Selasa, 13 April 2010

Trying to conceive: How to take your basal body temperature

By Monica Beyer

If you've been trying to get pregnant for a few months with no success (or are even just starting out) you may want to look into charting your basal body temperature for important fertility information.

What is basal body temperature?

Your basal body temperature is simply the temperature of your body at rest. More specifically, it is the temperature of your body after a good night's sleep and before you get out of bed, move, roll over or have sex. In keeping track of your temperature and entering it on a chart you will begin to notice certain important clues to your fertility. The most valuable clue -- and the one that you will probably be the most interested in -- is your ovulation date. Knowing when you ovulate will enable you to know when to take a pregnancy test and after a few cycles you will be able to see the big picture of your reproductive health.

Why is it important?

In the physiologic foundation of basal body temperature (or BBT) lies a simple truth about hormones. There are several hormones at play during your reproductive years and they coordinate quite well in order to first ripen and release an egg, and then to nurture your womb's lining in preparation for a fertilized egg. The hormone that helps you determine whether ovulation has taken place or not is called progesterone. This hormone is responsible for raising your BBT just enough to allow for your uterine lining to become even more warm and inviting for that fertilized egg -- an incubator of sorts. And by charting your BBT you can usually determine when this has happened!

Getting started temping

You will need to look for and purchase a thermometer that is made specifically for taking your BBT. The reason that you probably don't want to use your regular fever thermometer is because it may not be quite as accurate as a BBT thermometer. One that is backlit and also which beeps when done is even better, such as this one from BD.

Quick charting tips

You should make an effort to remember the following guidelines when temping in order to remain consistent and to keep your charts as accurate as possible:

* Temp at the same time every day. Many women will set their alarm clocks, take their temperature, and go back to sleep (even easier if you have a thermometer that has a memory function). Even a half hour earlier or later may cause your results to be inaccurate and may render your chart unclear. We don't want that!
* Temp before you do anything -- especially before you get out of bed and use the bathroom. Just grab your thermometer and temp!
* If temping orally, don't eat anything or take a drink before you temp.
* Make sure, if possible, that you have had at least 3 or 4 hours of consecutive sleep before taking your temperature.
* If you don't have a thermometer with a memory function, keep a small notebook and a pen on your bedside table for recording your findings.
* You can take your temperatures orally, but if you find that you are a mouth breather or your temps vary based on the room temperature you might explore temping vaginally. Just be sure to maintain the location throughout the entire cycle -- changing from one to the other will keep your chart from being accurate.

Charting your temps

You can make your own charts with pen and paper -- or even on a computer, with a program like Excel. You can also find some pre-made (blank charts) in a very popular fertility book. Please check out Taking Charge of Your Fertility by Toni Weschler. Not only does it provide in-depth information on fertility, charting and making it all come together, it is full of hope and inspiration. You can also find software programs that will help calculate your ovulation date for you. Good luck!

Minggu, 28 Maret 2010

Babymaking 101: 10 ways to increase your chances of conception

Alisa Ikeda

Most couples spend so many months and years trying not to get pregnant that they assume getting pregnant is what happens the moment they relax. It can be disheartening to realize there's more to babymaking than discontinuing contraception. Here are 10 simple things you can do to stack the pregnancy odds in your favor.

Most couples spend so many months and years trying not to get pregnant that they assume getting pregnant is what happens the moment they relax. It can be disheartening to realize there's more to babymaking than discontinuing contraception. Here are 10 simple things you can do to stack the pregnancy odds in your favor.

1. Eat, drink and make baby
Zinc shortages in men have been linked to lower testosterone levels and sperm counts, so men should consume foods rich in zinc, such as lean meats, eggs, seafood and whole grains. Calcium and vitamin D may improve men's fertility, so drink your milk, Men. And sip that tea, Ladies. According to a 1998 study by Bette Caan at the Kaiser Permanente Medical Care Program of Northern California, women who drank more than half a cup of tea per day were seven times as likely to conceive during the three months that the study lasted.

