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!".
http://pregnancyandbaby.sheknows.com/pregnancy/baby/Babymaking-101--10-ways-to-increase-your-chances-of-conception-5668.htm
Minggu, 28 Maret 2010
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
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.
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.
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.
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.
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.
Boxers or briefs - does it make a difference?
Wanda Steele, RNC
Does the type of underwear your partner wears have any real bearing on whether or not you will be able to achieve pregnancy? Obstetrical Nurse Wanda F Steele has some information.
Your question
We have been trying to conceive for seven months now and no luck. My husband asked if it could it be due to the fact that he wears briefs. Does this really matter? - Lyn
The expert answers
Hi, Lyn -
I know seven months may seem like a long time but when you are talking about infertility problems, but I'm afraid it isn't. Most doctors recommend that you start checking for a problem if you have not become pregnant after a year of "trying." When you consider everything that has to occur in the proper order at the proper time, etc., it is amazing that any eggs get fertilized!
I know that not getting pregnant when you want to be is not a laughing matter, so let's talk about your husband's underwear. It has been shown that men who wear briefs may have a possibility of a lower sperm count than men who wear boxers. The scrotums and testicles of men who wear briefs are at or are near body temperature, and they can produce a few less sperm. The reason for this is that the scrotum, by design, was made to hang down and not be up against the body, thereby keeping the testicles at a lower temperature than the rest of the body. Boxers allow the scrotum and testicles to be in the proper anatomical position for optimum sperm production.
I am certainly not advocating the use of any one style of men's underwear. After a proper sperm count is done on your husband and you have been thoroughly checked out, then the matter may be worthy of further consideration.
Good luck,
Does the type of underwear your partner wears have any real bearing on whether or not you will be able to achieve pregnancy? Obstetrical Nurse Wanda F Steele has some information.
Your question
We have been trying to conceive for seven months now and no luck. My husband asked if it could it be due to the fact that he wears briefs. Does this really matter? - Lyn
The expert answers
Hi, Lyn -
I know seven months may seem like a long time but when you are talking about infertility problems, but I'm afraid it isn't. Most doctors recommend that you start checking for a problem if you have not become pregnant after a year of "trying." When you consider everything that has to occur in the proper order at the proper time, etc., it is amazing that any eggs get fertilized!
I know that not getting pregnant when you want to be is not a laughing matter, so let's talk about your husband's underwear. It has been shown that men who wear briefs may have a possibility of a lower sperm count than men who wear boxers. The scrotums and testicles of men who wear briefs are at or are near body temperature, and they can produce a few less sperm. The reason for this is that the scrotum, by design, was made to hang down and not be up against the body, thereby keeping the testicles at a lower temperature than the rest of the body. Boxers allow the scrotum and testicles to be in the proper anatomical position for optimum sperm production.
I am certainly not advocating the use of any one style of men's underwear. After a proper sperm count is done on your husband and you have been thoroughly checked out, then the matter may be worthy of further consideration.
Good luck,
Timing of pregnancy may predict baby's gender
There's still no way to choose the sex of your baby, but Dutch researchers say they have found a way to better predict whether an expectant mom is having a boy or girl by looking at the timing of her pregnancy.
"Some people really want one or the other," says Patrick Weix, MD, obstetrician and gynecologist on the medical staff at Baylor Medical Center at Irving in Texas. "We obviously don't make any promises, but we just do our best to see if we can tell accurately what they're having," says Dr Weix.
A new study by Dutch researchers found a mother may be able to look at the timing of her pregnancy to predict whether it's a boy or girl well before an ultrasound can.
"In the study, if it took the woman longer to get pregnant then they actually had a higher percentage of boys being born," notes Dr Weix.
More specifically, the researchers found that for couples conceiving naturally, each additional year of trying to get pregnant was associated with a four percent increase in the likelihood of having a boy. Why? The answer is complicated, but it has to do with the differing swim rates between the male and female sperm.
"If there is a difficulty, if this becomes sort of the rate-limiting step, if there's a little bit of a hurdle than it's going to favor the male sperm," Dr Weix says.
Previous studies have also supported the results of this most recent research. Experts remind parents that a four percent increase in the likelihood of having one sex or the other is still very small.
"Some people really want one or the other," says Patrick Weix, MD, obstetrician and gynecologist on the medical staff at Baylor Medical Center at Irving in Texas. "We obviously don't make any promises, but we just do our best to see if we can tell accurately what they're having," says Dr Weix.
A new study by Dutch researchers found a mother may be able to look at the timing of her pregnancy to predict whether it's a boy or girl well before an ultrasound can.
"In the study, if it took the woman longer to get pregnant then they actually had a higher percentage of boys being born," notes Dr Weix.
More specifically, the researchers found that for couples conceiving naturally, each additional year of trying to get pregnant was associated with a four percent increase in the likelihood of having a boy. Why? The answer is complicated, but it has to do with the differing swim rates between the male and female sperm.
"If there is a difficulty, if this becomes sort of the rate-limiting step, if there's a little bit of a hurdle than it's going to favor the male sperm," Dr Weix says.
Previous studies have also supported the results of this most recent research. Experts remind parents that a four percent increase in the likelihood of having one sex or the other is still very small.
When trying to get pregnant, how long is our window of opportunity?
Jane Forester
If you're trying to conceive (TTC), you probably wonder when is your most fertile time -- and how long does that "magic moment" last? Family Physician Jane Forester has some information for you.
Your question
When you're trying to get pregnant, how long is the "window of opportunity" in terms of conception? How long can the egg live, and how long can sperm survive? - Joyce in Englewood,Colorado
The expert answers
To determine your "window of opportunity" for conception, you must individualize your own menstrual cycle.
For several months prior to wanting to conceive, you need to track your length of menstrual cycle. Whether 24 or 32 days, it doesn't matter regarding fertility, it just helps with planning. Besides the easiest way to determine ovulation, which is with an ovulation predictor kit, you can also count backwards by 14 days from your period and that is a close approximation to your ovulation date. So in a 32 day cycle, that would be day 18. This information is then useful in subsequent months.
Now for some more facts and more planning. The date of ovulation has a small variation with each menstrual cycle. The hormone called LH (leutenizing hormone) is what triggers ovulation and helps prepare the lining of the endometrium for implantation. Many infertility concepts are based on tracking the LH surge, since this heralds the release of the egg, and is your fertile period. The average egg lives only 24 hours, so it needs to be quickly after its release from the ovary. If an ova is to be fertilized, it is usually within 12 hours of ovulation, so the sperm must be ready. The average male ejaculate contains 200-300 million sperm, 60-90% are physically normal -- fewer than 200 of these sperm even get close to the egg, and only one sperm fertilizes the single egg released at ovulation. Sperm can live up to 72 hours once ejaculated. Sometimes the egg is found within 45 minutes for fertilization, while sometimes it can take as long as 12 hours. If the egg isn't yet released from the ovary, it is thought that the sperm can go into a holding pattern for about 24-48 hours while awaiting release of the egg.
In general, if conception is going to happen in any given cycle, it will probably be within the first few hours after intercourse. The plan of attack to achieve pregnancy is to have intercourse starting every other day after the completion of your period. This would assume with a seven day period, intercourse would take place on days 9, 11, 13, 15, and 17. Normally you can rest assured that this method best increases your chances for pregnancy in any given cycle, barring any other factors suggesting either a male or female factor preventing pregnancy to easily occur.
Best of luck trying, and remember -- try to have fun!
Jane Forester
Family Physician
Glencoe, Illinois
If you're trying to conceive (TTC), you probably wonder when is your most fertile time -- and how long does that "magic moment" last? Family Physician Jane Forester has some information for you.
Your question
When you're trying to get pregnant, how long is the "window of opportunity" in terms of conception? How long can the egg live, and how long can sperm survive? - Joyce in Englewood,Colorado
The expert answers
To determine your "window of opportunity" for conception, you must individualize your own menstrual cycle.
For several months prior to wanting to conceive, you need to track your length of menstrual cycle. Whether 24 or 32 days, it doesn't matter regarding fertility, it just helps with planning. Besides the easiest way to determine ovulation, which is with an ovulation predictor kit, you can also count backwards by 14 days from your period and that is a close approximation to your ovulation date. So in a 32 day cycle, that would be day 18. This information is then useful in subsequent months.
