Enhancing Fertility: What Works?
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Enhancing Fertility: What Works?
Recent improvements
in medication, microsurgery, and in vitro fertilization (IVF) techniques make
pregnancy possible for more than half of the couples pursuing treatments. But
what can you do to increase your chances of conceiving before getting into this
invasive, expensive, high-tech arena?
- Preconception visit: I recommend that all women go to see an obstetrician/gynecologist
when trying to conceive, whether or not they've had difficulties getting pregnant.
Getting good health care before you become pregnant will help you-and your
baby--throughout your pregnancy and delivery. As part of your visit, you will
be asked questions about your family and medical history, medications you
take, your diet and life style, and any past pregnancies...in addition to
having a complete physical exam and any lab tests your physician recommends.
- Stress Reduction techniques: Stress can affect your mood, your sleep
patterns, your immune system as well as the function of many body organs.
Chronic stress can also cause or worsen depression.
Although infertility can be a very stressful experience, there is very little
data to support the conventional wisdom that infertility is caused by stress.
In rare cases, high levels of stress in women can change hormone levels and
cause irregular ovulation. Some studies have shown that high stress levels
may also cause decreased sperm production in men. Research has shown that
women undergoing treatment for infertility have a similar, and often higher,
level of "stress" as women dealing with life-threatening illnesses such as
cancer and heart disease. Infertile couples experience repeated stress each
month, first hoping that they will conceive and then dealing with the disappointment
if they do not.
When diagnosed with infertility, many couples may no longer
feel in control of their bodies or their schedules. Fertility/infertility
testing and treatments can be physically, emotionally, and financially stressful.
Furthermore, a couple's intimacy and flexibility is often reduced by the infertility
experience, which further contributes to increased stress.
- Group Therapy/counseling: Harvard Medical School researchers recently
reported that group psychological intervention may improve the pregnancy
rates for patients with infertility. They studied 184 women attempting to
achieve pregnancy for one to two years who were not currently undergoing any
other forms of therapy or suffering from clinical depression. After one year,
more than half of the women who received counseling and participated in a
support group became pregnant versus one in five of the women in the control
group.
- Weight Changes: Both weight and exercise-independently--can affect
fertility.
Significant weight loss or being significantly underweight can decrease fertility.
In mild cases the ovaries may still produce and release eggs, but the lining
of the uterus may not be adequately prepared. In more severe cases, ovulation
may not occur, and menstrual cycles may become irregular or absent. In men,
being underweight or losing significant body weight may lead to decreased
sperm count or function.
Being overweight or obese can also affect fertility: increased weight can
increase insulin levels in women, which may cause the ovaries to overproduce
male hormones and stop releasing eggs. Weight loss is the best plan of action,
but fertility drugs can be helpful in overweight patients.
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 One in five couples who have a complete infertility evaluation are diagnosed with unexplained infertility - no specific cause is identified. 
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