2. Live clean and well
Abstain from alcohol, cigarettes (even second-hand smoke) and medications (prescription, over-the-counter and herbal), and steer clear of toxic chemicals, including household cleaners. Limit your consumption of chocolate and caffeinated sodas, teas and coffees. Excessive exercise and a very low body fat percentage can lead to fertility problems in women, so stay active, but don't overdo it.

3. Stay cool and hang loose
Sperm production is inhibited by overheated testicles, so men are advised to wear breathable boxers and loose-fitting pants, avoid soaking in hot baths or hot tubs and sitting in saunas, and even cut back on bicycling and rough sports.

4. Identify your window of opportunity
You've undoubtedly heard about various remedies to enhance fertility. While it's tempting to swallow those claims, you shouldn't take anything without first consulting your healthcare provider. Frankly, nothing makes a baby more effectively than simply timing intercourse with ovulation.

According to John R Sussman, MD, an ob/gyn in New Milford, Connecticut, and co-author of The Unofficial Guide to Having a Baby, babymaking is mainly a numbers game:

* You ovulate about 14 days before you get your period. "If your cycle length varies from 24 days to 30 days," says Dr Sussman, "then you can count on ovulating somewhere between Day 10 and Day 16."
* An egg only lives for 12 to 24 hours; intercourse after ovulation is usually too late.
* Sperm can live up to 72 hours; intercourse as much as three days before ovulation could still result in pregnancy.

Dr Sussman sums it up: "Your window of opportunity opens about three days before the earliest possible ovulation and closes about a day after the latest possible ovulation."

5. Use an ovulation predictor kit
Ovulation Predictor Kits [OPKs] are a great way to maximize your chances of conception, says Dr Sussman. These will help to quickly and accurately detects the increase in luteinizing hormone in your urine (LH Surge), which normally occurs 24 to 36 hours before ovulation. You are most likely to become pregnant if you have intercourse within 36 hours after you detect your LH surge.

Charting and tracking your basal body temperature (BBT) charting is another option recommended by some doctors.

6. See your caregiver
Schedule an appointment for a preconception checkup. Your caregiver will review your family history, make sure you're in good health, and will discuss your current contraceptive method. Many fertility experts recommend that a woman stop taking the birth control pill at least three months before she tries to become pregnant. This way, your cycles can return to normal, allowing you your best chance at achieving pregnancy and helping to more precisely determine gestational age if you do conceive.

If you have not already, you should talk to your caregiver about prenatal vitamins, and if she or he recommends them for you, begin taking them even before you try to conceive.

7. Time the baby dance
Dr Sussman generally recommends intercourse every one to two days within your window of opportunity. "Some people ask whether the sperm count suffers with intercourse every day. While that may be the case for certain men, it's not for all," he says.

A man's testosterone levels and sperm count are highest in the morning, so sex may be most productive then.

8. Choreograph the dancing
Not only does it matter when you have sex; it also matters how. According to some fertility experts, the missionary position (man on top) allows for deepest penetration and can deposit the sperm closest to the cervix.

Similarly, if the woman has an orgasm, her contractions may further carry the sperm into the cervix. Avoid artificial lubricants or oils; petroleum jelly, glycerin and even saliva, which can all kill sperm.

9. Stop babymaking and start lovemaking
When you're "trying," it's easy to let the mechanics of babymaking overshadow the romance of lovemaking. Unfortunately, stress can interrupt normal ovulation cycles in women, kill your sex drive, and can even cause men's testosterone levels and sperm count to drop.

If you want your baby's conception to be a loving and unforgettable experience, be sure you relax enough to enjoy it!

10. Seek help
Though it certainly can, conception doesn't typically happen overnight. So how long should you "try" before seeking intervention?

Many experts suggest waiting about a year after first trying to conceive, depending on your history, age and temperament. Says Dr Sussman, "Couples who have not conceived after three to six months of excellent timing should be offered at least a preliminary evaluation. Then there are couples who clearly haven't mastered timing or aren't in any hurry. They can comfortably wait for a year or more."

Sometimes the mere threat of intervention is enough to make sperm meet egg.