Now for some more facts and more planning. The date of ovulation has a small variation with each menstrual cycle. The hormone called LH (leutenizing hormone) is what triggers ovulation and helps prepare the lining of the endometrium for implantation. Many infertility concepts are based on tracking the LH surge, since this heralds the release of the egg, and is your fertile period. The average egg lives only 24 hours, so it needs to be quickly after its release from the ovary. If an ova is to be fertilized, it is usually within 12 hours of ovulation, so the sperm must be ready. The average male ejaculate contains 200-300 million sperm, 60-90% are physically normal -- fewer than 200 of these sperm even get close to the egg, and only one sperm fertilizes the single egg released at ovulation. Sperm can live up to 72 hours once ejaculated. Sometimes the egg is found within 45 minutes for fertilization, while sometimes it can take as long as 12 hours. If the egg isn't yet released from the ovary, it is thought that the sperm can go into a holding pattern for about 24-48 hours while awaiting release of the egg.
In general, if conception is going to happen in any given cycle, it will probably be within the first few hours after intercourse. The plan of attack to achieve pregnancy is to have intercourse starting every other day after the completion of your period. This would assume with a seven day period, intercourse would take place on days 9, 11, 13, 15, and 17. Normally you can rest assured that this method best increases your chances for pregnancy in any given cycle, barring any other factors suggesting either a male or female factor preventing pregnancy to easily occur.
Best of luck trying, and remember -- try to have fun!
Jane Forester
Family Physician
Glencoe, Illinois
Before pregnancy: What you can do to prepare your body
Whether it's your first pregnancy or you have had a child before, there are some smart ways to prepare yourself to give your baby a healthy start. Here are two answers to common questions about preconception health.
Before you conceive
Your question: "I'm thinking about getting pregnant sometime in the near future. What should I do to prepare?"
The answer: That's smart -- what you do before you are pregnant can affect your pregnancy! In addition to eating right, exercising and getting plenty of rest, there are five things you can do before getting pregnant to have a healthy pregnancy and to reduce your risk of having a baby with a birth defect.
1. Start taking 0.4 mg (400 mcg.) of folic acid every day now, because it takes some time for your body to build up proper stores of this important B-vitamin. It is important to take it before conception and early in pregnancy, since these defects occur in the first month of pregnancy before most women realize they're pregnant.
2. See your health care provider for a check-up, and make sure you've had all your immunizations, especially for rubella (German measles). If you're taking a prescribed medication, be sure your health care provider and pharmacist know that you're planning to become pregnant.
3. If you smoke, drink alcohol, or use drugs, STOP! These substances can threaten the health of your baby, and your own health too.
4. Stay away from toxic chemicals at home and at work--including insecticides, solvents (like some cleaners or paint thinners), lead, and mercury. Read the labels before using chemicals, and don't be afraid to ask your health care provider if you have questions!
5. If you have a cat, don't handle the cat litter--it can carry "toxoplasmosis" which can cause birth defects. If possible, take a break from this chore while you're pregnant! Also, wear gloves while gardening in areas cats may visit and while handling uncooked meats.
Pregnancies differ
Your question: "I didn't do those things before and my other children are just fine. Why should I worry now?"
The answer: Each pregnancy is a unique experience. While women who have already had children with birth defects may be at higher risk than others, most birth defects occur in pregnancies of women who haven't had an affected pregnancy before. Three to four percent of all babies are born with a major birth defect. And while only some women will ever have children with birth defects, we have no way of knowing in advance which women these will be. That's why it's so important that all women stay as healthy as possible, even if they haven't had any problems before. If you have already had a baby with a birth defect, consult your doctor before trying to become pregnant again.
Before you conceive
Your question: "I'm thinking about getting pregnant sometime in the near future. What should I do to prepare?"
The answer: That's smart -- what you do before you are pregnant can affect your pregnancy! In addition to eating right, exercising and getting plenty of rest, there are five things you can do before getting pregnant to have a healthy pregnancy and to reduce your risk of having a baby with a birth defect.
1. Start taking 0.4 mg (400 mcg.) of folic acid every day now, because it takes some time for your body to build up proper stores of this important B-vitamin. It is important to take it before conception and early in pregnancy, since these defects occur in the first month of pregnancy before most women realize they're pregnant.
2. See your health care provider for a check-up, and make sure you've had all your immunizations, especially for rubella (German measles). If you're taking a prescribed medication, be sure your health care provider and pharmacist know that you're planning to become pregnant.
3. If you smoke, drink alcohol, or use drugs, STOP! These substances can threaten the health of your baby, and your own health too.
4. Stay away from toxic chemicals at home and at work--including insecticides, solvents (like some cleaners or paint thinners), lead, and mercury. Read the labels before using chemicals, and don't be afraid to ask your health care provider if you have questions!
5. If you have a cat, don't handle the cat litter--it can carry "toxoplasmosis" which can cause birth defects. If possible, take a break from this chore while you're pregnant! Also, wear gloves while gardening in areas cats may visit and while handling uncooked meats.
Pregnancies differ
Your question: "I didn't do those things before and my other children are just fine. Why should I worry now?"
The answer: Each pregnancy is a unique experience. While women who have already had children with birth defects may be at higher risk than others, most birth defects occur in pregnancies of women who haven't had an affected pregnancy before. Three to four percent of all babies are born with a major birth defect. And while only some women will ever have children with birth defects, we have no way of knowing in advance which women these will be. That's why it's so important that all women stay as healthy as possible, even if they haven't had any problems before. If you have already had a baby with a birth defect, consult your doctor before trying to become pregnant again.
The preconception diet: Eating right before pregnancy
Nancy J Price
Everyone's heard the adage, "You are what you eat." Well, during pregnancy, your baby is what you eat, too! If you're trying to get pregnant, you want your body to be as healthy as possible so you can start off your pregnancy on the right foot. Get some nutritious tips here!
Preparing to conceive
Every mother wants her baby to be as healthy and strong as possible. Well, the best way to do that is to start at the very beginning: before conception.
Not only can eating the right foods (and avoiding the wrong ones) help you to have a healthy baby, it can actually make pregnancy possible.
So where to begin? Experts agree: Get your folate!
Folic acid
Kelly Shanahan, MD, a board-certified obstetrician/gynecologist, says that even before conception is confirmed, women can start implementing a healthier diet containing essential vitamins and nutrients, such as folic acid. Fertility specialist Mark Kan, MD, agrees that when it comes to preparing to conceive, "Folic acid is the most important dietary subject."
Folic acid, also known as folate, is necessary for proper cell growth and development of the embryo. According to nutritionist Martha Belury, PhD, RD, "Folic acid in a vitamin supplement, when taken one month before conception and throughout the first trimester, has been proven to reduce the risk for an neural tube defect-affected pregnancy by 50 to 70 percent."
If you're trying to conceive, the March of Dimes recommends taking a multivitamin supplement containing 400 micrograms (mcg) of folic acid every day. It's also important to have a healthy diet, which means eating food that's rich in folic acid, which include leafy green vegetables, avocados, peanuts, fortified cereals, breads and orange juice.
Building healthy eating habits
Belury says, "A wise approach to good nutrition habits during pregnancy is to consider choosing foods with high nutrient density. The same concept holds true for choosing beverage foods." A nutrient-dense food is one that provides a high amount of nutrients (e.g., vitamins, minerals, protein) relative to caloric content.
So now, more than ever, it's time to rethink your food choices. To start:
Steering clear
In addition to the foods you should eat, there are also certain foods you should avoid. These include (but aren't limited to):
As additional precautions, be sure to wash raw vegetables and fruits thoroughly. Cook ready-to-eat meats (like hot dogs) and leftovers until steaming hot.
Drinking to your health
Water should be your number one beverage before - and during - pregnancy. The human body is mostly composed of water, so consider it a vital nutrient. Drinking plenty of water, that is, a minimum of eight 8-ounce glasses each day, also helps flush your system of toxins. Belury notes, "Water is a very important beverage to consume in ample amounts before, during, and after pregnancy."
When you've had your water, Belury says that fruit and vegetable juices can provide ample amounts of vitamins and minerals with minimal to moderate calories.
