Read getting pregnant naturally epub format

Authors: Winifred Conkling

getting pregnant naturally

GETTING
PREGNANT
n
aturally

Healthy Choices to
Boost Your Chances
of Conceiving without
Fertility Drugs

W
INIFRED
C
ONKLING

For Hannah and Ella

Contents

Introduction

By llene Stargot, Founder and Executive Director, National Infertility Network Exchange (NINE)

1    Infertile or Subfertile? An Overview

2    Sex and Sexuality:
The Birds and the Bees for Grown-ups

3    Nutrition and Nutrition Supplements:
Eat, Drink—and Get Pregnant

4    Herbs: Mother Nature’s Medicines for Maternity

5    Homeopathy: Baby Doses for Big Results

6    Acupressure: Hands-on Healing

7    Mind-Body Connection:
Fertile Ideas to Boost Your Fertility

8    Lifestyle: Keys to Conception

Resources

Organizations of Interest

Recommended Reading

Index

About the Author

Note to the Reader

Copyright

About the Publisher

Introduction

I
don’t like the word “infertility;” it leaves no room for hope, even though many couples who have trouble conceiving go on to have children. I have known women with ovulation disorders and damaged tubes who became pregnant; I have known men with one-sided varicoceles and low sperm counts who have impregnated their wives. Instead of using the word “infertile,” I prefer to use the term “impaired fertility.” I have worked with hundreds of couples with impaired fertility, and I know that there are many things couples can do to enhance their chances of conceiving a child.

Human reproduction is an inexact science; most people shift back and forth between periods of fertility and infertility as their bodies pass through various hormonal stages and respond to physical and emotional stresses.
Our hormones—and our fertility—change in response to age, diet, and nutrition, and exercise and lifestyle, among other factors. Some of these factors we can control, others we cannot.

When it comes to getting pregnant, it’s up to you to make the most of each month. It’s up to you to eat right, to rest, and to make healthy choices in your life. It’s up to you to listen to your body; nobody knows your body better than you do. You must learn to recognize when something feels “off” so that you can follow up with a doctor.

If you are a man, it’s up to you to protect your sperm. Most men don’t realize that it takes almost three months to produce sperm, so that what you do today will affect your sperm months later. If you are a woman, it’s up to you to learn how to chart your fertility so that you can’ better time intercourse to coincide with ovulation. A simple temperature chart can also help you detect common fertility problems, such as a luteal phase defect. In many cases, no single thing you do or don’t do determines your fertility. It is the cumulative effect of a number of little things that can either enhance or impair your fertility. This is why you should do what you can to get pregnant naturally before you rush off to consult a reproductive endocrinologist.

The advice offered in this book can help you increase
your chances of conceiving a child. If you remain childless after a year, you may need to work with a fertility specialist. Of course, you may do everything right and still end up without a biological child.

I spent nine years trying to get pregnant, and I tried everything you can imagine. That’s why I never ask anyone I meet, “How many children do you have?” I remember what a difficult question that was to answer when my husband and I were trying desperately to conceive.

I am now the mother of two adopted children. Once I accepted that my body was not going to reproduce and that my husband and I were not going to build a family the way that we had hoped, dreamed, and planned, I realized that adoption offered another option. While adoption was my second choice, it was
not
second-best. I have been blessed with two wonderful children. I am a mother. My husband and I have built our family. I have everything but a pregnancy story. Best of luck to those of you entering this journey.

I
LENE
S
TARGOT
Founder and Executive Director
National Infertility Network Exchange (NINE)

1
Infertile or Subfertile?
An Overview

I
t’s ironic: When couples don’t want to have a baby, they assume that they are fertile and put a lot of energy into preventing pregnancy. Then, when they decide it’s time to start a family, they suddenly appreciate how difficult it actually is to conceive a child.

Getting pregnant requires exquisite timing, a balanced hormonal system, good general health—and a measure of good fortune. A woman’s endocrine system must release precise levels of hormones at specific times during her menstrual cycle. Her ovaries must produce and release at least one mature and healthy egg follicle, and that egg must be able to make its way through the Fallopian tubes toward a welcoming uterus. A man’s reproductive system must produce semen containing an abundant supply of healthy sperm ready to swim eagerly
toward the intended target. The woman’s cervix must produce enough mucus to protect the sperm and hurry them into the uterus and Fallopian tubes. Once the egg and sperm have been united, the thickened uterine lining must be responsive and ready to nourish the fertilized egg after it has implanted.