"I knew I would get pregnant as soon as I had that reproductive endocrinologist referral in hand," recalls Kelly Moronko, mother of one with one on the way in Riverside, California. "One week before my appointment I tested positive. I'd bet money that if I check my records the referral was approved the same day I ovulated!".

Minggu, 14 Maret 2010

The stress of 'trying'

by Real moms

It never fails... when you have a nice night out with your spouse, you end up fighting on the way home. Here is one womans account of an infertility seminar she went to... then her reaction to the stress, and the spat that followed in the car!

I had my infertility (IF) seminar this evening that was given by the Fertility Center I'm going to start going to. It was very informative and interesting. I already knew most of what they talked about from my research, but I think my husband learned a lot... Then dh and I got in a bit of a spat on the way home. I just got very emotional, like it was just all so scary and overwhelming? And it just hit me all of the sudden, and I started crying in the car, and he told me to just quit getting so upset like he usually does. It pisses me off, he just always seems to scold me for getting upset! I can't help being upset, and it's not healthy to let it all build up either. I told him I just have to let it out, I can't just go around pretending to be happy all the time just because he doesn't like to see me upset! Plus I told him that I wish he would be more involved in all this stuff, show a little more interest. Anyway, I think he will be now, he sort of understands what is happening better now. And he did say that he was sorry that I feel like he is scolding me. We'll see if he gets any better though.

Hi Kristin, Sounds like the meeting was definitely worthwhile. I'm sorry that you and your husband had a spat though. All that we have to go through with trying to conceive is so stressful. Maybe it was kind of hitting your husband about all that's involved too and that's why he wasn't more supportive? He could be at a much different spot in the whole process than you are. I know that I think about this stuff way more often than my partner and then have to remind myself that she's in a different place than I am and doesn't know or remember all of the terms that I use. I now write out the days of when things are going to happen (clomid, IUIs, pg testing, etc) so she can keep track and gave her a few books to read. It's helped her be more supportive. Anyhow, I hope that you and DH are able to both deal with all as best as you can. - Karen

As far as your husband scolding you, my partner does the same whenever I get too emotional. She says she is just trying to be strong for me, and trying to not let the emotional situation get out of control. She hates to see me cry, and thinks that's the way to stop me. But of course their telling us off just makes the whole situation worse doesn't it?! My partner is learning, slowly -- hopefully your husband will also. He does sound like a lovely man, and obviously really cares about you, he just needs more educating in how emotions work, about when it's a good time to cry, and how tears are healing. Of course nobody but us women really understand how bad we feel about not being able to get pregnant easily, that's why we need a board like this one. - Jenn

If there's one recurring theme apart from the obvious on these boards, it's that we think our men don't give us the support they always should. They get distressed or even angry when we're upset, and the more unhappy we are the less sympathetic they become, or APPEAR to become. I think they just get more and more helpless and less able to function when we are like that and then they feel scared and in adequate, but they always come up trumps when we really need there support. Emotionally they are SO different to us. So cry your tears when you have to, and discuss the the science bit with your husband if you can, but don't be offended by his wrong reaction. He LOVES you, and so do we. - Jane

I TOTALLY understand the emotions getting to us. I think our husbands and partners want to help us, and they feel helpless and it causes stress. I also know how emotions of "the moment" can get to us also. - Kim

My husband is very similar. The most upset I have ever gotten in this process was when they wanted to start me on FSH. I was just bawling like crazy and he kept saying, "So, what's the big deal?" We even had to go for a "booster consult" so the RE could explain the "risks" of FSH and all. I THINK maybe he got it a little then, but now it's been so long, I guess he has forgotten. I think you are doing everything right though. Hopefully you'll get your positive before the appointment. - Kerri

I wonder if all that info was just overwhelming to your husband, and as a result he took to arguing? I know it's awful, but sometimes I'm convinced men are just clueless! I know whenever I talk about the science behind all of the hormones and stuff (I'm a chemist, he is a words person -- NO scientific understanding), I'm sure all he hears is "Blah, blah, boobs, beer, blah, blah..." But maybe this will help him to understand more of what's going on, I hope! - Jodie

