A Baby, Maybe?

By The American Fertility Association

Neither of you can say when it started, but in baby-step increments, you both notice sidewalks full of strollers and find baby gap windows strangely irresistible. Your partner gets misty watching toddlers in the park. And none of your workmates suspects you’re spending hours poring over baby books.

What’s got a grip on you?

It’s simple: you want to have a baby. And it’s not so simple: you want to have a baby.

As with every monumental endeavor, each couple’s path to parenthood is uniquely unpredictable: smooth or rocky, straight or wildly circuitous.

Let this booklet help you navigate this exhilarating, sometimes crazy-making road trip towards conception. With heart, humor and a healthy dose of concrete knowledge about human reproduction, your journey starts now.

SEX-ED FOR DUMMIES

Birds, bees…. oh please. You learned everything you need to know back when pimples were your priority.

Right? Not exactly.

The number of ostensibly enlightened people who are sketchy on the basics of baby-making is stunning. In fact, of the more than 12,000 women who answered our 15-question survey on essential fertility facts, only one correctly answered all the questions. Most were unaware that the prime time for procreation is in one’s twenties and after that you are playing for time.

THE REAL DEAL AND TICK-TOCK TALK

The shocker is that fertility declines at a much earlier age than is generally assumed. If you’re a healthy woman, fertility peaks in your mid-twenties and starts to decline at about age 27. Millions of us are simply unaware how fast the fertility clock winds down.

It keeps on ticking for men, too. Recent studies indicate that men may start losing their fertility as early as 35. Over 50, many may experience a decline in sperm quality, dropping testosterone levels and a diminished libido.

So what’s up? Why does it get harder to conceive as we get older?

ALL YOUR EGGS IN, UM, ONE BASKET

Of all the factors this is the biggie:

• Women are born with all the eggs they’ll ever have; a generous endowment of seven million eggs, give or take a mill.
• Most ova never reach maturity; they’re resorbed into the body.
• By puberty, roughly 250,000 to 300,000 eggs remain, the number dropping with each ovulation and passing year.

But it’s more than a numbers game. There’s quality. Those eggs age right along with the rest of your body. The older the egg, the greater the potential for chromosomal abnormalities, which can lead to miscarriage or birth, defects.

The reproductive roadblocks are different in every case, but in 40% of the time the problem stems from the male, another 40% from the female. 10% will learn both partners contribute, and the remaining 10% will be left with an unexplainable mystery.

If you think you might be infertile, don’t panic.

Infertility does not mean sterility. With increasingly refined medical treatments, (including surgery to clear blocked fallopian tubes or hormones that fine-tune ovulation, for instance), up to 90% of infertile couples eventually become pregnant. (The success rate of medically-assisted pregnancies, however, is as dependent maternal age as it is with “natural” conception.)

REMEMBRANCE OF THINGS PAST

If you’re experiencing trouble, now is a crucial time for you and your partner to each create a detailed health history. Past and present illnesses, surgeries and medications can all have a profound effect on your fertility. See your doctor if either of you have experienced any of the following:

• Abnormal reproductive or sexual functioning. Irregular menstrual cycles and difficulty achieving or maintaining erections could require medical intervention.
• Chronic illness: Diabetes, hypothyroidism, hypertension, sickle cell, endometriosis and even peptic ulcers can cause infertility. Sometimes the treatment (high blood pressure medications, for example) inhibits conception. Review your prescriptions for contraindications.
• Past illnesses, treatments and surgeries: Radiation treatments, especially at levels used to cure cancer, can cause infertility in both genders. Men who had mumps during puberty may have impaired sperm production. Women who’ve had pelvic or abdominal surgery, such as an appendectomy, are susceptible to pelvic adhesions that inhibit conception. IUD’s can scar the uterus and cause repeated miscarriages.
• Sexually transmitted diseases, such as gonorrhea and chlamydia, are one of the leading causes of infertility. Even herpes can compromise a uterus’ ability to support a pregnancy.
• Exposure to environmental hazards: radiation, chemicals, workplace toxins and pesticide exposure can impede male sexual function and sperm production. Women exposed to some toxins are at an increased risk of miscarriage.

MALE CALL

There’s nothing like the possibility of male infertility to mess with a man’s machismo. Most men would rather have an eye poked out or at least change the subject. But the truth is, male factor is the root cause of infertility in 40% of all cases.

Just remember, infertility is a disease, attributable to a wide variety of causes, genetic, physiological or environmental.

It’s imperative that men undergo a complete fertility work-up just like their partners do. Find a urologist who specializes in male infertility, who will take a detailed health history and perform the right tests, including sperm analysis.

And there is help. Microsurgical repairs and even sperm extraction from testicles are but some of the breakthroughs that can bring a couple closer to their goal.

KEEP YOUR HEAD

Whether this is the first month you’re trying or you’ve been at it for what feels like an eternity—-stress is the relentless soundtrack.

It comes from anywhere and everywhere. Your parents want instant grandchildren. Your colleagues shower you with unsolicited, often loony, advice. Casual acquaintances chip in tips for sure-fire conception.

Not to mention that the relationship with your partner feels like it’s fraying.

It’s time to calm down and treat yourselves with the utmost kindness. Stress, in cahoots with a volatile mix of other emotions, is part of the make-a-baby fall-out.

The key to staying sane is managing that stress.