A single missed cue or minor glitch, and the system doesn’t work. Considering the complexities, it’s no wonder that a healthy and fertile couple stands only a 20 percent chance of conceiving a child in any given month. It also explains why more than 5 million Americans of childbearing age are considered technically infertile, meaning they have tried to conceive a child for one year or more without success.

But there is hope. As many as half of all infertile couples do go on to get pregnant and have healthy babies. These couples could more accurately be defined as
subfertile
. They may not suffer from a physical problem that prevents conception, but it may take them longer than one year to become pregnant. For these couples, the stork may arrive sooner if Mother Nature is offered a little extra help.

UNDERSTANDING INFERTILITY

Most couples who want to have children are successful—some sooner, some later. Typically, half of the couples who decide to stop using contraception will conceive within three to five months, and about 85 percent of the couples will conceive within a year. However, that leaves 15 percent—or roughly one out of every six couples—who will experience fertility problems.

Impaired fertility has many causes. For about 35 to 40 percent of couples, the problem lies within the woman; for another 35 to 40 percent, the problem lies within the man; and in the rest, both partners have a problem or the cause is unknown.

Among women, hormonal imbalance is the most common cause of infertility. Other possible causes include scarring or obstruction of the Fallopian tubes, an allergic reaction to sperm, endometriosis, hostile cervical mucus, chromosomal abnormalities, a prolapsed uterus, fibroids, or physical injury to reproductive organs, among other causes. And, of course, age plays a significant role: A woman’s fertility peaks in her mid-twenties; her fertility declines gradually until age thirty, and then begins to fall off more rapidly. Many women remain fertile into their forties, but conception becomes more difficult with each passing year.

Among men, abnormal sperm—either low sperm count or inferior sperm quality—is to blame for most fertility problems. It may take only one sperm to fertilize an egg, but the average ejaculation contains between 40 million and 150 million sperm. Most of these sperm don’t stand a fighting chance of getting within striking distance of the awaiting egg; some 80 to 90 percent of them are killed off by vaginal fluids. Due to this intense screening process, men who ejaculate fewer than 60 million sperm may have difficulty impregnating their partners. In medical terminology, oligospermia means low sperm count and azoospermia means the absence of living sperm in the semen.

Not surprisingly, the number of sperm in an ejaculate and the degree of fertility are strongly correlated. But even men with low sperm counts can impregnate their partners. In fact, studies at fertility clinics have found that 52 percent of men whose sperm counts were below 10 million per milliliter of ejaculate achieved pregnancy, as did 40 percent of those with sperm counts as low as 5 million per milliliter of ejaculate.

Numbers count, but when it comes to fertility, sperm quality is even more important than quantity. A man can have a high number of sperm, but if a majority of them are abnormally shaped or poor swimmers, he can have
a harder time becoming a father than a man with fewer sperm of a higher quality. Sperm quality is based on several factors, including motility (how fast and straight the sperm swims) and morphology (sperm size and shape). At least 60 percent of the sperm should be normal in appearance and motility. The quality of the seminal fluid—its volume and viscosity or stickiness—also plays an important role. Problems with sperm can stem from a number of causes, including a varicocele (a varicose vein in the scrotum), prostate infections, ductal obstructions, ejaculatory dysfunction, mumps, alcohol use, nicotine, illness, or excessive fatigue.

Many couples experience periods of infertility that come and go for no apparent reason. Approximately 25 percent of women have reported episodes of infertility at some point during their reproductive lives. In many cases, a couple may not know they are experiencing impaired fertility because they are not trying to get pregnant at that time. This ongoing fluctuation between periods of fertility and infertility may help to explain why each month approximately 3 percent of couples with unexplained infertility suddenly conceive on their own.

Subfertile couples may benefit from experimenting with the fertility-enhancing natural remedies and practices suggested in this book. Of course, fertility drugs
and assisted reproductive technologies can offer hope to couples with serious reproductive problems, but most subfertile couples would do well to begin with simple, natural methods of enhancing their fertility. In many cases, these low-tech treatments will work and a couple can avoid turning to expensive, invasive, and stressful high-tech fertility treatments.

W
HEN TO
G
ET
H
ELP

If you and your partner have had intercourse without using contraception twice a week for a year without becoming pregnant, it’s time to consider consulting a reproductive endocrinologist for counseling, as well as a urologist specializing in malefactor infertility. In addition, you should see a physician before the one-year mark if one of the following circumstances exist:

If a woman is over age forty.