And even though they can taste great, soft drinks offer empty calories, so consume them in moderation. Diet sodas, in addition to not being a positive contribution to your nutrition, have an artificial sweetener (such as aspartame, saccharin or acesulfame-K) in place of the sugar. In general, and in the absence of any maternal health problems, the March of Dimes and the American Dietetic Association agree that aspartame (also known as Nutrasweet) and acesulfame-K are safe to consume during pregnancy. However, the American Dietetic Association notes that saccharin can cross the placenta and may remain in fetal tissues, therefore, you should carefully consider your use of saccharin during pregnancy and while trying to conceive.
Caffeine
An ingredient in sodas, coffee, tea and even chocolate, caffeine is a stimulant (which means it can keep you awake or make you jumpy) and a diuretic (which means it stimulates urination, thereby reducing fluid levels in your body at a time when you want to be adequately hydrated).
According to the International Food Information Council Foundation, some studies have suggested that high levels of caffeine intake may actually extend the time it takes to conceive. However, when other lifestyle variables (smoking, for example) are considered, these findings are inconclusive. More recent research from the Centers for Disease Control and Prevention (CDC), Harvard Medical School and the University of California at Berkeley show that moderate caffeine consumption does not reduce a woman's chance of becoming pregnant.
During pregnancy, however, studies have shown that caffeine may cause a miscarriage or could slow the growth of your developing baby if you consume more than 300 mg (an amount equal to three cups of coffee) per day. If you have concerns about your caffeine intake, be sure to talk to your caregiver.
Alcohol
If there is any one beverage type to avoid while trying to conceive, alcohol -- in any of its forms -- is it. Why? First, birth defects associated with prenatal alcohol exposure can occur in the first 3 to 8 weeks of pregnancy, before you even know if you are pregnant, according to the National Center on Birth Defects and Developmental Disabilities. And although early pregnancy is a particularly vulnerable time, damage to your baby can occur throughout pregnancy as a result of continued alcohol exposure as organ systems grow to maturity.
Furthermore, if you are trying to achieve pregnancy, beer, wine and other spirits may hamper your efforts. The American College of Obstetricians and Gynecologists (ACOG) says that women who drink alcohol may have a harder time getting pregnant.
Smart for you, smart for baby
Without a doubt, the human body is an incredible thing. The things you eat recombine in an amazing way to create a precious new life. Making wise, informed decisions about your food and drink now -- even before conception -- will benefit both you and your baby for the long term.
Everyone's heard the adage, "You are what you eat." Well, during pregnancy, your baby is what you eat, too! If you're trying to get pregnant, you want your body to be as healthy as possible so you can start off your pregnancy on the right foot. Get some nutritious tips here!
Preparing to conceive
Every mother wants her baby to be as healthy and strong as possible. Well, the best way to do that is to start at the very beginning: before conception.
Not only can eating the right foods (and avoiding the wrong ones) help you to have a healthy baby, it can actually make pregnancy possible.
So where to begin? Experts agree: Get your folate!
Folic acid
Kelly Shanahan, MD, a board-certified obstetrician/gynecologist, says that even before conception is confirmed, women can start implementing a healthier diet containing essential vitamins and nutrients, such as folic acid. Fertility specialist Mark Kan, MD, agrees that when it comes to preparing to conceive, "Folic acid is the most important dietary subject."
Folic acid, also known as folate, is necessary for proper cell growth and development of the embryo. According to nutritionist Martha Belury, PhD, RD, "Folic acid in a vitamin supplement, when taken one month before conception and throughout the first trimester, has been proven to reduce the risk for an neural tube defect-affected pregnancy by 50 to 70 percent."
If you're trying to conceive, the March of Dimes recommends taking a multivitamin supplement containing 400 micrograms (mcg) of folic acid every day. It's also important to have a healthy diet, which means eating food that's rich in folic acid, which include leafy green vegetables, avocados, peanuts, fortified cereals, breads and orange juice.
Building healthy eating habits
Belury says, "A wise approach to good nutrition habits during pregnancy is to consider choosing foods with high nutrient density. The same concept holds true for choosing beverage foods." A nutrient-dense food is one that provides a high amount of nutrients (e.g., vitamins, minerals, protein) relative to caloric content.
So now, more than ever, it's time to rethink your food choices. To start:
- Look for foods with plenty of vitamins, minerals, protein and fiber
- Cut back on fat, extra sugar, preservatives and other additives
- Go organic -- buy products that are pesticide-free
- Look for hormone-free dairy products (such as those not containing Bovine growth hormone: rBST)
Steering clear
In addition to the foods you should eat, there are also certain foods you should avoid. These include (but aren't limited to):
- Raw or undercooked fish (including sushi), shellfish, eggs, meat or poultry
- Swordfish, shark, tilefish or king mackerel -- however, other fish may be consumed in moderation
- Unpasteurized milk and any foods made with it
- Soft cheeses like Brie, feta, Camembert, Roquefort and Mexican cheeses such as Quesa Blanca
- Raw egg -- including that in homemade cookie dough and batters
As additional precautions, be sure to wash raw vegetables and fruits thoroughly. Cook ready-to-eat meats (like hot dogs) and leftovers until steaming hot.
Drinking to your health
Water should be your number one beverage before - and during - pregnancy. The human body is mostly composed of water, so consider it a vital nutrient. Drinking plenty of water, that is, a minimum of eight 8-ounce glasses each day, also helps flush your system of toxins. Belury notes, "Water is a very important beverage to consume in ample amounts before, during, and after pregnancy."
When you've had your water, Belury says that fruit and vegetable juices can provide ample amounts of vitamins and minerals with minimal to moderate calories.
And even though they can taste great, soft drinks offer empty calories, so consume them in moderation. Diet sodas, in addition to not being a positive contribution to your nutrition, have an artificial sweetener (such as aspartame, saccharin or acesulfame-K) in place of the sugar. In general, and in the absence of any maternal health problems, the March of Dimes and the American Dietetic Association agree that aspartame (also known as Nutrasweet) and acesulfame-K are safe to consume during pregnancy. However, the American Dietetic Association notes that saccharin can cross the placenta and may remain in fetal tissues, therefore, you should carefully consider your use of saccharin during pregnancy and while trying to conceive.
Caffeine
An ingredient in sodas, coffee, tea and even chocolate, caffeine is a stimulant (which means it can keep you awake or make you jumpy) and a diuretic (which means it stimulates urination, thereby reducing fluid levels in your body at a time when you want to be adequately hydrated).
According to the International Food Information Council Foundation, some studies have suggested that high levels of caffeine intake may actually extend the time it takes to conceive. However, when other lifestyle variables (smoking, for example) are considered, these findings are inconclusive. More recent research from the Centers for Disease Control and Prevention (CDC), Harvard Medical School and the University of California at Berkeley show that moderate caffeine consumption does not reduce a woman's chance of becoming pregnant.
During pregnancy, however, studies have shown that caffeine may cause a miscarriage or could slow the growth of your developing baby if you consume more than 300 mg (an amount equal to three cups of coffee) per day. If you have concerns about your caffeine intake, be sure to talk to your caregiver.
Alcohol
If there is any one beverage type to avoid while trying to conceive, alcohol -- in any of its forms -- is it. Why? First, birth defects associated with prenatal alcohol exposure can occur in the first 3 to 8 weeks of pregnancy, before you even know if you are pregnant, according to the National Center on Birth Defects and Developmental Disabilities. And although early pregnancy is a particularly vulnerable time, damage to your baby can occur throughout pregnancy as a result of continued alcohol exposure as organ systems grow to maturity.
Furthermore, if you are trying to achieve pregnancy, beer, wine and other spirits may hamper your efforts. The American College of Obstetricians and Gynecologists (ACOG) says that women who drink alcohol may have a harder time getting pregnant.
Smart for you, smart for baby
Without a doubt, the human body is an incredible thing. The things you eat recombine in an amazing way to create a precious new life. Making wise, informed decisions about your food and drink now -- even before conception -- will benefit both you and your baby for the long term.
Rabu, 10 Maret 2010
Semen quality may start to decline in his 20s
Sarah Yang
With each passing year, semen quality in adult men declines, suggesting that age plays a greater role in male fertility rates than previously thought, according to a study by researchers at the University of California, Berkeley, and Lawrence Livermore National Laboratory.
Waning fertility
The study, published in the journal Human Reproduction, suggests that even healthy men may become progressively less fertile as time goes by.
