Pregnancy Lounge

Category: Getting Pregnant

  • Infertility Causes in Men

    Infertility affects men and women equally. In both men and women, multiple factors can account for difficulty with fertility. Male factors attribute to about 1/3 of infertility problems, while another 1/3 are caused by female factors. The remaining 1/3 of infertile couples have problems caused by a combination of factors in both partners or have unexplained causes. No obvious problem is found in around 10% of couples investigated for infertility. This is when no physical, hormonal or immunological cause for infertility is found in either partner.

    Sperm Abnormalities

    More than 90% of male infertility is caused from sperm abnormalities. Sometimes sperm are malformed and improperly shaped, which makes it difficult for the sperm to reach the egg. Abnormal shape and structure can lead to impaired mobility. If sperm cannot move rapidly and accurately towards the egg, fertilization cannot occur.

    Some men produce too few sperm. A sperm count of 13.5 million per milliliter of semen or less indicates low sperm concentration. Mild to severely impaired sperm production can be caused by undescended testicles, which occurs when one or both testicles fail to descend from the abdomen into the scrotum during fetal development. This affects sperm production, because the testicles are exposed to higher temperatures. Genetic causes, such as a chromosomal abnormalities can affect fertility, as well. Klinefelter’s syndrome, which is a disorder of the sex chromosomes, causes abnormal development of the testicles, resulting in low or absent sperm production. Cystic fibrosis is a genetic factor that can cause men to have missing or obstructed vas deferens.

    There are several reasons and causes for fertility issues in men. A few men produce no sperm at all, though this is rare, affecting less than 5% of infertile men. When no sperm are produced, it is impossible for conception to occur. If this is the case, reproductive organ damage may be to blame. A varicose vein in the scrotum (varicose) could be the cause of infertility, if sperm are being produced but die. Varicose veins can prevent normal cooling of the testicles and prevent sperm from surviving, due to raised testicular temperature.

    Problems with the delivery of sperm from the penis into the vagina can keep sperm from getting to the egg, including Retrograde ejaculation. This occurs when semen enters the bladder rather than emerging out through the penis. Also, some men are born with blockage of the ejaculatory ducts (the part of the testicle that contain sperm). Infections may temporarily affect fertility, including sexually transmitted diseases (STDs). These infections can cause scarring and block sperm passage. If mumps (a viral infection) occurs after puberty, inflammation of the testicles can impair sperm production.

    A man’s general health and lifestyle may affect fertility. Alcohol, smoking, drugs, emotional stress, vitamin deficiencies, age, heat (hot tubs included) and obesity can all temporarily reduce sperm count and quality. Overexposure to certain environmental elements, including pesticides, lead and toxins reduce sperm count by affecting testicular function or by altering the male hormonal system. Medical conditions such as a severe injury, surgery and certain diseases (including diabetes) can be contributing factors to male infertility.

    Infertility and Women
    Treatment of Infertility

  • Fertility Charting Tools

    To chart your fertility, the only tools you need are a ‘calendar’ or fertility chart/graph and a basal body thermometer. Basal thermometers are more accurate than regular thermometers and are ultra-sensitive, tracking your body’s slightest temperature shift. Most digital basal thermometers come with a sample graph that can be enlarged and duplicated on any copy machine, or you can even download a printable chart on-line. Some women prefer to do their charting completely on-line, it’s just a matter of person preference.

    Record your observations and findings on your chart each day. If you tend to have very regular cycles each month, your charts may look strikingly similar. If your monthly cycles are irregular, you may gain a wealth of information by charting for an extended period of time.

    –Tracking your basal body temperature (or BBT)
    –Observing changes in your cervical mucus
    –Monitoring your physical and emotional symptoms
    –Checking the position and shape of your cervix

  • Fertility Charting

    Fertility charting is basically a pregnancy achievement technique. It requires recording all of your fertility signs on a chart; allowing you to track ovulation, predict the most fertile time in your cycle, understand your own personal fertility patterns and increase your chances of becoming pregnant.

    Besides rapid pregnancy achievement, charting can also be helpful in diagnosing and resolving many fertility issues, such as hormonal imbalance or ovulation problems. Potential complications that charting may be able to alert you on include anovulation (when no egg is released), low estrogen, low progesterone, thyroid conditions and even possible miscarriage.

    For couples having difficulty in conceiving, fertility charting can be a very valuable tool. Charting can help you identify your most fertile days, so you can make love on those days to increase your chances of conception. A woman is only fertile for a few short days (the egg lives and can be fertilized for 12-24 brief hours after ovulation) during each menstrual cycle, so timing when you make love is critical part of conception.