If a woman is over age thirty-five and has not conceived after six months of regular unprotected intercourse.

If either partner may have scarring or damage to reproductive organs because of infections or sexually transmitted diseases.

If a woman has irregular periods or no periods at all.

If a woman has used or is using an intrauterine device (IUD).

If a woman has a history of endometriosis, pelvic infections, abdominal or urinary tract surgery, polycystic ovarian syndrome, or exposure to toxic chemicals or radiation.

If a man has a history of mumps, measles, very high fevers, or exposure to toxic chemicals or radiation.

If either partner is the child of a mother who took the synthetic estrogen diethylstilbestrol (DES) during pregnancy to prevent miscarriage. DES daughters often suffer from a range of reproductive problems; DES sons may have low sperm counts and other sperm anomalies.

M
ILESTONES TO
R
EMEMBER

1978: The world’s first “test-tube baby,” Louise Brown of Great Britain, was born.

1981: The first American test-tube baby, Elizabeth Jordan Carr, was born in Norfolk, Virginia.

Mid-1980s: Surrogate mother Mary Beth Whitehead fought to maintain custody of the infant “Baby M,” to whom she gave birth under contract with another couple.

1992: A sixty-two-year-old Sicilian widow became pregnant through artificial insemination with sperm that had been collected from her husband and frozen before he died.

1992: A fifty-three-year-old California grand-mother gave birth to twin girls for her daughter. The babies were conceived in a petri dish using sperm from her son-in-law and eggs donated by a twenty-year-old woman.

1993: Several grandmothers gave birth to their own grandchildren, using eggs provided by their daughters and sperm from their sons-in-law.

2
Sex and Sexuality:
The Birds and the Bees for Grown-ups

T
iming is everything—at least when it comes to getting pregnant. To conceive a child, you and your partner must have intercourse within a very narrow window of time. An egg is fertile for only six to twenty-four hours after ovulation; after that time it begins to disintegrate. Understanding your reproductive system and how it works can help you time intercourse to maximize your chances of conceiving each month.

While the mechanics of intercourse may seem self-evident, certain practical issues can affect your fertility. Your creativity in the bedroom (or wherever) can increase—or decrease—your odds of conception. In other words, it’s not just what you do, but how you do it. The following tips can help you get the timing down to a science—and help with some of the practical issues, too.

HERS
Get to Know Your Menstrual Cycle

As you know, to become pregnant you must have intercourse near the time of ovulation. The tough part, of course, is determining exactly when you ovulate. If you have been blessed with a consistent, predictable menstrual cycle, you can use the “calendar method.” This method involves keeping track of the length of your menstrual cycle, then calculating when you are most likely to release an egg. If all your hormones are in balance, you probably ovulate approximately fourteen days before the first day of your next menstrual period. That makes it relatively easy to make an educated guess of the approximate date of ovulation.

To estimate your date of ovulation, take the length of your cycle and subtract fourteen days. For example, if you have a twenty-eight-day cycle, you ovulate on day fourteen (twenty-eight minus fourteen). If you have a thirty-five-day cycle, you ovulate on day twenty-one (thirty-five minus fourteen), and if you have a twenty-one-day cycle, you ovulate on day seven (twenty-one minus fourteen).

Chart your menstrual cycle for three months to form a baseline or average length of your cycle. The typical cycle ranges from twenty-four to thirty-six days, so don’t get hung up on the “average” twenty-eight-day cycle.

Once you determine your approximate ovulation date, have intercourse every other day for five days before the target date and three days after. If you have intercourse every other day during this time, you will probably include your fertile time.

Monitor Your Cervical Mucus

Your cervical mucus doesn’t lie: Once you become acquainted with its changes in texture and volume throughout your menstrual cycle, you may become adept at reading this crucial fertility marker.

Your cervical mucus changes in response to fluctuations in the level of estrogen in your body. During the first half of your cycle, the egg matures within the ovarian follicle and the body releases increasing amounts of estrogen. This estrogen helps thicken the lining of the uterus, preparing it for implantation of the fertilized egg. The hormonal changes also create the fertile cervical mucus, which helps the sperm reach the uterus and Fallopian tubes. The fertile mucus provides a protective alkaline medium for the sperm to travel through the vagina. You want to have intercourse during the time the fertile mucus is present.