About your husband, they all are like that in the beginning. Firstly, they feel frustrated that they can't do anything. Then they really don't realise how much these hormones affect us. Believe me, they do get educated in the process, and they appreciate what we go through more in time. My husband used to be like that, "scold" me if I got very upset. I've broken down at least a couple of times in the doctors' office, and having the doctor say it's healthy to cry and perfectly normal, he is more at ease about that now. He also did not understand why invitro fertilization was so worrisome to me. He used to say it's not much more than an intrauterine insemination! Until we started the process, and now he is much more gentle with me. He does understand that the hormones wreak havoc with our emotions. And seeing me never complain about shots, he has become more appreciative of things. In this process, I'm glad to say we have become closer than we were before.

My husband isn't very supportive, and he gets mad when I get upset. I know how frustrating that is. It's normal to cry and you would have issues if you hold it all in, so I don't think that your response was anything but normal. - Sara

Bottom line is I KNOW our husbands and partners love us. They just don't know how to make it better for us, hence their "odd" reactions! But believe me, they are always there for you when you need them! - milli

Thanks everyone, you are all such great friends! Don't know what I would do if I hadn't found this board, honestly I think they would have carted me off with a straight jacket on by now! I have been really down and emotional today, and I have tears in my eyes from reading all your messages! What a sap I am! And I know that my husband loves me dearly, I should be happy that he is so strong and positive in all of this and doesn't break down all the time like I do. But sometimes I feel like he is too sure that it will just be an easy fix, and he won't look ahead to the future and think about the "what if's". I suppose it doesn't help to dwell on that stuff, but I want to be realistic here and think about how far we are willing to go and how much in debt we are willing to sink. I guess I just have to take things one day at a time. That's what he always says... perhaps just once he is right! - Kristin

Motherhood after breast cancer?

Research Australia

A quarter of young breast cancer sufferers have reported no discussion of fertility issues at the time of diagnosis, despite the possibility of infertility after treatment.

"Timing is everything," said Belinda Thewes, a UNSW PhD candidate in the Faculty of Medicine. "These women need more information when they are diagnosed about the effect that treatment could have on their fertility, so they can take appropriate steps to preserve it, if they want to."

The paper acknowledges that breast cancer in women who are childless at diagnosis is becoming more common. 10,000 women are diagnosed each year with breast cancer. Between 6 and 7 percent of those are under 40.

"Being diagnosed with a potentially life threatening illness is bad enough, but when you're younger there are other factors which need to be considered," said Ms Thewes. "The treatments that are used can affect a woman's fertility and this can be exceptionally distressing, especially for women who may not yet have children, but want to do so."

The research Fertility- and Menopause-Related Information Needs of Younger Women With a Diagnosis of Early Breast Cancer has just been published in the international Journal of Clinical Oncology.

"When I first started doing this research there were no younger celebrities who were diagnosed with breast cancer," said Ms Thewes, who was based at the Department of Medical Oncology at the Prince of Wales Hospital. "Since then, Kylie Minogue, Belinda Emmett and Jane McGrath have all been diagnosed. These women have raised awareness that young women do get breast cancer and that fertility may be an issue." The options for younger women who may still want to have children after successful treatment include using IVF prior to chemotherapy and using more experimental techniques such as freezing the woman's ovary tissue. A woman may not become infertile after treatment, but if she does, she may choose to adopt or use donor eggs or embryos. 228 women who were 40 or younger, with a diagnosis of early-stage breast cancer, took part in the study. All completed the questionnaire 6 to 60 months after diagnosis. The paper found that 71 percent of these women had discussed fertility-related information with a health professional, while 86 percent of them discussed menopause.

"While oncologists have extensive knowledge about cancer, they might not have similar levels of knowledge about fertility," said Ms Thewes. "We need to encourage a multidisciplinary approach."

The team is now developing some tools for younger women with a diagnosis of breast cancer to help inform and educate them about fertility preservation methods following diagnosis and the management of menopausal side-effects of breast cancer treatment. This multi-centre research was a collaboration between the Dept Medical Oncology Prince of Wales Hospital and researchers at 19 oncology clinics in NSW, Victoria and the ACT.