    In addition, many doctors and naturopaths strongly encourage fertility charting because it’s completely safe, natural and does not rely on drugs or medical procedures and there are no health risks or side effects. Plus, by charting your fertility, you will also become more aware of the patterns unique to your body, along with gaining a better understanding of how pregnancy is achieved. Once you understand these patterns and changes (and with a little patience), you can begin to anticipate ovulation through a combination of methods:

    –Tracking your basal body temperature (or BBT)
    –Observing changes in your cervical mucus
    –Monitoring your physical and emotional symptoms
    –Checking the position and shape of your cervix

    Read more on Fertility

  • Getting Pregnant

    One can increase their chances of getting pregnancy and increasing fertility. Most people believe the most fertile days during their cycle is 14 days after the beginning of their period, when really ovulation usually takes place about 14 days before your period begins. This is most accurate only if your periods are very regular. Say you have a 32-day cycle, then your most fertile day is most likely about day 18. Or if you have a 27 day cycle, day 13 is your most fertile day. It’s best to have intercourse starting a few days before ovulation, to heighten your chances of conceiving and improving fertility.
     

    Your Man and Conception

    Toxic chemicals can also cause deformed or low numbers of sperm. The following substances can potentially interfere with both men’s and women’s fertility: alcohol, caffeine, some drugs (including over-the-counter, prescription and “recreational”), cigarette smoking, marijuana, radiation, and chemicals such as lead, pesticides, polystyrene, benzene, mercury, and anesthetic gases. With regard to fertility, removing the problem usually allows the generation of new healthier sperm, but it may take up to 3 months for the quality and quantity to improve the chances of getting pregnant.

    Wearing tight underware or pants may push the testicles against the body, causing excessive heat- lowering a man’s sperm count. Have your partner trade in is tighty-whiteys for boxers at least 2 to 3 months before trying to get pregnant. Also, hot tubs, saunas, long distance bike-riding, a high fever as well as working around hot furnaces or ovens may also cause a man’s sperm count to drop dramatically.

  • Emotional Fertility Signs

    For fertility, charting your mood swings, thoughts, emotions and energy level along with your cervical mucus and changes, your other physical changes and your BBT, you may discover that they are closely linked to possible conception. On the other hand, some women don’t notice cyclic mood and energy variations whatsoever.

    Estrogen rises and peaks as ovulation approaches, therefore many women experience increased sexual feelings, heightened desire, and more feelings of affection. This may be due in part to the increased slippery-feeling cervical mucus (which is similar to arousal fluid, but more watery) that is produced as ovulation draws near, causing increased libido on your most fertile days. It’s no coincidence that the word “estrogen”, the fertility hormone, stems from Latin roots which mean “creating mad desire.”

    Other secondary signs you may notice as ovulation approaches may include: increased energy level, heightened sense of vision, smell or taste, easier concentration and mood swings. After ovulation, as your fertile phase ends, you may suddenly feel depressed or let down. Many times you may experience a drop in your libido as well. These feelings are important signals and are good to note on your chart.

    —Physical Fertility Symptoms

  • Eating to Conceive

    When preparing for pregnancy, many doctors recommend a 3 to 4 month preparation period, which includes a healthy diet. While trying to conceive, it’s a good time to begin good eating habits, as well as starting prenatal vitamins, to ensure that your baby will have all the essential nutrients from the moment of conception.

    Avoid junk foods, fatty foods and sugar. These foods make up the small tip of the pyramid and tend to replace more nutritious foods. If you get hungry between meals, try eating fresh fruit, vegetables, low-fat yogurt or a handful of nuts.

    Make sure you eat plenty of fruit and vegetables, since they contain essential sources of many vitamins and minerals, including folic acid, vitamin A and vitamin C. They are also helpful in keeping you regular, because they are a great source of fiber. When trying to conceive, try and eat organic, as much as possible to avoid chemicals and pesticides which can affect your hormones.

    Cut down on caffeine now, because it has been proven to have a harmful effect on reproductive health. It has also been known to delay your chances of conceiving. Coffee, tea, chocolate, cocoa, soft drinks and some over-the-counter drugs contain caffeine. But on the other hand, tea has been known to increase a woman’s chances of conceiving. To reduce the caffeine content in your tea by as much as half, brew the tea bag for just one minute, since the shorter the brewing time- the lower the caffeine concentration. Avoid herbal teas, without first talking with your doctor, because they can be potentially harmful to your unborn baby.

    Extremely poor eating habits before pregnancy can harm both you and your baby, as well as your fertility. The Food Guide Pyramid is a good model for healthy eating. The steps of the pyramid show you how to make the best food choices. Eat at least the minimum recommended servings from each level of the pyramid for optimum health.