After the estrogen has peaked (at ovulation), the progesterone levels surge, prompting a change in the cervical
mucus, often in as little as a couple of hours. At this point, your chances of conception have passed.

Fertile mucus is noticeably different from mucus at other phases of your menstrual cycle: It is slick, transparent, gelatinous, and stringy. It is stretchy; in fact, you can rub it between two fingers and stretch it for an inch or more (nonfertile mucus does not stretch). When fertile mucus dries in the crotch of your panties, it may feel stiff and appear white or yellowish. (Some women mistakenly believe that they have a vaginal yeast infection or they have been remiss in their personal hygiene during this phase of their cycle, but this discharge is perfectly normal.)

Please note that you may not be able to use the cervical mucus test if you are taking birth control pills (or for at least two months after you stop taking them). Also be aware that bathing, showering, swimming, and unprotected intercourse can temporarily alter your mucus, so check your mucus before these activities or several hours after you’re finished.

As a woman ages, she produces less fertile mucus. Twenty-something women often have two to four days of fertile mucus, while thirty-something women may have one day or less. The older you get, the more important it is for you to learn to recognize your fertile days so that you can take maximum advantage of them.

M
EET
Y
OUR
M
UCUS

Early in your cycle:
Your vagina will be dry with little or no cervical mucus.

As ovulation approaches:
A few days before ovulation your mucus flow will increase and become creamy, white, and wet. Begin having intercourse every forty-eight hours during this phase.

Fertile mucus at ovulation:
Your mucus will become thin, slippery, stretchy, and clear; it will resemble the appearance and consistency of egg white. You want to strive to have intercourse during the time you have fertile mucus.

After ovulation:
Immediately following ovulation your mucus will turn sticky, much like the consistency of rubber cement. After two or three days, it will become dry, until the cycle starts again.

Take Your Temperature

You can learn a lot about your body by using a thermometer. By keeping track of your basal body temperature—your temperature in the morning before you get out of bed—you can learn to approximate the time of ovulation and when in your cycle you will be most fertile. (Unfortunately, when monitoring the ever-changing cycle
of fertility, we deal with approximations, not predictions.)

First, get a thermometer, a piece of paper, and a pen or pencil to record your temperature; keep these items by the side of the bed. To get an accurate reading, you’re going to need to take your temperature
first
thing in the morning—meaning before you sit up in bed, before you go to the bathroom, before you say good morning to your spouse, before you talk to anyone on the phone.

Some women take their temperature rectally for a more accurate reading, but an oral thermometer should be sufficient in most cases. You may want to buy a basal body temperature thermometer, designed to make it easier to read the temperature to the tenth of a degree. These thermometers usually come with a preprinted chart and directions for monitoring your temperature. They are available in most drugstores and usually cost less than $10.

Try to take your temperature after at least three hours of consecutive sleep and at the same time each day, plus or minus an hour or so. Keep in mind that every extra half-hour you snooze your body temperature will rise by about one-tenth of a degree.

Most women report a slight drop in their temperature just before ovulation (when the levels of estrogen increase to release the egg during the next few days). A day or two
later, they note a sharp rise of 0.5 to 1 point when the egg is released (when the levels of heat-producing progesterone increase). By the time the temperature spikes—usually to over 98 degrees, though it may go to 99 degrees or higher in some women—ovulation has already occurred.

This temperature shift—and ovulation—usually occur at fourteen days into your menstrual cycle, or about day fourteen of a twenty-eight-day cycle. The morning temperature then should remain elevated for the second half of the menstrual cycle (the luteal phase), dropping slightly just before menstruation when the cycle starts over again.

To maximize your chances of conception, have intercourse every other day for two to four days before you anticipate the shift in temperature (and ovulation), as well as two to four days after your temperature rises. (If you chart your temperature for several months, you will recognize your personal ovulation pattern and become more adept at detecting when ovulation should occur.)

Normal body temperatures vary from person to person, but it is the change in temperature, not the temperature itself, that is important in measuring fertility. You may have a hormonal imbalance and should consult a doctor if your temperature remains the same throughout your cycle (you may not be releasing an egg) or if your temperature tapers off during the second half of your
cycle (you may not have sufficient hormonal support to produce a mature egg). If your temperature remains elevated for more than two weeks after ovulation, you may be pregnant!

