Protecting Your Fertility

Protecting Your Fertility: Now and for Future Pregnancy

To many couples, one of the most important events in their lives is the birth of their child.  While the ability to conceive a pregnancy is often safely taken for granted, one in seven couples will struggle with infertility.  For those couples, this basic desire to have a family may become a challenge that can ultimately strain their relationships and become an overwhelming issue that consumes their lives.

Although most couples spend their early years focusing on how not to get pregnant, there are some basic tips for each stage of life that, if followed, will significantly lessen the likelihood that they will ultimately face infertility.

Singles Can Safeguard Their  Future Fertility

Many behavioral choices made early in life can significantly affect one’s subsequent fertility.  For example, certain lifestyle choices – such as smoking, risky sexual behavior, and diet and exercise – can ultimately impair or enhance the ability to conceive.

Although everyone knows that cigarette smoking increases the risk of developing cancer, heart disease, and lung disease, few people know that smoking can also lead to early menopause and infertility.  In fact, smokers have a 66 percent higher chance of infertility and, if they do conceive, they have a 70 percent increased risk of having a miscarriage.  While most smokers say that they will quit smoking as soon as they conceive, for many the damage has already been done.    Even second-hand smoke can negatively affect fertility, so it’s very important that young adults – and even parents and grandparents – either avoid becoming smokers or quit immediately.

Other habits, such as illicit drug use and alcohol abuse, can also negatively impact one’s fertility.  Marijuana can interfere with ovulation and sperm production, and – contrary to popular belief – it can also adversely affect sexual performance. Cocaine can alter blood flow to the uterus, potentially affecting implantation.  Common street drugs such as crystal methamphetamine, ecstasy, and oxycontin can cause lower sperm counts, decreased libido, and problems with ovulation.  Even certain prescription drugs, when abused, can lead to infertility. Alcohol abuse can also adversely affect hormone production and metabolism, leading to potential problems with ovulation and sperm production.

Drug and alcohol abuse may also impair one’s otherwise good judgment and lower inhibitions leading to risky sexual behavior.  Unprotected sexual intercourse – whether promiscuous OR ISOLATED – significantly increases the risk of infection with a sexually transmitted disease (STD).  Although many young adults believe that oral contraceptives or spermicides protect against STD transmission, in fact, only latex condoms provide such protection – and then only when used correctly.  Some contraceptives, such as the IUD or using spermicides alone, may actually increase the risk of STD transmission. These infections, specifically gonorrhea and chlamydia, can do irreversible damage to the fallopian tubes, markedly increasing the risk of infertility.

While there is no diet that will ensure normal fertility, experts agree that all women should follow a well balanced diet as well as a regular exercise regimen to optimize their overall health.  In addition, all women should consider taking a daily multivitamin.  Over-the-counter prenatal vitamins are an excellent choice, as they provide a cost-effective, enhanced combination of supplements in one daily pill that exceeds that found in many more expensive, multi-pill regimens.  In addition, when one is ready to pursue pregnancy, the higher levels of folic acid found in prenatal vitamins can protect against the development of fetal malformations such as spina bifida.

Fertility Considerations for Married Couples

One of the last things on newlyweds’ minds, appropriately so, is fertility.  However, it is important to at least broach the subject of conception early in marriage.  With many couples choosing to get married at later ages, an early conversation about fertility is even more important.  While it is fact that a woman’s fertility declines as she ages, it is important to separate the hype from the reality.

MYTHS:

  • Women can easily conceive into their early to mid-40s
  • Infertility is a female problem
  • If we just keep trying we’ll get pregnant

FACTS:

  • Women are born with all of the eggs that they will ever have, approximately 6-7 million
  • This number decreases rapidly:
    • At puberty, a woman has 300,000-500,000 eggs
    • By age 40, only 10,000 eggs remain
  • Infertility is due to male problems in 40-50 percent of cases, so men should also be evaluated by a fertility doctor
  • Couples who fail to conceive after one year of unprotected intercourse (six months if the woman is over 35) should see a specialist

Fertility rates remain high throughout one’s twenties and early thirties, so for most couples, there is no need to rush into pregnancy.

It’s Time: You’ve Decided to Get Pregnant!

When a couple decides that they are ready to pursue pregnancy, there are several things that they should consider.  Typically it is fine to attempt conception as soon as one stops using contraception.  The “old wives’ tale” about needing to be off of birth control pills for three months before conception was never true.  Similarly, one needs to wait only one cycle after having an IUD removed before trying to conceive.

There are certain tests that couples may choose to undergo before attempting pregnancy.  These “preconceptual tests” can evaluate one’s chromosomes for the presence of over 100 genetic diseases that are potentially preventable with today’s technology.  Examples include Tay Sach’s disease, Canavan’s disease, and sickle cell anemia.  A simple saliva or blood test can identify whether either partner is a “carrier” of these genetic conditions.  As both partners need to be carriers for a child to be affected with most genetic diseases, if one partner tests negative, there is no need to worry that an affected child will be conceived.  In cases in which both partners test positive for the same condition, advanced fertility treatments can diagnose the presence of disease in an embryo prior to the time of implantation.  Then, if the couple so chooses, a fertility specialist can transfer only those embryos that do not carry the disease.

Once you are ready to attempt conception, a few basic tips can help shorten the process and make it more successful.  Couples should have sex every other day mid-cycle; women should consider buying an over-the-counter ovulation prediction kit to let them know both if and when during their cycle they are ovulating; and couples who have not conceived after 12 months of trying should seek care from a fertility specialist.  This last recommendation has been modified to six months if the woman is 35 or older.  In addition, couples should seek care sooner if they already know that they may have a problem.  For example, if either partner has previously had an STD, if the woman has irregular cycles or she has had abdominal or pelvic surgery, or if either partner has a chronic medical condition such as diabetes, hypertension, or cancer, they should consult a fertility specialist right away.

Prepare to welcome the next generation

Infertility affects one in seven couples in the United States, or approximately 7.3 million couples.  Although the overwhelming majority of affected couples can be successfully treated, taking simple steps before one is even ready for pregnancy can preserve your fertility and enable most couples to easily conceive whenever the time is right for them.