"Prior studies on semen quality typically included men who came to fertility clinics," says Brenda Eskenazi, professor of epidemiology and maternal and child health at UC Berkeley's School of Public Health, and co-author of the study. "This is one of the first studies to focus on men with no known fertility concerns, giving us a better sense of whether age affects semen quality in a healthy population."
The researchers recruited 97 men between the ages of 22 and 80 who were employed or retired from Lawrence Livermore National Laboratory. Samples were brought to the onsite research laboratory within two hours after collection to accurately measure sperm motility -- its liveliness and direction of movement -- and other indicators of semen quality. The researchers gathered extensive medical, lifestyle and occupational exposure history from the men, and excluded those who had smoked in the prior six months or had other relevant health problems.
While age had an effect on semen volume, the more significant impact was on sperm motility, which researchers found decreased by 0.7 percent per year. That means the chance of sperm motility being clinically abnormal is 25 percent at age 22, 40 percent by age 30, 60 percent by age 40 and 85 percent by age 60.
"Simply put, sperm slow down with age," says study co-author Andrew Wyrobek, head of the Health Effects Genetics Division at Lawrence Livermore National Laboratory. "In addition, age impacts progressive motility, which is the ability of sperm to move forward with a clear goal in mind. Sperm that swim around in circles may get trapped in the female mucosa, while sperm that moves in a linear direction will have a greater chance of colliding with the egg."
Progressive motility also started to decrease in men in their 20s by 3.1 percent per year. By age 30, the probability of progressive motility being clinically abnormal is about 50 percent, gradually increasing to 82 percent by age 80.
Unlike the female biological clock -- which reflects a marked decline in fertility in a woman's mid-30s -- the male clock proceeds gradually, the researchers found.
The decreased fertility associated with maternal age has been well established, but understanding the effects of paternal age has become increasingly important. Over the decades, more and more men are having children at older ages. Since 1980, there has been a 24 percent increase in men aged 35 to 54 fathering children. But research has also indicated that older men take longer to conceive than their younger counterparts. One study of 8,515 planned pregnancies found that men older than 35 have half the chance of fathering a child within 12 months compared with men younger than 25, even when the age of the mother is considered.
The study by UC Berkeley and Lawrence Livermore helps shed light on why paternal age matters.
"Women tend to be the focus in fertility issues," says Eskenazi. "What we are saying is that men are not scot-free in this. Many of us have heard of men in their 70s and older who have kids, but the probability of that happening may be lower than we thought."
The authors said that changes in semen quality with age may be due to various physiological factors, including age-related narrowing and sclerosis of the testicular tube, degeneration of germ cells, and normal changes in the prostate, or to increased probability of exposure to disease or environmental agents.
"We considered time worked at Lawrence Livermore and occupational exposure in our study, and found no evidence that they affected semen quality," says Eskenazi.
The authors note that semen quality is considered a proxy for fertility, indicating that men who wait until they are older to have children are risking difficulties conceiving.
"Of course, age is just one of many factors to consider when having a child," said Wyrobek. "We want couples to be informed when making their decision."
With each passing year, semen quality in adult men declines, suggesting that age plays a greater role in male fertility rates than previously thought, according to a study by researchers at the University of California, Berkeley, and Lawrence Livermore National Laboratory.
Waning fertility
The study, published in the journal Human Reproduction, suggests that even healthy men may become progressively less fertile as time goes by.
"Prior studies on semen quality typically included men who came to fertility clinics," says Brenda Eskenazi, professor of epidemiology and maternal and child health at UC Berkeley's School of Public Health, and co-author of the study. "This is one of the first studies to focus on men with no known fertility concerns, giving us a better sense of whether age affects semen quality in a healthy population."
The researchers recruited 97 men between the ages of 22 and 80 who were employed or retired from Lawrence Livermore National Laboratory. Samples were brought to the onsite research laboratory within two hours after collection to accurately measure sperm motility -- its liveliness and direction of movement -- and other indicators of semen quality. The researchers gathered extensive medical, lifestyle and occupational exposure history from the men, and excluded those who had smoked in the prior six months or had other relevant health problems.
While age had an effect on semen volume, the more significant impact was on sperm motility, which researchers found decreased by 0.7 percent per year. That means the chance of sperm motility being clinically abnormal is 25 percent at age 22, 40 percent by age 30, 60 percent by age 40 and 85 percent by age 60.
"Simply put, sperm slow down with age," says study co-author Andrew Wyrobek, head of the Health Effects Genetics Division at Lawrence Livermore National Laboratory. "In addition, age impacts progressive motility, which is the ability of sperm to move forward with a clear goal in mind. Sperm that swim around in circles may get trapped in the female mucosa, while sperm that moves in a linear direction will have a greater chance of colliding with the egg."
Progressive motility also started to decrease in men in their 20s by 3.1 percent per year. By age 30, the probability of progressive motility being clinically abnormal is about 50 percent, gradually increasing to 82 percent by age 80.
Unlike the female biological clock -- which reflects a marked decline in fertility in a woman's mid-30s -- the male clock proceeds gradually, the researchers found.
The decreased fertility associated with maternal age has been well established, but understanding the effects of paternal age has become increasingly important. Over the decades, more and more men are having children at older ages. Since 1980, there has been a 24 percent increase in men aged 35 to 54 fathering children. But research has also indicated that older men take longer to conceive than their younger counterparts. One study of 8,515 planned pregnancies found that men older than 35 have half the chance of fathering a child within 12 months compared with men younger than 25, even when the age of the mother is considered.
The study by UC Berkeley and Lawrence Livermore helps shed light on why paternal age matters.
"Women tend to be the focus in fertility issues," says Eskenazi. "What we are saying is that men are not scot-free in this. Many of us have heard of men in their 70s and older who have kids, but the probability of that happening may be lower than we thought."
The authors said that changes in semen quality with age may be due to various physiological factors, including age-related narrowing and sclerosis of the testicular tube, degeneration of germ cells, and normal changes in the prostate, or to increased probability of exposure to disease or environmental agents.
"We considered time worked at Lawrence Livermore and occupational exposure in our study, and found no evidence that they affected semen quality," says Eskenazi.
The authors note that semen quality is considered a proxy for fertility, indicating that men who wait until they are older to have children are risking difficulties conceiving.
"Of course, age is just one of many factors to consider when having a child," said Wyrobek. "We want couples to be informed when making their decision."
The male factor: The low down on fertility sperm testing
About 30 to 40% of all infertility cases have a male factor as the main cause and 40-50% as a contributing cause. Bearing these statistics in mind, it is somewhat puzzling that women seem to be the first to "blame" when infertility becomes an issue. The bottom line is that just because sperm move do not mean they are capable of initiating making a baby. Thousands of would-be parents can now be saved from costly infertility treatments through a new sperm test called Sperm Chromatin Structure Assay (SCSA) . Reproductive experts used to think that in this era of in-vitro fertilization (IVF) all that were needed were several live sperm to make a baby. Experts now know that this is not entirely the case.
Looking deeper
Dr Ken Gelman is a Cooper City, Florida-based endocrinologist and fertility expert, and one who is frustrated with the medical community that he says often negates the male role in infertility. As Dr Gelman explains, what matters is not only the sperm count, percentage of sperm that swim, how they appear and whether the sperm can penetrate and fertilize an egg, but also the health of the sperm, and the amount of DNA damage inside. "This is really a biochemical issue at the molecular level. Looking at sperm underneath a microscope is very important, but not a perfect way of assessing the ability of sperm to fertilize a woman's eggs or contribute to a birth," he says.
Dr Gelman says the test is able to screen a man for sperm DNA damage, and possible infertility and it is painless, non-invasive, and cost efficient in the sense that it can screen men who might have very unhealthy or damaged sperm before their female partners go through unnecessary infertility treatments. It entails the production of a semen sample and a standard semen analysis is done on one part of the sample and the other portion is frozen and sent to the specialized lab in South Dakota that performs the assay. The percentage of damaged sperm is calculated and the sperm is determined to have good, fair or poor fertility potential. The test determines three key factors:
Looking deeper
Dr Ken Gelman is a Cooper City, Florida-based endocrinologist and fertility expert, and one who is frustrated with the medical community that he says often negates the male role in infertility. As Dr Gelman explains, what matters is not only the sperm count, percentage of sperm that swim, how they appear and whether the sperm can penetrate and fertilize an egg, but also the health of the sperm, and the amount of DNA damage inside. "This is really a biochemical issue at the molecular level. Looking at sperm underneath a microscope is very important, but not a perfect way of assessing the ability of sperm to fertilize a woman's eggs or contribute to a birth," he says.