Note Changes in Your Cervix

You can learn to recognize the approach of ovulation by learning to recognize the changes in your cervix as ovulation approaches. If you want additional information on how to detect ovulation, take time to feel your cervix throughout the month so that you can learn to appreciate the subtle but important changes that occur during your menstrual cycle:

During your menstrual period, your cervix should be easy to touch with the tip of a finger inserted into the vagina. The area at the opening of the cervix should feel soft and opened wide to allow the uterine lining to escape.

After the bleeding stops, your cervix should feel firm and tightly closed; some say it feels like the tip of a nose. If you have not delivered a child vaginally, the opening of the cervix may feel like a dimple or pointed impression. If you have had a child vaginally, the opening may feel wider.

As the body prepares for ovulation, the cervix will
rise or move away from the vaginal opening. (You will have to insert your finger deeper into your vagina to feel it.) The cervical opening should feel softer and wider, to allow the sperm to enter the uterus and fertilize the ripened egg.

After ovulation, the cervix lowers and grows firmer, and the opening closes tightly to prevent sperm from entering the uterus since conception can no longer occur.

Try an Ovulation Predictor Test

If you don’t trust yourself to read your body’s ovulation warning signs, you can pick up an ovulation predictor test kit at almost any pharmacy or grocery store for about $20. This test looks for the surge in luteinizing hormone (LH) that occurs just before ovulation. (The rise in LH actually triggers the release of the egg from the ovary.) Ovulation should take place twelve to thirty-six hours after the test is positive.

The kits are relatively easy to use and tend to be quite accurate—as long as you follow the directions. However, keep in mind that the test does not guarantee that ovulation has taken place. Some women, especially those with premature ovarian failure or those over age forty or approaching menopause, sometimes have LH surges that are not followed by the release of an egg. If you want
some assurance that you are identifying your time of ovulation accurately, give an ovulation predictor kit a try for a month or two, but don’t rely on this test if your infertility continues for several months longer.

Stay on Your Back for Twenty to Thirty Minutes After Intercourse

It takes about twenty minutes or so for the sperm to work their way through the cervical mucus and up to the Fallopian tubes in search of the prized egg. Staying horizontal won’t guarantee success, but it can help minimize the risk of sperm leakage from the vagina—and it certainly can’t hurt. Plan ahead and have a book, music, or the television remote nearby to help pass the time, or close your eyes and take a nap.

Don’t Douche

Your vagina can keep itself clean, so there is no medical or hygienic reason to douche. Douching with commercial products can disrupt the natural pH of the vagina, possibly damaging or destroying sperm.

Even douching with plain water isn’t good for you: It has been linked to an increased incidence of ectopic pregnancy and pelvic inflammatory disease. A recent study conducted by researchers from Emory University in Atlanta and the Federal Centers for Disease Control
and Prevention found that women who douched were almost four times as likely as those who had not to develop an ectopic pregnancy. The longer a woman douched regularly, the greater her risk. After fifteen years of regularly douching, the risk of an ectopic pregnancy was seven to eight and a half times that of a woman who had never douched. An estimated 37 percent of American women douche; if you are among them, discontinue the practice, at least until you have finished having children.

Take Cough Syrup

Guaifenesin, the active ingredient in Robitussin and several other cough syrups, works by thinning the mucus in the lungs. As an added benefit, it also thins the cervical mucus, making it better suited for moving sperm through the reproductive organs. Take one to two teaspoons a day, starting three or four days before ovulation.

HIS
Ejaculate Every Two or Three Days

You’re going to have to pace yourself: Ejaculating too much—or too little—can lower your sperm count. Don’t
believe the old wives’ tale about “storing up” sperm to promote conception.

Most infertile couples focus on the timing of intercourse near the anticipated time of ovulation, but it is helpful to enjoy your sex life all month long. While absence may make the heart grow fonder, studies have found that abstinence makes the sperm grow weaker. Researchers have found that waiting more than two or three days between ejaculations (whether through intercourse or masturbation) can lead to a diminished number of active sperm and inferior sperm quality. Regular sexual activity increases testosterone levels, which stimulates sperm production and maturation. So to maximize your sperm count, enjoy a rewarding sex life all month long, not just around the time of ovulation.

Take a Cold Bath—Before Sex, Not Instead of It

“Go take a cold shower” may be one way of turning down the heat when someone’s amorous ambitions cannot be acted on, but evidence suggests that a cold bath or shower thirty minutes before intercourse can actually improve fertility. Evidence indicates that a cold bath increases the flow of oxygen in the body and the level of testosterone in the blood. So you might as well try a five-minute soak to cool things off—then enjoy yourself as things heat up.