    If your planning to get pregnant, it’s best to refrain from drinking alcohol. Even moderate alcohol consumption can reduce your chances of conception. And once pregnant, drinking alcohol can have very harmful effects on your unborn baby.

    It is a good idea to start taking a prenatal vitamin (that contains folic acid) about 3 months before conceiving, if possible. Folic acid helps prevent neural tube defects such as spina bifida and anencephaly. But keep in mind that even if you are taking a daily prenatal vitamin, eating a balanced diet is still the best nutrition.

  • more Reasons for Cesareans

    Failure to progress, or “dystocia” accounts for close to 30% of all cesareans. When the cervix won’t dilate or if it slows down or stops altogether at some point and labor is taking longer than average, a cesarean may be suggested. Also, prolonged labor may be caused by the baby not descending or contractions that aren’t strong enough, even after an attempted augmentation with cervical ripening agents or Pitocin.

    If the baby’s head is too large to fit through the pelvis (which is often called cephalopelvic disproportion or “CPD”), either because the mother is too small or the baby is too big, a cesarean may be necessary. Sometimes a woman has a deformed pelvis because of a birth defect or a debilitating disease such as rickets or polio, which makes a vaginal delivery incredibly difficult or impossible.

    A cesarean may be necessary if certain maternal health conditions are present. Toxemia, high blood pressure, gestational diabetes (which can lead to an extra large-sized baby), pre-eclampsia, heart or pulmonary disease, HIV infection, obstruction of the birth canal by fibroids and active genital herpes lesions are all possible indicators that a cesarean may need to take place, but not in all situations. Maternal exhaustion accounts for a small number of cesareans.

    Problems with the baby such as genetic deformity, neural tube defects, hydrocephalus or heart problems can lead to a cesarean. Some babies may not survive the process of labor and vaginal birth. Also, multiple births run a higher risk of complications if a vaginal delivery is attempted. Cesareans are routinely performed with the delivery of twins, triplets (or more), since giving birth to multiples poses unique challenges. Multiples are much more common now, as a result of fertility treatments, which also contributes partially to the increase in the overall cesarean rates.

    Close to a third of all cesareans are repeat cesareans, although more and more women are electing to try VBAC (vaginal birth after cesarean). On the other hand, many hospitals and doctors are choosing not to offer VBACs any longer.

    The reason for the high number of repeat cesareans is partly because of the concern for a possible uterine rupture. Pre-planned or “elective” cesareans (for non-medical reasons) are becoming increasingly popular. The reason for this jump is mainly simply for convenience purposes (for the doctor, as well as the mother).

  • Cervix, Changes and BBT

    Cervix, Changes and BBT

    bbt basal body temperatureA combination of charting your basal body temperature (BBT), cervical mucus and cervical position and shape will indicate when the most fertile time of your cycle is. Cervical change signals general fluctuations in your estrogen levels and can be very helpful and fairly reliable in predicting your fertility. Checking your cervical position and shape takes some practice. Also, to chart this particular sign, there are some guidelines you should follow to achieve the best results.

    Your Cervical Changes and Shape

    Right after your period ends, the position of your cervix is low, hard and closed. At this point in your cycle, it should be easily reached by your fingertip and feel as if you are touching the tip of your nose. A firm, pointed shape generally indicates low estrogen and you are considered to be infertile during this time.

    As estrogen and fertility increase (immediately prior to ovulation), your cervix softens, opens up and rises to it?s highest point within your body so that it?s harder to reach. The opening increases as well, which makes the slit or tiny hole feel much larger, becoming more receptive to sperm, allowing them to make their way more easily through your cervix. Your cervix remains this way until after ovulation has taken place.

    Once ovulation has occurred- when estrogen levels suddenly drop, you can feel your hardened, closed cervix back in its lower (pre-ovulatory) position. Keep in mind that women who have given birth previously may notice that their cervix feels slightly open, even after ovulation. When the position of your cervix drops, it will become easy to reach once more. At this point, you are considered infertile once again and cannot get pregnant.

    You should begin observing your cervical position and shape the first day after your period ends. Cervical position can be monitored throughout the day and be done while checking your cervical mucus. Before checking your cervix, be sure to wash your hands thoroughly. The best time to check it is right after you have showered. Sitting on the toilet or with one foot on the toilet seat (or bathtub) may be the most comfortable positions for checking your cervix. You can check your cervical position by gently inserting your finger and feeling for your cervix, which is located at the top of your vagina. Record if it?s hard to reach (high position) or easier to reach (low position) and also if it feels firm or soft. It normally takes a few months to see all the changes in your cervix during your cycle and notice a pattern.

