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Eight Tips on How to Boost Your Fertility
October is National Infertility Awareness Month. Understandably, we appreciate the opportunity to educate the public about the issues and current developments in this area. The 2009 Annual Meeting of the American Society for Reproductive Medicine will be held in Atlanta from October 18-21. You can follow along on Twitter to see some of the issues that will be discussed as we enter #ASRM09 these days!
I want to share some tips on how to improve your fertility. This problem affects approximately 7.3 million women and men in the United States, representing 15% of couples in prime reproductive age.
I want to start with age because it’s one of the big ones. Women are born with 1-2 million eggs, and by the age of 37 they have 25,000 eggs left. How well you reproduce depends on several factors, but one of the most important is age. The quality of these eggs starts to deteriorate after 30 and even more so after 35 due to poor egg quality. Egg quality cannot be changed. Consider starting a family sooner rather than later. If this is not possible, the use of birth control pills can increase the viability of eggs in a woman’s ovaries by putting the ovaries into a dormant state. Seek help for infertility early rather than putting it off. If you’re over 35, create a well-defined, aggressive treatment plan with a specific timeline. Don’t let your doctor convince you that “everything is fine and you just have to wait it out.” Basically, I counsel my patients over 35 if they haven’t gotten pregnant after 6 months, see a fertility specialist for a full and thorough evaluation (which should only be 1-2 months), create a treatment plan at a certain time, and move on. through this plan sequentially. For example, if you start with ovulation induction and intercourse, use it for 4-6 months, then switch to IUI for only 4 attempts, then switch to IVF. As time goes on, your chances get less and less, even with IVF.
The key ingredient here is good health and exercise in the years leading up to pregnancy. It is recommended to exercise at least 5 hours every week. Good habits start early, but it’s never too late to start! In some cases, weight can also affect your ability to get pregnant, and being too much above or below your ideal BMI (Body Mass Index) can be harmful. Visit the National Institutes of Health website to calculate your BMI: http://www.nhlbisupport.com/bmi/. Aim for an ideal BMI, but don’t delay pregnancy to lose weight if you’re over 35.
A good diet before pregnancy is also important. It’s good to eat plenty 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 whole milk products, not skim milk products, are responsible for protecting against ovulatory infertility. Another interesting finding is that folic acid improves ovulation in women and sperm quality in men! It can be taken as a multivitamin and found in foods such as oranges. Eliminating trans fats in women with diabetes also seems to help. Moderate caffeine and alcohol intake is also important. Again, ideal weight is beneficial. No matter what anyone says, there are no diets or foods that “improve” fertility, but a healthy diet in general can help.
TIME SEXUAL ACTIVITIES
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 cycle is 25 days, ovulation is likely to occur around day 11 of your cycle. Your fertile period would then be CD# 9-13. Those are the days I would recommend intercourse. You must stop intercourse on CD#7 and wait until CD#9 to start. During these five days, have intercourse once a day, only one ejaculation per day. Start using ovulation kit CD #9 (counting back 16 days after the end of the average cycle). Remember that 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 with time is, make it fun NOT scientific! You husband will become a reluctant participant if forced. Don’t tell him, “Honey, my fertile time is sex again,” rather he shouldn’t even know. You should only set the stage to get him interested, excited and “horny”. That way you’ll both enjoy the experience and the rehearsal won’t be a chore.
GET RID OF THE SMOKING HABIT
Virtually all studies show that smoking impairs fertility. For women, 10 or more cigarettes a day reduces egg quality. Smoking after conception is associated with miscarriage and ectopic pregnancy. Men who smoke have a problem with lower sperm count and lower sperm motility, which means that sperm functionality is reduced. Even worse is smoking marijuana. Any chemical that enters your body enters your bloodstream, cells, and sperm and/or eggs. This is an absolute no! The same goes for other recreational drugs, including large amounts of alcohol. My rule of thumb is if it affects your brain cells then it affects your reproductive cells.
Couples trying to conceive can become stressed, especially if they have been trying for more than a few years. Yoga, acupuncture, massage and meditation tapes specially made for infertility patients all help. My patients are encouraged to use relaxation techniques. This helps them navigate the emotional ups and downs of the IVF process. Patients approach the day of the procedure much calmer, more relaxed, and this can significantly affect the course of recovery and transfer. Insurance may also be covered if an anxiety disorder can be proven. As mentioned above, make it fun and enjoyable, not homework.
SEE YOUR DOCTOR
You want a doctor who knows fertility all the time. Most of these types of doctors will be able to offer ALL levels of infertility treatment. Just like 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 they can do for you, Clomid or IVF. It is easy to check. . . just ask “what level and type of treatment can you give me?” Most importantly, infertility should be diagnosed and treated by a medical professional, not family doctors, nurse practitioners, PAs, or physician assistants.
IF ALL ELSE FAILS…
If your fertility journey is facing too many obstacles, you may need to explore other options. Keep in mind that if you fail to get pregnant naturally, it is NOT the end of the road. I advise my patients: “Nowadays we can get almost anyone pregnant, it just depends on what I 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 actually pinpoint where the problem is. 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 cause infertility problems for many couples.
A doctor’s diagnosis is necessary to effectively determine the best course of action for a couple trying to conceive. But don’t let your doctor just give you Clomid without a 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 something else is the problem and Clomid won’t change it. Make sure the treatment you are getting is for a specific problem. Ask your doctor to explain their strategy, why they are using the recommended treatment and what they are 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’ve seen who have had multiple cycles of Clomid or IUI only to find out that her tubes are blocked!
Above all, stay positive, we are here to help!
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