Dr Gelman says the test is able to screen a man for sperm DNA damage, and possible infertility and it is painless, non-invasive, and cost efficient in the sense that it can screen men who might have very unhealthy or damaged sperm before their female partners go through unnecessary infertility treatments. It entails the production of a semen sample and a standard semen analysis is done on one part of the sample and the other portion is frozen and sent to the specialized lab in South Dakota that performs the assay. The percentage of damaged sperm is calculated and the sperm is determined to have good, fair or poor fertility potential. The test determines three key factors:
- What is the likelihood of the sperm contributing to the birth of a healthy baby?
- What percentage of sperm has damage?
- Can the sperm sample be used for in-vitro procedures or should the male partner be treated to improve the quality of the sperm?
Planning for a healthy pregnancy
Ann Douglas
Hoping to win at Baby Roulette? Before you and your partner toss the birth control in the trash and embark on any serious babymaking efforts, you've got some important decisions to make.The choices you make right now are every bit as important to your future baby's health and well-being as the decisions you make after the pregnancy test comes back positive.
Here are 10 steps you should plan to take in the year prior to conception.
Six months to a year ahead of time
1. What's up, doc?
A generation ago, your doctor would have thought you were crazy if you called to set up an appointment to talk about your conception plans. Today, it's fast becoming the norm for couples to book a preconception health checkup.
You may have to do a little arm-twisting to get your partner to accompany you to your appointment -- a lot of guys feel that their role in Operation Conception is limited to heading up the elite Sperm Squadron forces! -- but, whether he's prepared to admit it or not, your partner also needs to do a little preconception health planning of his own.
2. Testing one, two, three
I know, I know lying spread-eagled on an examination table isn't my idea of a good time either, but the experts are pretty much unanimous on this point: the ideal time to schedule a pap test is before you start trying to conceive. That way, should anything abnormal show up, you and your doctor will be able to deal with the problem prior to rather than during your pregnancy.
3. All systems go
You wouldn't even dream of heading off on a cross-country expedition without checking to ensure that your car's equipment was in good working order.Well, you're about to embark on the ultimate of journeys -- the journey to motherhood -- so it's even more important to make sure that your body is firing on all cylinders.
Your doctor will generally give you the green flag if you are in reasonably good health (e.g. any chronic health conditions, such as heart problems, diabetes, or high blood pressure are under control, and you haven't tested positive for any sexually-transmitted diseases such as Chlamydia, syphilis, gonorrhea). Your doctor may also want to talk to you about any hazards that you may face in the workplace -- strenuous working conditions or exposure to hazardous agents, for example-- since they may impact on your pregnancy as well.
4. The human pincushion
Don't relish the thought of being turned into a human pincushion? Chances are you won't have to. While it's always a good idea to have your immunity to both rubella (German measles) and chickenpox checked before you start trying to conceive,most adult women are immune to these two diseases. If it turns out that you're not, it's time to roll up your sleeve: both diseases can be devastating to the developing baby.
What's more, if contracted during pregnancy, chickenpox can pose significant health risks to the pregnant woman as well.
5. Shaking your family tree
Something else you might want to do before you and your partner move into the "action phase" of babymaking is to find out what types of skeletons are swinging from your family tree.
Certain types of birth defects and serious -- even fatal -- diseases are genetic in origin, and it's possible that you and your partner may be carriers for certain types of these inherited diseases.A geneticist can help you to determine your odds of giving birth to a healthy baby.
Three months ahead of time
6. Lifestyle makeover
If your idea of vigorous exercise involves wrestling with your partner for the TV remote, there's no time like the present to start being more physically active. Not only will you strengthen your heart and lungs -- two organs that get a considerable workout during pregnancy -- you'll also be better psychologically equipped to weather the emotional highs and lows of pregnancy.
And if you're carrying around a few extra pounds, this is the perfect time to deal with that problem, too, and reduce your risks of experiencing certain types of fertility problems and pregnancy complications. (Studies have shown that women who are significantly over- or underweight face an increased risk of infertility, and overweight women face an increased risk of requiring a cesarean delivery or experiencing other pregnancy-related complications). Of course, crash dieting is a definite no-no.That can send your body into starvation mode, which will hamper -- not help -- your chances of conceiving anytime soon.
7. Nutrient check
Your baby needs a whole cocktail of nutrients in order to grow and develop -- nutrients that you may have a hard time serving up if you end up battling morning sickness during your first trimester. That's why it's important to try to "stockpile" as many as these nutrients as possible prior to pregnancy.
At the top of your nutrient wish list should be folic acid -- a "miracle nutrient" that has been shown to dramatically reduce the incidence of such neural tube defects as anencephaly and spina bifida if taken in the months leading up to and during the first trimester of pregnancy. How much folic acid you need will depend on your individual and family health history: if you've previously given birth to a baby with a neural tube defect or if you have epilepsy, anemia, insulin-dependent diabetes, or certain other health conditions, your healthcare provider may recommend that you consume a higher than average amount.
When you're ready to start trying to conceive
8. Kick any remaining bad habits
You don't have to be a saint to be a candidate for motherhood, but it doesn't hurt to have a few saintly habits.
Since no safe level of alcohol consumption has been established for pregnancy, most doctors suggest that you abstain entirely rather than flirting with the possibility of giving birth to a baby with serious developmental and behavioral problems, and other anomalies. Ditto for street drugs: they're just plain bad news for babies and mothers-to- be.
And as for smoking: well it shouldn't be news to you that smoking's a no-no, too. Not only has smoking been linked to premature birth and low-birthweight babies: it can also increase your newborn baby's susceptibility to SIDS and other health problems.
9. Slam the medicine cabinet shut
Don't pop any medication in your mouth -- prescription or over-the-counter -- without checking with your doctor to ensure that it's safe to use once you start trying to conceive. (He may want to fiddle with your prescription meds a little -- perhaps changing you to a less harmful drug or taking you off medications altogether for the foreseeable future.)
Bear in mind that even "natural" herbal products can pose a significant risk to a developing baby, particularly since many of these products have not been tested on pregnant women.
10. Lose the birth control
The final step in your countdown to conception is to lose the birth control. If you've been using the birth control pill or some other form of hormonal birth control (e.g. implants or injections), you'll need to wait for at least one normal period before you start trying to conceive -- something that makes it easier for your caregiver to pinpoint your due date.
If the intra-uterine device (IUD) has been your birth control method of choice, you'll still need to put on the brakes momentarily: most doctors recommend that you wait for at least one normal period before you start trying to conceive.
While there are no guarantees in the reproductive world, it only makes sense to do what you can to tilt the roulette wheel in your favor. With any luck, you'll walk away with the ultimate prize: a healthy baby.
Daddies in waiting
Preconception planning isn't just a girl thing. It's also important for fathers-to-be. Here are some important health issues you and your partner should be thinking about if there's a baby in your future:
Hoping to win at Baby Roulette? Before you and your partner toss the birth control in the trash and embark on any serious babymaking efforts, you've got some important decisions to make.The choices you make right now are every bit as important to your future baby's health and well-being as the decisions you make after the pregnancy test comes back positive.
Here are 10 steps you should plan to take in the year prior to conception.
Six months to a year ahead of time
1. What's up, doc?
A generation ago, your doctor would have thought you were crazy if you called to set up an appointment to talk about your conception plans. Today, it's fast becoming the norm for couples to book a preconception health checkup.
You may have to do a little arm-twisting to get your partner to accompany you to your appointment -- a lot of guys feel that their role in Operation Conception is limited to heading up the elite Sperm Squadron forces! -- but, whether he's prepared to admit it or not, your partner also needs to do a little preconception health planning of his own.
2. Testing one, two, three
I know, I know lying spread-eagled on an examination table isn't my idea of a good time either, but the experts are pretty much unanimous on this point: the ideal time to schedule a pap test is before you start trying to conceive. That way, should anything abnormal show up, you and your doctor will be able to deal with the problem prior to rather than during your pregnancy.