    –Tracking your basal body temperature (or BBT)
    –Observing changes in your cervical mucus
    –Monitoring your physical and emotional symptoms
    –Checking the position and shape of your cervix

    Read more on Fertility Charting

  • Cervix and Changes

    A combination of charting your basal body temperature (BBT), cervical mucus and cervical position and shape will indicate when the most fertile time of your cycle is. Cervical change signals general fluctuations in your estrogen levels and can be very helpful and fairly reliable in predicting your fertility. Checking your cervical position and shape takes some practice. Also, to chart this particular sign, there are some guidelines you should follow to achieve the best results.

    Your Cervical Changes and Shape

    Right after your period ends, the position of your cervix is low, hard and closed. At this point in your cycle, it should be easily reached by your fingertip and feel as if you are touching the tip of your nose. A firm, pointed shape generally indicates low estrogen and you are considered to be infertile during this time.

    As estrogen and fertility increase (immediately prior to ovulation), your cervix softens, opens up and rises to it?s highest point within your body so that it?s harder to reach. The opening increases as well, which makes the slit or tiny hole feel much larger, becoming more receptive to sperm, allowing them to make their way more easily through your cervix. Your cervix remains this way until after ovulation has taken place.

    Once ovulation has occurred- when estrogen levels suddenly drop, you can feel your hardened, closed cervix back in its lower (pre-ovulatory) position. Keep in mind that women who have given birth previously may notice that their cervix feels slightly open, even after ovulation. When the position of your cervix drops, it will become easy to reach once more. At this point, you are considered infertile once again and cannot get pregnant.

    You should begin observing your cervical position and shape the first day after your period ends. Cervical position can be monitored throughout the day and be done while checking your cervical mucus. Before checking your cervix, be sure to wash your hands thoroughly. The best time to check it is right after you have showered. Sitting on the toilet or with one foot on the toilet seat (or bathtub) may be the most comfortable positions for checking your cervix. You can check your cervical position by gently inserting your finger and feeling for your cervix, which is located at the top of your vagina. Record if it?s hard to reach (high position) or easier to reach (low position) and also if it feels firm or soft. It normally takes a few months to see all the changes in your cervix during your cycle and notice a pattern.

    –Tracking your basal body temperature (or BBT)
    –Observing changes in your cervical mucus
    –Monitoring your physical and emotional symptoms
    –Checking the position and shape of your cervix

    Read more on Fertility Charting

  • Cervical Mucus and Charting

    In conception, cervical mucus is an essential element because it nourishes and protects sperm, keeping them alive for up to five days inside your cervix, until ovulation occurs and fertilization can take place. Slippery cervical mucus also provides channels, which help sperm swim through your cervix. Without enough fertile mucus, your cervix is blocked and conception can’t happen.

    Whether your cycles are long, short, regular or irregular- charting your cervical mucus patterns (along with your BBT) is a great way to pinpoint your most fertile days and predict when you will ovulate, so you can be sure of which days lovemaking may result in pregnancy.

    In charting the changes in your cervical mucus, you will be looking for changes in consistency, quantity and color. The consistency of your cervical mucus changes throughout your menstrual cycle based on the hormonal shifts that are associated with ovulation, caused by estrogen and progesterone.

    Once your period has stopped, your cervical mucus is typically dry or it may feel dense, tacky, chalky or crumbly. The number of dry days after your menstrual bleeding ends, varies from cycle to cycle. Sperm are prevented from penetrating your cervix on days when there is no mucus. As you get closer to ovulation your cervical mucus will get thinner, because of increased levels of estrogen.

    Eventually, your cervical mucus turns to a consistency similar to raw egg whites (about 1-3 days prior to ovulation), which helps sperm to penetrate your cervix. This cervical mucus is very slippery and stretchy, sometimes changing in color, appearing fairly clear or yellowish. It may feel abundant, wet (similar to what you feel at the beginning of your period) and can be stretched into a thread between your fingers. This type of cervical mucus signals that eggs are developing and indicates that you are highly fertile. You and your partner should make love every day that you see or feel this type of fertile cervical mucus, for the best chance of conceiving.

    After ovulation you will notice that your cervical mucus typically gets thicker, sticky or dries up all together, becoming a protective barrier against sperm once again. This is caused by a decrease in your estrogen levels and an increase in your progesterone levels.

    You should start checking your cervical mucus on the first day after your period, and check it several times during the day. You can check it externally by wiping downward with toilet tissue, while sitting on the toilet. It can be more accurate to insert your index or middle finger (making sure your hands are clean), and observe your cervical mucus by feeling it and recording your observations on your chart.

