For many couples, having a healthy baby is an important goal. But for some, conceiving a child isn’t easy. Difficulty or an inability to conceive naturally, also called infertility, is a common problem. The Centers for Disease Control and Prevention reports that “about 6 percent of married women aged 15 to 44 years in the United States are unable to get pregnant after one year of trying (infertility). Also, about 12 percent of women aged 15 to 44 years in the United States have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status (impaired fecundity).”
“There’s a lot of things that can cause infertility,” says Dr. Zev Williams, chief of the Division of Reproductive Endocrinology and Infertility and associate professor of obstetrics and gynecology at Columbia University Fertility Center in New York. “But it should be reassuring to couples that for so many of the common problems, there’s very good solutions available.”
[See: Diet and Lifestyle Advice for Polycystic Ovary Syndrome.]
One of the most common causes of infertility, Williams says, is when the woman isn’t ovulating, or releasing eggs, regularly. This can happen for a few reasons, but a common one is a condition called polycystic ovary syndrome, a treatable hormonal disorder that affects the ovaries and metabolism. The U.S. Department of Health and Human Services reports that PCOS affects about 1 in 10 women, but up to half may be undiagnosed. “If there’s no egg being released, then there’s no chance for fertilization,” Williams says. But in the case of PCOS, it can often be fixed with “simple pills that can be taken to help that woman start to ovulate regularly.”
Other conditions may also decrease your chances of conceiving, including tubal disease, Williams says. This occurs when there’s a blockage or “damage to the fallopian tubes so the sperm can’t even reach the egg. In that situation, something like in vitro fertilization would be a successful solution.” IVF is a procedure in which the egg and sperm are harvested from the parents. The egg is then fertilized outside the body in a “test tube” — more accurately a petri dish in a lab. The first successful IVF procedure was conducted in 1978, leading to the healthy birth of Louise Brown in England who recently celebrated her 40th birthday.
Although the focus with fertility often falls on the woman because she will carry the baby, infertility is not solely a female problem. The CDC reports that “in about 35 percent of couples with infertility, a male factor is identified along with a female factor. In about 8 percent of couples with infertility, a male factor is the only identifiable cause.”
In many discussions of fertility, “the father has been ignored,” says Dr. Marianne J. Legato, an academic, physician, author, lecturer and pioneer in the field of gender-specific medicine. A professor emerita of clinical medicine at Columbia University Vagelos College of Physicians and Surgeons and an adjunct professor of medicine at Johns Hopkins University School of Medicine, Legato is also the director of the Foundation for Gender-Specific Medicine and has done extensive work in the field of reproductive medicine. She says that “male fertility is down. Worldwide there’s been an estimated 40 percent decrease in the number of fertile males in the world, which is very alarming. We’re not quite sure why that’s true, but the increasing frequency of toxins in the environment, of hormones like estrogen added to foods — all of that has had a negative effect on male fertility and that should be taken very seriously.”
In many cases, these issues can be corrected, but you have to know what you’re working with first. “The first thing that should be done is to test the quality and amount of sperm in the father,” Legato says. This testing takes the form of a semen analysis, which will examine the number and concentration of the sperm in the man’s ejaculate as well as their size and shape (morphology) and swimming ability (motility).
Once that’s been analyzed, the man may be able to make some simple changes to improve his sperm’s chances of fertilizing an egg naturally. Legato says “there’s a 42- to 76-day window of opportunity before a conception actually takes place to plump up (no pun intended) the quality of the sperm,” and that improving the man’s diet is very important to improving the quality of sperm.
[See: Why Can’t I Get Pregnant?]
Legato says the “single most important nutritional intervention we can make is to ensure enough quantities of what we call antioxidants.” Antioxidants are compounds that inhibit oxidation in the cells, which can prevent damage. “Some of the most damaging things in the environment are toxins called free radicals, and the way we protect against them is to supply the person with antioxidants. Antioxidants prevent damage to the sperm,” and can boost a man’s fertility. “Good nutrition supplements” that help you achieve “adequate levels of vitamin E, which affects sperm motility, and beta carotene, which helps sperm concentration and motility,” may also help.