Midlife moms: How to conceive in your 40s

Joanne Kimes

Unless you're a high school virgin having sex for the first time under the school bleachers with a boy who claims he loves you but will never acknowledge you again after this encounter, getting knocked up can be an enormous challenge.

Modern choices

Getting a sperm and egg together may seem like a simple feat, but it requires the split second timing of a NASA moon launch. Plus, if you take that same high school virgin, tack on about twenty-five years, the "challenge" of conceiving becomes more like a miracle.

Generations ago, when Mother Nature had her way, girls would start popping out babies in their teens and continue to do so until they reached their forties. That's when either their aging reproductive organs would make conception difficult or they'd die of a toenail infection that went horribly awry. But now with the advent of birth control and antibiotics, women live much longer and can choose to delay having children for decades.

The aging paradox

Unfortunately, Mother Nature hasn't had time to adapt to these changes so a woman in her 40's faces unique challenges that can make conception difficult. For one, her cycle is irregular which means ovulation is more unpredictable. Also, her eggs are less viable which leads to more miscarriages and chromosomal abnormalities. And, she's had more time to develop conditions such as cysts, endometriosis, and fibroids that can add even more obstacles to the already overwhelming challenge.

But, that doesn't mean that a woman in her forties can't conceive and give birth to a beautiful baby. It just means she has to fight Mother Nature as she does with other aging dilemmas like covering her stubborn grays and smoothing out her wrinkles with Botox. On that note, here are ways to give Ms. Nature a run for her money so that you'll be swaddling your baby in no time:

Action plan!

1. See a fertility specialist as soon as you're ready to conceive. That way you'll know where you stand in terms of your overall reproductive health and your fertility level. Your partner should be checked out as well since it takes two to tango, as well as get knocked up. While you're there, learn about the available treatments such as hormone shots, artificial insemination and IVF so you can make an informed decision if need be.

2. Since a woman over 40 can have more hormone fluxes which can lead to an irregular cycle, it's more important than ever to know when you ovulate. To do so, get an ovulator predictor kit so you can predict your fertile days.

3. Keep a positive attitude and don't focus on the negatives. For instance, yes, you may have an irregular cycle, but it's also more likely that you'll release more than one egg each month doubling your chances of conception. And true, the odds of miscarriage and chromosomal problems are higher than when you were younger, but the odds of everything going right is still higher than anything going wrong.

Keeping the spark alive

Marla Hardee Milling

"I rushed downstairs to get a little hanky panky, and my-ever-so-gracious husband was still sleeping, so I proceeded to give him a back rub and try to rouse him a little bit. He was so unwilling. He told me, 'Oh honey, not now; we will do it tonight.' I told him that tonight might be too late. He was still unwilling to do his soldier boy duty for the day. I was so upset, I started to tear up. I know he wants a baby, too, but sometimes his sleep is just way too important," laments a visitor to the message boards.

Does this situation sound familiar?

Hopping into bed as often as you can when you first decide to conceive can be fun. But if you don't get pregnant right away, having frequent sex with your mate may cause one or both of you to suffer sexual burnout.

Loss of spontaneity
"Lately, I've been saying 'no.' I'm so tired and sore," says Erin Hewson of Austin, Texas. At age 33, Hewson says she worries about her window of opportunity to become pregnant. She bought a few ovulation predictor kits, but she doesn't want to keep shelling out bucks to buy the kits every month. Now she relies on her own intuition, as well as charting the days of her cycle, to figure out when she is ovulating.

"The only 'strategy' we've come up with is to do it every other day just before and during ovulation," says Hewson. "We also use a lot of Astroglide to assist in moving things along."

"Our sex is less spontaneous," Hewson continues. "My husband is more of a schedule keeper than me. I feel like it trivializes sex, and I wish we could get pregnant more naturally. We've been reduced to biology, it seems."

"Unfortunately, couples trying to conceive sometimes come to think of sex as a chore that they are doing just to try to get pregnant," says Dr. S�ndor Gardos, president and CEO of, a former fellow at the College of Physicians and Surgeons, Columbia University and a research scientist at the HIV Center for Clinical and Behavioral Studies. "Be sure to try to have sex every now and then just for fun and not only when you think the time is optimal for conception. If you allow sex to become a job, it can become very difficult to get back into the swing of things later on."