    –Tracking your basal body temperature (or BBT)
    –Observing changes in your cervical mucus
    –Monitoring your physical and emotional symptoms
    –Checking the position and shape of your cervix

    Read more on Fertility Charting

  • Average Basal Body Temperature BBT

    Average Basal Body Temperature BBT

    chartCharting your BBT allows you to confirm the onset of ovulation, making it a very useful method in helping to plan the timing of intercourse that will lead to conception. By keeping track of your BBT, you can also gain an understanding of the general patterns of your menstrual cycle. After recording your temperature on a chart for a few months, you can begin to notice a distinct pattern of temperature fluctuations in your monthly cycle, which will help you to predict your most fertile days in the future.

    Your temperature in the morning, right after you wake up, is low between your period and ovulation. Around the time of ovulation, your temperature rises and remains high for about two weeks until your next period. This temperature rise will let you know that ovulation has occurred. But remember charting your BBT tells you when you have ovulated after it has happened, so you should also look for other fertility signs, such as observing your cervical mucus, which changes several days before ovulation.

    Your BBT is directly related to your levels of estrogen and progesterone. The presence of the hormone estrogen helps cause the low temperature before ovulation. On average, your BBT will range from 97.0-98.2 degrees Fahrenheit, prior to ovulation, although it can vary slightly one way or the other. Sometimes, your temperature may actually take a dip the day of ovulation, but this doesn’t always happen.

    Higher temperatures reflect the higher levels of the hormone progesterone in your system, which is secreted after ovulation. Typically, it will rise at least 0.4 to 0.6 degrees- jumping up to 98.0-98.6 degrees and beyond, although there is a wide range of “normal” temperatures. Your temperature will remain higher until the end of your cycle, when your progesterone levels begin to drop. Your period often begins within a day or two following the decline in progesterone.

    If your temperature stays high for 17 days in a row and you don’t have your period, it could be an early indication of pregnancy. Pregnancy causes your temperature to remain high beyond the typical 14 days after ovulation, so an elevated temperature past the expected date of your period can mean you’re pregnant (unless of course you have a fever).

    You can find a reliable basal thermometer at practically any drugstore and they are inexpensive. Basal thermometers are more accurate than regular fever thermometers and are ultra-sensitive, tracking your body’s slightest temperature shift. Digital thermometers are best, because they are quicker and you don’t have to shake them down.

    When charting your basal body temperature it’s important that you take your temperature first thing in the morning, before you get out of bed. For your temperature reading to be accurate, you must take it before you do anything: before standing, going to the bathroom or brushing your teeth. It’s easiest just to keep your thermometer next to your bed, within easy reach. Also, for best results, try to take your temperature as close as possible to the same time everyday and after at least 4 hours of continuous sleep, otherwise it will be slightly different.

    Taking your temperature at an unusual time, going to bed late, illness, fever, stress, drinking alcohol, exercise, using an electric blanket or heating pad can all affect your basal body temperature, causing it to be higher than normal. Also, some fertility medications, such as Clomid can cause elevated temperatures and make charting less accurate.

  • CDC Recommendation on PreConception

    (continued “preconception”)

    These special preconception recommendations, developed through a consultation process with a select panel of specialists, include maximizing public health surveillance and monitoring which includes improving health programs and policies, the offer of pre-pregnancy checkups for women/couples who are planning a pregnancy, increasing the public’s knowledge and awareness of the importance of preconception health and encouraging everyone to have a reproductive life plan that focuses on drawing attention to reproductive health to reduce unplanned pregnancies, fetal exposure to teratogens, age-related infertility and to improve pregnancy outcomes.

    Other new recommendations include augmentation of research, additional interconception (the time between pregnancies) care and intervention for women who had a previous pregnancy that resulted in infant death, preterm birth or birth defects to reduce future risks, provide preventive visits along with primary care visits for risk assessment and educational counseling related to reproductive health risks, integration of preconception health components into existing public health programs, increase the number of women who receive timely interventions following preconception risk screening and increase public as well as private health insurance coverage for low-income women to improve preventative and preconception health access and affordability.

    Preconception care is a good idea, making a difference in the lives of future babies and helping them have the healthiest start possible, but will be difficult to include as part of standard medical appointments, according to some doctors. In addition, most health insurance companies don’t even have a billing code to allow doctors to begin billing for it. CDC is requesting the American Medical Association (AMA) develop a billing code for preconception care to allow doctors the opportunity of offering these additional preconception services to women. Preconception care recommendations should be implemented over a period of time within the next 2-5 years.