. Yoga, acupuncture, massage and meditation tapes made specifically for infertility patients are of great help. My patients are encouraged to use relaxation techniques. It helps them get through the emotional ups and downs of the IVF process. Patients approach the day of the procedure in a much calmer and more relaxed manner and it can make a difference in how well the recovery and transfer goes. Going to see a therapist for massage therapy or meditation therapy may also be covered by insurance, if an anxiety disorder can be shown. As mentioned above, make it fun and enjoyable, not homework.

EXAMINE YOUR DOCTOR

You want a doctor who knows fertility from start to finish. Most of these types of doctors will be able to offer ALL levels of infertility treatment. Just as you don’t want a doctor who only does Clomid, you don’t want a doctor who only does IVF. You will be pushed into the only thing Clomid or IVF can do for you. It is easy to spot this. . . just ask, “what levels and types of treatment can you do for me?” Most importantly, infertility should be diagnosed and treated by a specialist physician, not by general practitioners, nurse practitioners, PAs, or physician assistants.

IF ALL ELSE FAILS…

If your fertility journey is running into too many obstacles, you may need to explore other options. Keep in mind that if you don’t get pregnant naturally, that’s NOT the end of the road. I advise my patients: “Nowadays, we can get almost anyone pregnant, it just depends on what you have to do to get pregnant.” There are many reasons why a woman or man may be infertile and a visit to a good fertility specialist will certainly narrow down or pinpoint where the problem lies. Treatment often varies from person to person, so don’t expect to find the answer in a forum or chat room. Blocked fallopian tubes, high FSH levels, abnormal sperm count or low motility, all these and more explain the infertility problems in many couples.

A diagnosis by a physician is necessary to effectively identify the best course of action for the couple trying to conceive. But don’t let your doctor prescribe Clomid for no good reason. Clomid is NOT a miracle drug. It has a specific purpose, which is to induce ovulation in women who do not ovulate. If you have regular cycles, it is a sign that you are ovulating. That means the problem is something else and Clomid won’t change that. Make sure the treatment you are receiving is treating a specific problem. Ask your doctor to explain his strategy, why you’re using the treatment he recommends, and what he’s treating. Treatment without a specific reason is a waste of time and money, as is treatment without completing a full infertility evaluation. I can’t tell you how many patients I have seen who have been on multiple cycles of Clomid or IUI only to find out their tubes are blocked!

Above all, stay positive, we are here to help!

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