3. All systems go
You wouldn't even dream of heading off on a cross-country expedition without checking to ensure that your car's equipment was in good working order.Well, you're about to embark on the ultimate of journeys -- the journey to motherhood -- so it's even more important to make sure that your body is firing on all cylinders.
Your doctor will generally give you the green flag if you are in reasonably good health (e.g. any chronic health conditions, such as heart problems, diabetes, or high blood pressure are under control, and you haven't tested positive for any sexually-transmitted diseases such as Chlamydia, syphilis, gonorrhea). Your doctor may also want to talk to you about any hazards that you may face in the workplace -- strenuous working conditions or exposure to hazardous agents, for example-- since they may impact on your pregnancy as well.
4. The human pincushion
Don't relish the thought of being turned into a human pincushion? Chances are you won't have to. While it's always a good idea to have your immunity to both rubella (German measles) and chickenpox checked before you start trying to conceive,most adult women are immune to these two diseases. If it turns out that you're not, it's time to roll up your sleeve: both diseases can be devastating to the developing baby.
What's more, if contracted during pregnancy, chickenpox can pose significant health risks to the pregnant woman as well.
5. Shaking your family tree
Something else you might want to do before you and your partner move into the "action phase" of babymaking is to find out what types of skeletons are swinging from your family tree.
Certain types of birth defects and serious -- even fatal -- diseases are genetic in origin, and it's possible that you and your partner may be carriers for certain types of these inherited diseases.A geneticist can help you to determine your odds of giving birth to a healthy baby.
Three months ahead of time
6. Lifestyle makeover
If your idea of vigorous exercise involves wrestling with your partner for the TV remote, there's no time like the present to start being more physically active. Not only will you strengthen your heart and lungs -- two organs that get a considerable workout during pregnancy -- you'll also be better psychologically equipped to weather the emotional highs and lows of pregnancy.
And if you're carrying around a few extra pounds, this is the perfect time to deal with that problem, too, and reduce your risks of experiencing certain types of fertility problems and pregnancy complications. (Studies have shown that women who are significantly over- or underweight face an increased risk of infertility, and overweight women face an increased risk of requiring a cesarean delivery or experiencing other pregnancy-related complications). Of course, crash dieting is a definite no-no.That can send your body into starvation mode, which will hamper -- not help -- your chances of conceiving anytime soon.
7. Nutrient check
Your baby needs a whole cocktail of nutrients in order to grow and develop -- nutrients that you may have a hard time serving up if you end up battling morning sickness during your first trimester. That's why it's important to try to "stockpile" as many as these nutrients as possible prior to pregnancy.
At the top of your nutrient wish list should be folic acid -- a "miracle nutrient" that has been shown to dramatically reduce the incidence of such neural tube defects as anencephaly and spina bifida if taken in the months leading up to and during the first trimester of pregnancy. How much folic acid you need will depend on your individual and family health history: if you've previously given birth to a baby with a neural tube defect or if you have epilepsy, anemia, insulin-dependent diabetes, or certain other health conditions, your healthcare provider may recommend that you consume a higher than average amount.
When you're ready to start trying to conceive
8. Kick any remaining bad habits
You don't have to be a saint to be a candidate for motherhood, but it doesn't hurt to have a few saintly habits.
Since no safe level of alcohol consumption has been established for pregnancy, most doctors suggest that you abstain entirely rather than flirting with the possibility of giving birth to a baby with serious developmental and behavioral problems, and other anomalies. Ditto for street drugs: they're just plain bad news for babies and mothers-to- be.
And as for smoking: well it shouldn't be news to you that smoking's a no-no, too. Not only has smoking been linked to premature birth and low-birthweight babies: it can also increase your newborn baby's susceptibility to SIDS and other health problems.
9. Slam the medicine cabinet shut
Don't pop any medication in your mouth -- prescription or over-the-counter -- without checking with your doctor to ensure that it's safe to use once you start trying to conceive. (He may want to fiddle with your prescription meds a little -- perhaps changing you to a less harmful drug or taking you off medications altogether for the foreseeable future.)
Bear in mind that even "natural" herbal products can pose a significant risk to a developing baby, particularly since many of these products have not been tested on pregnant women.
10. Lose the birth control
The final step in your countdown to conception is to lose the birth control. If you've been using the birth control pill or some other form of hormonal birth control (e.g. implants or injections), you'll need to wait for at least one normal period before you start trying to conceive -- something that makes it easier for your caregiver to pinpoint your due date.
If the intra-uterine device (IUD) has been your birth control method of choice, you'll still need to put on the brakes momentarily: most doctors recommend that you wait for at least one normal period before you start trying to conceive.
While there are no guarantees in the reproductive world, it only makes sense to do what you can to tilt the roulette wheel in your favor. With any luck, you'll walk away with the ultimate prize: a healthy baby.
Daddies in waiting
Preconception planning isn't just a girl thing. It's also important for fathers-to-be. Here are some important health issues you and your partner should be thinking about if there's a baby in your future:
- Workplace exposure to lead, mercury, anesthetic gases, biological hazards, pesticides, herbicides, radiation or other health hazards on the job: These can affect a man's fertility and/or the health of his offspring.
- Medication use: Some medications are fertility impairing while others are linked to fetal abnormalities.The jury's still out on most herbal products.
- X-rays to the groin area: One US study indicated that such paternal X-ray in the year prior to conception can affect a baby's growth rate.
- Weight: The excess quantities of the female sex hormone estrogen that can be found in overweight men can interfere with communication between the testes and the pituitary gland, hampering a man's fertility.
- Groin injuries: Athletic injuries can temporarily or permanently hamper fertility and sexual function. What's more, some research links long-distance cycling with groin numbness and impotence.
- Avoid overheating the genitals: Wearing tight clothing, soaking in hot tubs and otherwise overheating the testicles can interfere with sperm production and leave a man less fertile.
- Skip the vices: Cigarettes, street drugs and excessive alcohol use have all been linked to reduced fertility and other negative health effects.
Conceiving after the snip: Vasectomy reversal vs. in vitro fertilization
Angeline Beltsos, MD and Meredith Martin-Johnston, MPH
So you or your partner has had a vasectomy... but now you have changed your mind, and would like to have a baby. What are your choices? There's both vasectomy reversal and sperm retrieval combined with IVF. Here's a look at the facts.
Vasectomy reversal
The procedure consists of a surgical procedure reconstructing your male partner's reproductive tract. This is usually a one day outpatient procedure, and is one of the more difficult procedures performed by urologists. Pregnancy most likely will not occur for 12 to 24 months after the procedure, but this also depends on discomfort and recovery time.
Usually, more recovery time will be needed than the time needed to recover from the first vasectomy procedure. In some cases, the reconstruction fails, and then sperm retrieval for IVF is recommended.
When a reversal is performed, a sample of sperm can be obtained and frozen which can be used for IVF in case the reversal is unsuccessful. This is easy to do and adds little cost to the procedure. Make sure to discuss this with your surgeon, since a repeat testicular surgery would be needed if the reversal does not work. Results are not immediate, and it may take 12 to 24 months to see the benefit of surgery.
Success rates
The success rates depend on what was cut, and what needs to be put back together. Depending on what needs to be reconstructed, a successful reconnection occurs 60 to 90 percent of the time, and the pregnancy rates that follow range from 40 to 70 percent. The longer the time between the initial vasectomy and the reversal, the less chance there is of success. Again, results are not immediate and may take 12-24 months to see the benefit of surgery.
Surgery costs
The cost of surgery is usually not covered by insurance since it is an elective procedure, and the cost can range from about $5,000 to $13,000. You should always check your coverage with your insurance company first.
Risks
Possible risks include postoperative pain, infection, tenderness, bruising, bleeding and swelling. There is also a chance of failure, in that the reconstruction of the reproductive tract does not take place. Risks also may include difficulty breathing, decreased urination or blood clots.
Other considerations include that the woman should also be checked beforehand to make sure that her fallopian tubes are open and that her ovaries are working properly. Also, if you want more than one child, a vas reversal may be a better choice. The advantages include that it is a one-day procedure; no drugs are needed for the female partner, and there is less chance of a multiple birth.