Williams says that in cases of low sperm count or abnormal sperm characteristics, if other interventions don’t help, doctors can try to solve the conception problem with “intrauterine insemination where the sperm are placed right inside the uterus, or doing IVF where a single sperm is placed directly into the egg.”
In addition, Legato says lifestyle adjustments may help. Discontinuing the use of alcohol, tobacco and other drugs and reducing stress can also improve the quality of a man’s sperm, and are important factors in a successful conception. Losing weight if you’re obese or not gaining more weight may also help. “To sum up, fertility is not only the business of the wife, it’s also that of the husband. Nutrition and other factors in the environment, lifestyle, toxins in the environment — all of that can affect the quality of sperm,” she says.
For women, good nutrition is also very important to creating a healthy environment in which conception can take place as well as supporting a growing fetus. Following the so-called Fertility Diet may help you conceive and provide an appropriate balance of nutrients needed to support a developing baby. Talk with your doctor about the best way to achieve the necessary levels of important nutrients such as calcium, iron, folate and vitamins A, C, D, B6 and B12.
No matter the cause of the infertility, the doctor who can help you find ways to improve your chances of conception is a reproductive endocrinologist. Reproductive endocrinology is a subspecialty of obstetrics and gynecology that addresses hormonal function as it relates to reproduction. These highly trained specialists can treat infertility in a variety of ways.
Williams says couples should seek help from a reproductive endocrinologist “if they’ve been trying to conceive for a year without success if they’re under age 35, or if they’ve been trying for six months over the age of 35, with one big caveat — which is that’s assuming there’s no other medical issue going on that’s making it difficult for them to conceive.” In those cases, you may want to seek help sooner, particularly if you’re older. “If someone has a medical condition that’s making it hard for them to get pregnant, it doesn’t matter how long they try, it’s going to be unlikely for them to be successful,” he says.
Generally speaking, the longer you wait to try conceiving or seek help for problems conceiving, the harder it becomes to get pregnant, Williams says, in part because “a woman is born with all the eggs she’ll have. And through her life, those eggs get used up. So over time, there’s fewer and fewer eggs, and it’s harder and harder to get an egg.” In addition, as time marches on, “each egg has a higher and higher chance of having a chromosomal abnormality. So there’s this balance we try to make where we don’t want to intervene when it’s not necessary, but we don’t want a couple to delay too long in getting intervention when they really need it,” he says.
[See: The Real Sperm Killers.]
When it comes time to find the right doctor for your situation, “you want to make sure that whomever you’re seeing is board-certified in reproductive endocrinology and fertility,” Williams says. The American Board of Obstetrics and Gynecology offers board certification in the subspecialty of reproductive endocrinology and infertility, and in order to qualify for this certification, physicians need to “have the necessary training and experience and also judgment.” Williams says it’s important to verify the quality of the fertility clinic where you’ll be treated. One way to do that is to determine whether the facility is “a member of the Society for Assisted Reproductive Technology.” The SART organization issues standards for assisted reproductive technology and maintains a database and oversight of fertility centers around the country. Williams says it’s also helpful to seek recommendations from friends and family members who may have had similar problems.
Lastly, dealing with fertility problems, when all you want is to start a family, can be emotionally challenging. But being anxious about the situation only adds to the difficulty. Legato says “we know that a stressless environment, a peaceful environment really prevents the child from being born with anxiety issues, and the husband’s stress also contributes to that. I think trying to establish a peaceful environment in both the father’s and mother’s life is important.” Williams adds that “it can often be a very difficult time for the couple, and it’s important to be supportive of each other. Especially when going through something like this, it’s good to have each other there to support one another.” So stress less, eat right, take care of each other and talk to your doctor if you’re still having trouble getting pregnant.
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Diet and Lifestyle Advice for Polycystic Ovary Syndrome
Which Doctor Can Help Me With Infertility? originally appeared on usnews.com