Consult a Doctor if You Have Very Little Seminal Fluid

In some cases, a physical problem can cause a man to ejaculate into his bladder, rather than out through the end of the penis. He enjoys the pleasurable sensations associated with an orgasm, but no fluid is released. Then, the next time he urinates, a milky white fluid—semen—is excreted along with the urine.

In many cases, this problem, known as retrograde ejaculation, stems from a neurological disorder that causes a lack of control of the muscles at the base of the bladder that normally close off just before ejaculation. (The nerve damage can be a complication of diabetes.) Retrograde ejaculation can also be a side effect of certain medications, including those used to treat depression and hypertension. A change in medications or, in some cases, surgery can be effective in treating the problem.

Keep in mind that the volume of ejaculate is not a reflection of the number of sperm a man is producing. A man can be sterile and produce a tablespoon of semen, while potent men can release just a drop or two. As for average, most men release between one-half and one teaspoon of ejaculate.

A S
EASON FOR
L
OVE

If your sperm count is low, check the calendar. According to researchers at the University of Texas Health Center in Houston, sperm counts fluctuate throughout the year, peaking between February and March, and falling to the lowest levels in September. No wonder Valentine’s Day is February 14.

Treat Impotence

Don’t be embarrassed: Sooner or later, most men experience occasional episodes of impotence. However, an ongoing problem with impotence—the inability to achieve and maintain a successful erection—can obviously interfere with fertility. Fortunately, impotence and problems of sexual dysfunction affect only about 5 percent of infertile men.

Many erection problems have at least some physical cause. To achieve an erection there must be cooperation of blood vessels, nerves, and tissues. Impotence can be caused by a number of health problems, including diabetes, heart and circulation problems, stroke, epilepsy, Alzheimer’s disease, neurological disorders, alcohol and drug abuse, Parkinson’s disease, and liver and kidney disease. Impotence can also be caused by certain mediations,
such as tranquilizers, diuretics, and anti-ulcer, anti-psychotic, anti-depressant, and anti-hypertensive drugs. Some over-the-counter antihistamines and decongestants can cause temporary impotence as well.

The other cases of impotence stem from psychological factors, such as relationship problems, stress, anxiety, grief, depression, fatigue, boredom, and guilt. Sexual intimacy can make some people feel very vulnerable, causing a number of stresses and uncomfortable feelings.

With patience and treatment, most cases of impotence can be managed and overcome, but you must be willing to ask for help. The prescription drug Viagra, approved by the FDA last year, has been shown to help 70 percent of men with impotence. For more information on impotence, talk to your doctor or contact:

Potency Restored
8630 Fenton Street, Suite 218
Silver Spring, MD 20910
(301) 588-5777

Impotence Institute of America
10400 Little Patuxent Parkway, Suite 485
Columbia, MD 21044
(410) 715-9605

Impotence Information Center
American Medical Systems
Minneapolis, MN 55440
(800) 543-9632

COUPLES
Be Conventional: Stick to the Missionary Position

The so-called missionary sexual position—man on top, woman on the bottom—reduces the risk of sperm leaking from the vagina and increases contact of the semen with the cervix. If you are a woman, after intercourse you might want to tip your hips back, slip a pillow or two under your hips, and gently press the labia (lips) of your vagina together to give the sperm every chance possible to work their way north to the Fallopian tubes.

Another option is rear entry or “doggie style.” This position allows for the deposit of sperm close to the cervix. When you’re trying to conceive, don’t make love sitting, standing, or with the woman on top.

Make Love Before You Make Breakfast

Making love is a nice way to say good morning. There are no studies to show that morning intercourse improves the odds of conception, but experts do know that sperm counts are higher in the morning (provided you
haven’t had intercourse the night before). In addition, male hormones peak in the morning, which may help explain why many men feel passionate first thing in the morning.

Have Sex Every Other Day

Some infertile couples assume that conception can most easily be achieved by having intercourse as often as possible near the time of ovulation. However, too much of a good thing can compromise sperm count.