Re-ignite the flame
Don't put so much pressure on yourself to perform. The stress you create may actually be one of the reasons for your difficulty conceiving.

"Make time for 'dates' just like when you were first getting to know each other as a couple," says Gardos. "It can be challenging when you are trying to conceive to set aside quality time just to have fun, but it is vital if you want to keep sex exciting."

Lori Ramsey, a mom of four in Heber Springs, Arkansas, and owner of, says she and her husband suffered sexual burnout while trying to conceive their third child. But instead of giving in to the lack of desire, she looked for a solution.

"I purchased the book 101 Nights of Grrreat Sex by Laura Corn. We went out on dates during ovulation time to spice things up, and we tried to be spontaneous by not thinking about making a baby," says Ramsey. "There were months when I wouldn't even mention the fact that I was ovulating. The month I conceived, we had decided to give up on trying."

Underlying issues
Too much sex may not be the only reason some women start resisting their husbands. Aline Zoldbrod, Ph.D., author of Sex Talk: Uncensored Exercises for Exploring What Really Turns You On (New Harbinger 2002), says there are important, deep dynamics underlying women's sexual burnout during infertility.

"We have reason to believe that most women grow up with a 'someone will be growing inside me some day' identity that is essential to female sexual identity," says Zoldbrod. "Commonly, women feel alienated and disgusted by their uterus, and, by extension, their vaginas and clitorises, for not performing. But in order to become aroused and orgasmic, women need to focus on sensations in just those body parts that they hate."

"Do a meditation where you remind yourself that the whole reason you wanted a child to begin with is because you love your mate so much," Zoldbrod says. Make a list of all the sensual and sexual activities you really like, particularly those that are not focused on intercourse. Have your partner make a similar list. Go over the lists together and see which activities would be mutually pleasurable."

Try new things
When you make your list, don't forget to add some suggestions that may be new to you or your partner. How about watching a steamy movie together?

"Men may need to combat sexual burnout by stimulating themselves visually during times of scientifically timed intercourse," says Zoldbrod. "Both partners can check into watching erotic movies by Candida Royalle, who makes movies with story lines and don't objectify women."

Or maybe you could benefit from some props. "Sex toys are a wonderful way to relieve sexual burnout and boredom for couples trying to conceive," says Gardos. "The nice thing about sex toys is that they are just for fun. Unfortunately, when you become so focused on trying to get pregnant, it can be hard to have sex simply for pleasure. Sex toys can lighten things up and allow you to explore new sensations and ways of relating with your partner. If you've never tried sex toys before, this may be the perfect time. You may even learn something new that stays with you even after you become pregnant."

It can be very discouraging when month after month you get a regular visit from "Aunt Flo." But instead of spiraling into depression, use this time to get closer to your partner. Communicate, share fantasies, cuddle with each other -- just relax and let sex become as exciting and fun as it once was.

How many times should you DTD on your fertile days

Mark Kan, MD

Making a baby can take a little more time than we might expect, so when do we know when it's time to seek help from a specialist? Obstetrician/Gynecologist Mark Kan explains. (Have a question for our fertility expert or another advisor? Send it to us here!)

Your question:
I checked an ovulation calendar and it said I was most fertile during 2 consecutive days. Should we try numerous times throughout those 2 days, or just once per day or what would be best? I heard that you shouldn't have sex everyday when trying to conceive. Does this stil apply during those ovulation days?

The expert answers:
Studies have shown that the best time to attempt intercourse for conception is the just prior to the release of the egg.

Ovulation occurs approximately 36 hours from the onset of the LH surge and 12 hours from the peak of the LH surge. When using home electronic ovulation monitors, the last day of HIGH fertility to the first day of PEAK fertility is best.

The egg may live up to 24 hours and the sperm up to 3 days.

Attempting conception every day or every other day will give you a good chance around those times, provided you try before the egg is released.