Sperm retrieval and IVF
This is a surgical procedure where sperm is extracted from the male partner's testes. In vitro fertilization, or IVF, involves both you and your partner. She will undergo ovarian stimulation with medication to produce several eggs. The egg retrieval is done with a small needle to remove the eggs from the ovary. The sperm are obtained from the testes with a surgical procedure. It is not as invasive as the reversal, with less expense, faster recovery and greater success.
This surgery can be done ahead of time and the sperm or tissue could be frozen or it can be done fresh on the same day as the egg retrieval. The sperm is injected into the egg, called intracytoplasmic sperm injection, or ICSI, and the fertilized eggs are placed back into your uterus. A pregnancy test can be taken two weeks later to determine pregnancy.
Success
IVF success rates can range from 25 to 50 percent. As women age, the success rates decrease significantly. A consultation with your OB/GYN or a reproductive endocrinologist is important before testicular surgery is done.
Cost
Insurance may cover for this procedure in certain states. Otherwise, you may be self-pay at a cost of around $5,000 to $10,000 for the procedure and around $3,000 to $5,000 for the medications.
Risks
Risks include ovarian swelling or hyperstimulation. There is a chance for complications of the egg retrieval, which is rare but may include bleeding or damage to the ovary. There is a 20 to 30 percent chance of a multiple pregnancy. The rare possibility of damage to the testicle or sperm can result from the sperm extraction.
Advantages include that it is a shorter period of time before you can begin to try for pregnancy. You may try immediately with IVF once the sperm retrieval has been done. This is much faster than the vas reversal where you may have to wait one to two years to see if it worked. IVF may also treat any female problems of infertility and it may be covered by insurance.
In summary, there are always choices and both of these should be considered after consulting both a doctor who does the reversal and a doctor who specializes in female reproduction to properly consider the best choice for you and your partner.
So you or your partner has had a vasectomy... but now you have changed your mind, and would like to have a baby. What are your choices? There's both vasectomy reversal and sperm retrieval combined with IVF. Here's a look at the facts.
Vasectomy reversal
The procedure consists of a surgical procedure reconstructing your male partner's reproductive tract. This is usually a one day outpatient procedure, and is one of the more difficult procedures performed by urologists. Pregnancy most likely will not occur for 12 to 24 months after the procedure, but this also depends on discomfort and recovery time.
Usually, more recovery time will be needed than the time needed to recover from the first vasectomy procedure. In some cases, the reconstruction fails, and then sperm retrieval for IVF is recommended.
When a reversal is performed, a sample of sperm can be obtained and frozen which can be used for IVF in case the reversal is unsuccessful. This is easy to do and adds little cost to the procedure. Make sure to discuss this with your surgeon, since a repeat testicular surgery would be needed if the reversal does not work. Results are not immediate, and it may take 12 to 24 months to see the benefit of surgery.
Success rates
The success rates depend on what was cut, and what needs to be put back together. Depending on what needs to be reconstructed, a successful reconnection occurs 60 to 90 percent of the time, and the pregnancy rates that follow range from 40 to 70 percent. The longer the time between the initial vasectomy and the reversal, the less chance there is of success. Again, results are not immediate and may take 12-24 months to see the benefit of surgery.
Surgery costs
The cost of surgery is usually not covered by insurance since it is an elective procedure, and the cost can range from about $5,000 to $13,000. You should always check your coverage with your insurance company first.
Risks
Possible risks include postoperative pain, infection, tenderness, bruising, bleeding and swelling. There is also a chance of failure, in that the reconstruction of the reproductive tract does not take place. Risks also may include difficulty breathing, decreased urination or blood clots.
Other considerations include that the woman should also be checked beforehand to make sure that her fallopian tubes are open and that her ovaries are working properly. Also, if you want more than one child, a vas reversal may be a better choice. The advantages include that it is a one-day procedure; no drugs are needed for the female partner, and there is less chance of a multiple birth.
Sperm retrieval and IVF
This is a surgical procedure where sperm is extracted from the male partner's testes. In vitro fertilization, or IVF, involves both you and your partner. She will undergo ovarian stimulation with medication to produce several eggs. The egg retrieval is done with a small needle to remove the eggs from the ovary. The sperm are obtained from the testes with a surgical procedure. It is not as invasive as the reversal, with less expense, faster recovery and greater success.
This surgery can be done ahead of time and the sperm or tissue could be frozen or it can be done fresh on the same day as the egg retrieval. The sperm is injected into the egg, called intracytoplasmic sperm injection, or ICSI, and the fertilized eggs are placed back into your uterus. A pregnancy test can be taken two weeks later to determine pregnancy.
Success
IVF success rates can range from 25 to 50 percent. As women age, the success rates decrease significantly. A consultation with your OB/GYN or a reproductive endocrinologist is important before testicular surgery is done.
Cost
Insurance may cover for this procedure in certain states. Otherwise, you may be self-pay at a cost of around $5,000 to $10,000 for the procedure and around $3,000 to $5,000 for the medications.
Risks
Risks include ovarian swelling or hyperstimulation. There is a chance for complications of the egg retrieval, which is rare but may include bleeding or damage to the ovary. There is a 20 to 30 percent chance of a multiple pregnancy. The rare possibility of damage to the testicle or sperm can result from the sperm extraction.
Advantages include that it is a shorter period of time before you can begin to try for pregnancy. You may try immediately with IVF once the sperm retrieval has been done. This is much faster than the vas reversal where you may have to wait one to two years to see if it worked. IVF may also treat any female problems of infertility and it may be covered by insurance.
In summary, there are always choices and both of these should be considered after consulting both a doctor who does the reversal and a doctor who specializes in female reproduction to properly consider the best choice for you and your partner.
Can you conceive when he's on Viagra?
Nancy & Betsy
Viagra is a medication used to treat erection difficulties (including erectile dysfunction). So if your partner takes this little blue pill (generic name: Sildenafil), is it safe to try to conceive?
The answer to that question is yes, says Ob/Gyn David M Barrere, MD, FACOG. "There are no contraindications to conceiving while your partner takes Viagra," he says. "During the testing phase of Viagra, there was no effect on sperm motility, form or structure after single 100-mg oral doses in healthy volunteers." He also notes that, although the recommended dose is 50 mg, it may be increased to a maximum of 100 mg or decreased to 25 mg, depending upon the patient's response.
So how does Bob Dole's favorite wonder pill do its job, anyhow? Barrere explains, "Viagra works by inhibiting an enzyme, phosphodiesterase type 5 (PDE5), resulting in smooth muscle relaxation and flow of blood into the corpus cavernosum of the penis. This helps to achieve and maintain an erection."
According to the manufacturer Pfizer, erectile dysfunction is often the result of a decrease in blood flow to the penis. This can be caused by high blood pressure, high cholesterol and stress, among other things.
Once he takes it, Viagra can get the job done in as little as 30 minutes, and then works for at least four hours.
Keep up the good work, man.
Viagra is a medication used to treat erection difficulties (including erectile dysfunction). So if your partner takes this little blue pill (generic name: Sildenafil), is it safe to try to conceive?
The answer to that question is yes, says Ob/Gyn David M Barrere, MD, FACOG. "There are no contraindications to conceiving while your partner takes Viagra," he says. "During the testing phase of Viagra, there was no effect on sperm motility, form or structure after single 100-mg oral doses in healthy volunteers." He also notes that, although the recommended dose is 50 mg, it may be increased to a maximum of 100 mg or decreased to 25 mg, depending upon the patient's response.
So how does Bob Dole's favorite wonder pill do its job, anyhow? Barrere explains, "Viagra works by inhibiting an enzyme, phosphodiesterase type 5 (PDE5), resulting in smooth muscle relaxation and flow of blood into the corpus cavernosum of the penis. This helps to achieve and maintain an erection."
According to the manufacturer Pfizer, erectile dysfunction is often the result of a decrease in blood flow to the penis. This can be caused by high blood pressure, high cholesterol and stress, among other things.
Once he takes it, Viagra can get the job done in as little as 30 minutes, and then works for at least four hours.
Keep up the good work, man.
How often are tubal reversals successful?
Mark Kan, MD
Medical Editor Mark Kan, MD, offers some information about the reversal of tubal ligation and the potential of future pregnancies.
Your question
How often are tubal reversals successful? What needs to be done to reverse tubal sterilization?