Your goal, of course, is to fertilize a mature egg as soon as possible after it is released from the ovary. Since this window of opportunity can be just six or eight hours for some women, intercourse must occur in a timely fashion. Mother Nature makes this task somewhat easier because sperm can survive inside the vagina for up to five days. (Actually, the length of time the sperm remain alive depends on where a woman is in her menstrual cycle: If she is in an infertile phase, the sperm will die within hours; if she is approaching ovulation, the sperm can survive for days in the more hospitable wet cervical mucus.)

Waiting two days between lovemaking sessions is ideal for most couples. Having intercourse daily will reduce sperm count somewhat, which can make a difference in cases where the man has low or borderline
sperm count. One exception: Men who have excessively high sperm counts (as determined by a sperm analysis conducted by a doctor) may find that daily intercourse helps lower the sperm count to a more normal level, which can prevent the sperm from fighting one another.

Don’t try to “save up” sperm by avoiding intercourse for a week or more before ovulation. This period of abstinence will lower sperm production, and it will result in the release of a large number of old sperm cells, which are less likely to achieve fertilization.

Also, keep in mind that the slippery, clear fluid or gel that is released prior to ejaculation contains live sperm. This pre-ejaculate is designed to protect the sperm by neutralizing acids in the urethra and vagina. Don’t confuse the release of this fluid with premature ejaculation; when ejaculation occurs, the prostate will release a greater supply of fluid that will allow the sperm to travel in the vaginal canal.

C
HOOSING THE
S
EX OF
Y
OUR
B
ABY

If you’re having trouble getting pregnant, you probably don’t care about the sex of your child—you just want to have a healthy baby. But, to the degree that you can choose, some people like to try to tip the scales in favor of one sex or the other.

It’s the sperm that determine the sex of the baby. The male sperm (with Y chromosomes) tend to be smaller, lighter, faster, and more fragile than the female sperm (with X chromosomes), which tend to be bigger, heavier, slower, and longer-lived. While these methods are far from foolproof, evidence does suggest that the timing of intercourse can influence the sex of the baby. Consider the fact that fraternal twins (which come from two separate eggs) tend to be the same sex, and they would have been fertilized at the same time.

FOR A GIRL

Make love using shallow penetration in the missionary position; this will deposit the sperm at the mouth of the cervix and favor the slower-swimming female sperm.

The woman should avoid orgasm; this will keep the vaginal canal relatively acidic, which will tend to kill off male sperm in favor of female sperm.

Make love on the second or third day before you anticipate ovulation. This will allow the longer-lasting female sperm to be present in the Fallopian tube at the time the egg is released from the ovary.

FOR A BOY

Make love using deep penetration (perhaps in the rear-entry position), which will deposit the sperm at the neck of the cervix, where they can sprint inside the uterus and speed their way up to the Fallopian tubes. In addition, the area deep inside the vagina tends to be more alkaline and more hospitable to male sperm.

The woman should have an orgasm; this will create a more male-sperm-friendly alkaline environment.

Make love as close to the time of ovulation as possible; this will allow the energetic, fast-swimming male sperm to reach the egg first. Also have intercourse on the day following your perceived peak day, just in case you miscalculated.

Skip Oral Sex

The bacteria found in saliva can degrade semen and reduce the chances of conception. Studies have found that saliva significantly decreases sperm motility and progression, causing many sperm to shake and vibrate without moving forward. Both partners should avoid giving or receiving oral sex during those lovemaking sessions in which you are trying to get pregnant.

Don’t Have Intercourse Under Water

While making love in a pool or on the beach can be erotic and exciting, under-water intercourse can undermine your chances of conceiving a child. The chlorine found in the pool water can alter the vaginal pH level, and the presence of any water can wash away or alter the all-important vaginal mucus, which helps the sperm work its way to the awaiting egg.

Avoid Commercial Vaginal Lubricants

Massage oils and lubricating jellies, liquids, and suppositories may enhance lovemaking, but they may inhibit babymaking at the same time. Many commercial lubricants can interfere with the sperm’s ability to make its way through the reproductive tract. Oil-based lubricants, such as petroleum jelly, can alter the vaginal pH and damage sperm. Even water-based products (usually marked “safe to use with condoms”) can slow down or trap sperm.

Instead of using commercial products, use egg white if you really need a lubricant. The egg white is pure protein—and so are the sperm—and the egg white won’t disrupt the natural pH balance in the vagina.

Note:
Do not use egg white if either partner is allergic to eggs. Be sure to separate the yolk from the egg before using egg white as a lubricant.