Express yourself. If you don’t want to broadcast that you’re trying to get pregnant, confide in a trusted friend or your journal. If you are dealing with infertility, find a reputable support group where you can unload and get a sympathetic hearing as well as advice.

DO TRY THIS AT HOME

After dreaming, dithering and much discussion—you’ve agreed, “OK, now!” So boost your chances of pregnancy by insuring you’ve got the timing down. Our data reveals that up to 20% of couples having difficulty consistently miscalculate the best time for intercourse. That’s because there’s a slender 12-to-24 hour monthly window when an egg can be fertilized, usually around the middle of your menstrual cycle. Calculate your prime time for conception by subtracting 17 days from the average length of your cycle.

For greater precision, track your basal body temperature (BBT). Using an over-the-counter thermometer, you religiously take your temperature every morning before you get out of bed. BBT usually registers between 97.2 and 97.6 degrees during the first half of the menstrual cycle; then spikes one-half to one degree right after ovulation. Charting your pattern over several cycles helps you predict when you ovulate, ergo, your best shot at conception.

For pinpoint accuracy, try over-the-counter fertility kits and monitors. Ovulation test kits measure the surge in your fertility hormone (LH), a chemical go-ahead. Monitors, while more pricey, give advance notice of your peak fertility period. Used correctly, these ovulation predictors take out the guesswork.

How often? Have intercourse every other day during your most fertile period, at least four separate times. Just don’t get overly ambitious. Having sex more than once a day depletes the sperm count.

Just lie there? Stay put after intercourse to keep the sperm inside and swimming upstream. (Headstands might be your idea of post-coital fun, but there is no medical evidence that it improves the conception odds.)

Do come clean! Over the years you’ve both undoubtedly vowed to embrace a healthy lifestyle—lots of fresh foods, plenty of shut-eye, and exercise. Okay, do it. We’re talking common-sense health habits that can enhance your baby-making chances.

Tackle the diet drill. Pile your plate with fruits, fiber, veggies and low-fat protein. Protein prevents estrogen from lengthening menstrual cycles. Vitamin C helps keep sperm motile. Beans, leafy greens, orange juice and some high-fiber grains provide the folic acid you both need. It increases sperm count and prevents birth defects. And steer clear of heavily processed foods.

Limit those lattes. The jury’s still out on the coffeeconception connection. But more than one cup a day may delay pregnancy.

Too fat or too thin? You may be surprised that up to 12% of fertility problems are affected by your size. Being too thin can slam the brakes on menstruation. Too heavy, and you’re tinkering with hormones necessary for conception. Ditto overweight guys—who could have hormonal problems associated with lower sperm count and quality.

Butt out. Consider that cigarette your last, no exceptions. Tobacco plays havoc with your estrogen metabolism, boosts miscarriage rates, increases the risk of ectopic pregnancy and cervical cancer, and leaves you vulnerable to pelvic infections. Smoking also damages sperm and lowers sperm counts.

Get regular exercise, but don’t go overboard. Bag the triathlon. Intense workouts, like long-distance running, can trigger amenorrhea—the absence of menses. Strenuous exercise can overheat the testicles and reduce sperm count.

Abstain from alcohol. Drinking is linked to low sperm count, menstrual and ovulatory dysfunction, miscarriage and birth defects.

Same for drugs. Even marijuana can mess with ovulation and, yes guys, sexual function. Even prescription pharmaceuticals can have an adverse affect, so check with your doctor.

But before you get on the stick, you should know that one year of unprotected sex, (six months if the woman is over 35), that hasn’t produced a pregnancy may indicate infertility. This is the big red flag signaling you both to see a specialist straight away.

THE TRYING GAME

For some couples, it seems like conception requires only a flirtatious glance and proximity.

For others, though, reproduction is more of a trying game. Statistically speaking, it will take a 30-year-old couple six months to conceive a child. Nine months for those 35 and older. At age 37, about half of all couples will not conceive within a year; by 42, it jumps to approximately 90%.

Infertility is a club no one’s clamoring to join. But if you are having difficulty, you have lots of company: infertility affects roughly six million people in the US; that’s one out of every ten couples.

Couple care. Few other experiences tax a couple like trying to get pregnant. While sex may now feel reduced to another obligation, make room for other intimacies: hugs, kisses—physical contact that doesn’t always end in intercourse.

Move, meditate, and breathe. Take your mind off yourself. Try volunteering or picking up a hobby. Don’t forget, you are more than your ability to procreate.

IF YOU THINK YOU’RE PREGNANT

Everything falls into place, your timing is impeccable, your lifestyle beyond reproach. One day you just might feel a little something, say tender breasts, even before you miss a period. You suspect you’re pregnant. Don’t wait. Get tested. There are plenty of reliable, easy-toread home pregnancy tests. The earlier you know, the sooner you can begin taking proper care of yourself and the baby to be.

UNTIL THEN

The stress, pressure and agitation of trying to conceive and infertility can exact a hefty toll. Handling it on your own works for some, but for others, professional counseling is invaluable. The American Fertility Association can help you find a knowledgeable counselor as well as refer you to support groups. Call toll free at (888) 917-3777 to get the help you need from the people who’ve been through it.

This brochure was sponsored by an unrestricted educational grant from Unipath Diagnostics. http://www.clearblueeasy.com