The expert answers
Tubal sterilization is generally considered a permanent procedure. While it is not always possible, reversal of sterilization procedures can be attempted in appropriate patients. An alternative to tubal reversal surgery is in-vitro fertilization (IVF), which bypasses the tubes altogether, and can also lead to a successful pregnancy.
The method of initial tubal sterilization is important. Because tubal sterilization requires the tubes to be tied, clipped or burned with electrical current, there is always fallopian tube damage. This damage often precludes successful reversal surgery. The operative report from the initial surgery will detail which technique was performed. A patient considering this procedure should have a complete work-up, checking for male infertility, normal ovulation and other causes of infertility.
A hysterosalpingogram (X-ray test of the uterus and tubes) is routinely performed to check the status of the uterine cavity and proximal fallopian tubes. These tests are performed to ensure there are no other reasons for infertility before an elective reversal surgery. Given the appropriate candidate, reversal techniques have reported success rates between 50 to 80 percent. Additional benefits include a lower rate of multiple gestation when compared to IVF and the ability for future conception without additional procedures. It is important to know that even in the best candidates, the surgery may not be possible or successful. In addition, there are routine surgical risks involved with laparoscopy and laparotomy.
A reproductive endocrinology and infertility specialist is a reproductive surgeon trained in both tubal surgery and IVF. These specialists can explain the risks and benefits of both procedures, and help you make the best decision for achieving pregnancy.
Medical Editor Mark Kan, MD, offers some information about the reversal of tubal ligation and the potential of future pregnancies.
Your question
How often are tubal reversals successful? What needs to be done to reverse tubal sterilization?
The expert answers
Tubal sterilization is generally considered a permanent procedure. While it is not always possible, reversal of sterilization procedures can be attempted in appropriate patients. An alternative to tubal reversal surgery is in-vitro fertilization (IVF), which bypasses the tubes altogether, and can also lead to a successful pregnancy.
The method of initial tubal sterilization is important. Because tubal sterilization requires the tubes to be tied, clipped or burned with electrical current, there is always fallopian tube damage. This damage often precludes successful reversal surgery. The operative report from the initial surgery will detail which technique was performed. A patient considering this procedure should have a complete work-up, checking for male infertility, normal ovulation and other causes of infertility.
A hysterosalpingogram (X-ray test of the uterus and tubes) is routinely performed to check the status of the uterine cavity and proximal fallopian tubes. These tests are performed to ensure there are no other reasons for infertility before an elective reversal surgery. Given the appropriate candidate, reversal techniques have reported success rates between 50 to 80 percent. Additional benefits include a lower rate of multiple gestation when compared to IVF and the ability for future conception without additional procedures. It is important to know that even in the best candidates, the surgery may not be possible or successful. In addition, there are routine surgical risks involved with laparoscopy and laparotomy.
A reproductive endocrinology and infertility specialist is a reproductive surgeon trained in both tubal surgery and IVF. These specialists can explain the risks and benefits of both procedures, and help you make the best decision for achieving pregnancy.
Male fertility and tobacco
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?)
Your question:
My husband is a smoker (about 1 pack a day). Has there been any research done on how the chemicals effect the male's fertiity or longterm health of the fetus.
The expert answers:
Great question. There have been many studies of smoking and fertility. Male smokers have decreased sperm parameters and decreased fertility. Female smokers also have decreased rates of fertility and decreased fallopian tube function. smoking can lead to all kinds of serious problems with the baby. Quitting smoking is the single most important thing you can do for your health and well-being, including your fertility. Smoking cessation programs are available through most major hospitals.
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?)
Your question:
My husband is a smoker (about 1 pack a day). Has there been any research done on how the chemicals effect the male's fertiity or longterm health of the fetus.
The expert answers:
Great question. There have been many studies of smoking and fertility. Male smokers have decreased sperm parameters and decreased fertility. Female smokers also have decreased rates of fertility and decreased fallopian tube function. smoking can lead to all kinds of serious problems with the baby. Quitting smoking is the single most important thing you can do for your health and well-being, including your fertility. Smoking cessation programs are available through most major hospitals.
Erectile dysfunction should not be a threat to your private life
ERECTILE DYSFUNCTION is no longer a taboo topic. This problem is not treated like a problem no more. It is more of a fact that needs a simple doctor's prescription. There are many and many medications that promise to give you a good result. But you have to remember one thing - no pill will promise to give you the desire to have sex when you don't want it. Erectile dysfunction pills are produced to help men feel strong again. As we all know good sexual life means a lot to men. Therefore those who do not receive joy from sex are not fully satisfied in life. As the result lots of complexes and insecurities appear.
Before you rush to grab your coat to purchase erectile dysfunction medication, we want to update you with some of the most important information on the drugs. Most impotence drugs resemble each other. Mainly this is so because of the fact that they are meant to cure impotency and their ingredients and effect on the body is the same. If you want to experiment and try different medication in order to choose the best one for yourself - you can do so, but it is better to get an advice from a good specialist that will prescribe you the dug according to your problem and budget. Usually erectile dysfunction medicine is quick and effective.
What is necessary to remember for every individual is that impotence drugs are good for 90% percent of people but not to everyone. It may depend on lots of things from overall health state to body reaction on the drug itself. It is not recommended to mix any medication with any other type of drugs as it may lead to unpredictable consequences. The reason why we always advice our readers to seek some professional advice is because anybody who suffers from side -effects while taking drugs can fall into category of people that will suffer more from the drug that is supposed to help than they have to really. The period of time that the drug stays active during is 36 hours so it may be too much to handle well.
Erectile dysfunction medication has been the matter of multiple researches that clinical staff studied. There researches gave a certain guarantee that the pills actually help those that address them for impotence help. Whether you have mild, moderate and severe erectile dysfunction - there will always be a pill that will control your sexual potency and make it better. But don't get caught up in lies when you hear that drugs like Viagra will give you an urge to have sex. The truth is that the drug will only help you stay sexually active when you have the desire to have sex but you can't. Satisfaction and the ability to maintain erections for successful sexual intercourse are the main promises of any impotence pill.
Cialis is one of the best impotence curing medication on the market right now. It is better than well-known Viagra as its effectiveness lasts slightly longer. But don't just trust our work like that and get it straight away. It is important to buy Cialis with a full awareness of the right choice made. Just like any other pill, this medication can be harmful to those who do not know how to treat themselves with pills. You can pre-order the drug from any online pharmacy or buy Cialis in the local drugstore. Either way you will make a right decision if that's what you need to take.
Before you rush to grab your coat to purchase erectile dysfunction medication, we want to update you with some of the most important information on the drugs. Most impotence drugs resemble each other. Mainly this is so because of the fact that they are meant to cure impotency and their ingredients and effect on the body is the same. If you want to experiment and try different medication in order to choose the best one for yourself - you can do so, but it is better to get an advice from a good specialist that will prescribe you the dug according to your problem and budget. Usually erectile dysfunction medicine is quick and effective.
What is necessary to remember for every individual is that impotence drugs are good for 90% percent of people but not to everyone. It may depend on lots of things from overall health state to body reaction on the drug itself. It is not recommended to mix any medication with any other type of drugs as it may lead to unpredictable consequences. The reason why we always advice our readers to seek some professional advice is because anybody who suffers from side -effects while taking drugs can fall into category of people that will suffer more from the drug that is supposed to help than they have to really. The period of time that the drug stays active during is 36 hours so it may be too much to handle well.
Erectile dysfunction medication has been the matter of multiple researches that clinical staff studied. There researches gave a certain guarantee that the pills actually help those that address them for impotence help. Whether you have mild, moderate and severe erectile dysfunction - there will always be a pill that will control your sexual potency and make it better. But don't get caught up in lies when you hear that drugs like Viagra will give you an urge to have sex. The truth is that the drug will only help you stay sexually active when you have the desire to have sex but you can't. Satisfaction and the ability to maintain erections for successful sexual intercourse are the main promises of any impotence pill.
Cialis is one of the best impotence curing medication on the market right now. It is better than well-known Viagra as its effectiveness lasts slightly longer. But don't just trust our work like that and get it straight away. It is important to buy Cialis with a full awareness of the right choice made. Just like any other pill, this medication can be harmful to those who do not know how to treat themselves with pills. You can pre-order the drug from any online pharmacy or buy Cialis in the local drugstore. Either way you will make a right decision if that's what you need to take.
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