Consider Whether Either Partner Has Anti-sperm Antibodies

Anti-sperm antibodies are evidence of an overzealous immune system. When the immune system is working as it should, the white blood cells produce proteins known as antibodies, which seek out and destroy hostile proteins, known as antigens. These antigens attack a range of foreign invaders—viruses, bacteria, fungi, and other microorganisms that can cause illness. Sometimes, however, the body mistakenly sets its sights on harmless proteins, such as sperm. When antibodies attach themselves to the sperm, they can cause problems with motility and the ability of the sperm to penetrate the egg.

Experts disagree about how often anti-sperm antibodies cause infertility, but some believe the condition exists in up to 20 percent of infertile women and 10 percent of infertile men Many researchers believe that the antibodies can reduce the chances of conception, but do not necessarily prevent it.

In women, experts believe the problem can be triggered by infection, though the condition is not very well understood. In men, anti-sperm antibodies sometimes appear after vasectomy; the condition can also follow infection or injury to the genital area. Lab tests involving blood, cervical mucus, and sperm will be needed to detect the presence of the antibodies.

If a man has anti-sperm antibodies, he should work
with a urologist with expertise in fertility to take steps to manage the problem. If a woman has developed antibodies to her partner’s sperm, the problem can be corrected in some cases by having the man wear a condom during intercourse and oral sex for six months to give the woman’s immune system a chance to stop forming antibodies. Then, after this period of rest, it is possible that the couple can have intercourse without a condom at the time of ovulation and pregnancy can occur before the antibodies form again. If you have this problem, this low-tech approach is certainly worth a try, and some researchers have reported success rates of up to 50 percent using this technique. If this method does not work, do not despair. Many couples with immunological disorders can conceive with the help of assisted reproductive technologies.

This is a complex problem that will probably require diagnosis and treatment from a physician. If either partner has a history of infections or sexually transmitted diseases, consult a fertility expert to find out if anti-sperm antibodies are contributing to your problems with conception. Keep in mind that the low-tech techniques described in this book cannot help you if anti-sperm antibodies are present.

Test for Sexually Transmitted Diseases and Treat Them Promptly

Sexually transmitted diseases (STDs) can scar the reproductive system and cause infertility in both women and men. Americans report 12 million new cases of STDs and 1 million cases of pelvic inflammatory disease each year, according to the Centers for Disease Control and Prevention in Atlanta. About 12.5 percent of these infections lead to infertility after a single episode, and an astonishing 75 percent of people are left infertile after three infections. (People who smoke are particularly susceptible to scarring and infertility because smoking slows down the healing process.)

In women, pelvic inflammatory disease (PID) is almost always sexually transmitted. It can be caused by any of a number of organisms, but once they reach the vagina during intercourse, they spread throughout the reproductive system. PID is often found in women who have had multiple sex partners, especially in couples who did not use a barrier form of contraception (such as condoms or diaphragms). It can also be caused by abortion and the use of IUDs (intrauterine devices). PID may show up as pelvic pain, odorous vaginal discharge, vaginal bleeding, painful urination, fever, chills, nausea, and vomiting—or it can be present without any symptoms at all. Ideally, a woman should have a complete gynecological
exam before trying to conceive, so that her doctor can identify and treat any harmful microorganisms that might be present.

In men, the sperm are produced in the testicles, then they must move along an eighteen-foot, tightly coiled tube known as the epididymis. The sperm must then travel through the vas deferens, the tube connecting the epididymis and the prostate gland. Many sexually transmitted diseases can cause tubular scarring and infertility; blocked sperm ducts account for an estimated 10 to 15 percent of male infertility. The more sex partners a man has had, the greater the number and type of bacteria he will have in his prostate gland and seminal fluid, and the greater the chance that these bacteria will cause PID in his female partners.

For both women and men, the best way to protect your fertility and to minimize your risk of developing STDs is to limit your number of sexual partners, use condoms, and seek medical care as soon as symptoms appear. In many cases, the damage caused by an STD is irreversible—and the damage is done before the infection is diagnosed and treated. For more information on sexually transmitted diseases, contact your gynecologist or another physician.

FERTILITY CHECKLIST

HERS

Calculate your anticipated day of ovulation using the calendar method.

Learn to recognize changes in your cervical mucus.

Chart the changes in your basal body temperature.

Monitor changes in your cervix.

Try an ovulation predictor kit.

Stay flat on your back for 20 to 30 minutes after intercourse.

Don’t douche.

Take a cough syrup with guaifenesin.