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Eight Tips on How to Boost Your Fertility
The month of October is National Infertility Awareness Month. Understandably, we appreciate the opportunity to educate the public regarding issues and current advances in this field. The annual meeting of the American Society for Reproductive Medicine 2009 will be held in Atlanta October 18 – 21. You can follow along on Twitter to see some of the issues that will be discussed by entering #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, representing 15% of couples in their prime reproductive years.
I want to start with age, because it’s one of the biggies. Women are born with 1-2 million eggs and at the age of 37 they still have 25,000 left. How well you reproduce depends on a number of factors, but one of the most important is the age factor. The quality of those eggs starts to deteriorate after 30, and more strongly after 35, due to the poor egg quality. There is no way to change egg quality. Try to start your family sooner rather than later. If that’s not possible, staying on birth control pills can extend the life of the eggs in a woman’s ovaries by putting the ovaries to rest. Seek help for infertility problems early rather than putting it off. If you are over 35, create a well-defined, aggressive treatment plan with a set timeline. Don’t let your doctor assure you that “everything is just fine and you just have to wait for it to happen.” Basically, I advise my patients over 35, if no pregnancy after 6 months, see a fertility specialist for a complete and thorough evaluation (which should only take 1-2 months to complete), make a treatment plan in a fixed time and move through that plan successively. For example, if you start with ovulation induction and intercourse, use that for 4-6 months, then move to IUI for only 4 attempts, then move to IVF. As time goes by, your chances only diminish, even with IVF.
The most important ingredient here is good health and exercise in the years before you try to conceive. It is recommended to exercise at least 5 hours every 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 much above or below your ideal BMI (body mass index) can be harmful. See the National Institute of Health website to calculate your BMI: http://www.nhlbisupport.com/bmi/. Aim to be at an ideal BMI, however, do not postpone pregnancy for weight reduction if you are over 35.
A good diet before you start your efforts to conceive is also important. It makes sense to eat enough fruit and vegetables, but did you know that milk products and yogurt have been found to be just as important? A Harvard Medical School study suggests that whole milk products, not skim, are responsible for protecting against ovulatory infertility. Another interesting finding is that folic acid improves ovulation in women, and in men, the quality of sperm! It can be taken as a multi-vitamin and found in foods such as oranges. Eliminating trans fats in women who have 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 can generally help.
TIMED SEXUAL ACTIVITY
Many couples trying to conceive use over the counter ovulation kits. There are some things to keep in mind though. Most women ovulate 14 days before their next period. For example: if your cycles are 25 days, you are likely to ovulate around cycle day #11. 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 for CD #9 to begin. Have intercourse once a day on 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 you should see a specialist to determine what is going on. But the absolute bottom line with timing is this, make it fun NOT scientific!! Your husband will become a reluctant participant if forced. Don’t tell him, “honey it’s my fertile time again, we should have sex”, rather, he shouldn’t even know. You just need to set the stage to get him interested, excited and “horny”. That way, you’ll both enjoy the experience, and trying won’t be a chore.
KICK THE SMOKING HABIT
Almost all studies show that smoking impairs fertility. In women, 10 or more cigarettes a day reduces egg quality. Post-conception smoking is linked to miscarriages and ectopic pregnancies. In men who smoke there is a problem of lower sperm counts and lower sperm motility as well, which means lower sperm functionality. Even worse is smoking marijuana. Every chemical that goes into your body goes into your bloodstream, into your cells and into your sperm and/or eggs. This is an absolute no no! The same with other forms of recreational drugs including large amounts of alcohol. My rule of thumb is, if it affects your brain cells, it also 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 made specifically for infertility patients all help. My patients are encouraged to use relaxation techniques. It helps them through the emotional ups and downs of the IVF process. The patients approach the day of the procedure in a much calmer, relaxed way and it can make a difference in how well the pick-up and transfer goes. To see a therapist for massage therapy or meditation therapy can also be insured, if it can be shown that there is an anxiety disorder. As mentioned above, make it fun and enjoyable, not homework.
SCRUTINIZE YOUR DOCTOR
You want a doctor who knows fertility inside and out. 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 stuck in the only thing they can do for you, Clomid or IVF. It is easy to screen this. . . simply ask, “what level and types of treatment can you perform for me?” Most importantly, infertility should be diagnosed and treated by a medical specialist, not general practitioners, nurses, PAs or medical assistants.
IF ALL FAILS…
If yourfertility journey meets too many roadblocks, then you may need to explore other options. Keep in mind that if you fail to achieve pregnancy naturally, that is NOT the end of the road. I advise my patients, “Nowadays we can make almost anyone pregnant, it just depends on what I have to do to achieve the pregnancy”. There are many reasons why a woman or man can be infertile and a visit to a good fertility specialist will certainly narrow down or actually find where the problem lies. Treatment often varies from person to person, so don’t expect to find the answer on a forum or in a chat room! Blocked fallopian tubes, high FSH levels, abnormal sperm count or low motility, all these and more account for infertility problems in many couples.
A diagnosis by a doctor is necessary to effectively identify the best course of action for the couple trying to conceive. But, don’t let your doctor just put you on Clomid without a good reason. Clomid is NOT a miracle drug. It has a specific purpose, which is to stimulate ovulation in women who do not ovulate. If you have regular cycles, that 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 receive treats a specific problem. Ask your doctor to explain his/her strategy, why they use the treatment they recommend and what they treat. 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 been on multiple cycles of Clomid or IUI’s only to find out their tubes are blocked!
Above all, stay positive, we are here to help!
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