What Can I Do To Improve My Chances Of Achieving A Successful Pregnancy?
GENERAL
Couples experiencing delays in achieving pregnancy seek answers to their infertility and often ask what they might do to improve their prospects for success. When the female partner is less than 35 years of age and the couple has been trying to establish a pregnancy for one year or greater, it is time to seek professional help. If the woman is 35 years of age or older, the couple should see an infertility specialist after 6 months of attempts to conceive. Consultation with the OB/GYN physician or a reproductive endocrinologist would be the ideal first step in investigating the cause for the delay in conception. Seeking qualified professional help is probably the single most important step in achieving success. Based on many years of experience caring for infertile couples and utilizing the various treatments that we have available, there is little doubt in my mind that effective treatment will successfully treat most couples with infertility.
THE INFERTILITY TEAM
Establishing trust and a comfortable relationship with the infertility team is of paramount importance. Managing infertility is clearly a team effort and the team must be there for the couple at every turn. The “infertility team” includes receptionists who do their best to accommodate scheduling needs, nurses who are empathetic and field all questions with patience and understanding, billing personnel who work hard to help the couple with insurance issues and act as the couple’s advocate in communications with their insurer, physicians who are knowledgeable and compassionate, and experienced embryologists who are highly skilled, detail oriented and who communicate complex scientific matters clearly with the couple.
WEIGHT
There is evidence that women who are overweight have reduced fertility potential. The good news is that well controlled studies have shown that even modest reductions in weight result in significant improvements in fertility. Weight reduction of 5-10% of body weight has been demonstrated to improve fertility significantly. A small reduction in weight can be a significant piece of the overall equation toward improving fertility potential.
UNDERSTANDING PROSPECTS FOR SUCCESS
It is vitally important that the couple preparing to begin treatment has a realistic expectation of their prospects for success. Once the infertility evaluation is complete, it is fair and reasonable for couples to ask what their chances of success are, given their testing results. The physician or other member of the team should provide an accurate indication of the monthly prospects for success given the results of the workup and the proposed treatment. This information is vitally important to couples so that they have realistic expectations of treatment, understanding that a failed treatment cycle does not preclude future success. Sometimes couples go forward with a treatment plan in spite of the fact that they understand the prospects for success may not be good. Having an honest pre-treatment appraisal of their prospects for success helps couples prepare for treatment failure.
Human reproduction is an inherently inefficient process. Fertile couples have an approximately 20% chance of conception each month, therefore achieving pregnancy may take many months. Infertile couples have significantly less than 20% chance to conceive on their own each month. Infertility treatments certainly improve the couple’s chances for pregnancy each month, but most treatments (other than IVF) result in monthly pregnancy rates of somewhat less than 20%. Therefore, it is important that couples realize that successful treatment may take several months. Having an understanding of this concept is vitally important to couples in treatment and helps them to deal with disappointments which are an inevitable part of achieving success.
ACUPUNCTURE
Acupuncture has been used by many couples in an effort to improve their prospects for success. While the science supporting the beneficial effects on pregnancy rates is controversial with some studies showing improvement, and some failing to show benefit, my own personal experience is that most couples who choose to use acupuncture feel “relaxed” and tolerate all of the interventions of infertility treatment with greater ease. As a stress reducer, acupuncture seems to have benefits and I would encourage the use of this alternative care option, in conjunction with established conventional treatment plans.
MALE CONSIDERATIONS
Leading a healthy lifestyle which includes a healthy diet with abundant fresh fruit and vegetables is an important consideration for men as well as women who are attempting to achieve pregnancy. Elimination of tobacco is an important goal since cigarette smoking has been linked to reduced fertility in both men and women. Alcohol in high concentrations is detrimental to sperm production and therefore should be minimized. It is important to realize that the process of sperm production requires approximately 80 days. Therefore, men who drink heavily should not expect the quality of their sperm to improve for at least 80 days once they have discontinued drinking. A high quality multi-vitamin supplement which includes antioxidants is recommended for men trying to achieve pregnancy. Men should realize that anabolic steroids sometimes used to improve muscle growth and strength may severely suppress sperm production. It is also quite common for men to be receiving supplemental testosterone in one form or another because of a laboratory finding of “low testosterone”. Very often, testosterone supplementation with Androgel or similar products severely reduce sperm production, sometimes shutting down sperm production altogether. It may be necessary to reduce the dose of testosterone or discontinue it temporarily to improve prospects for successful pregnancy.
MIND BODY CONNECTION
There have been significant strides toward understanding the “mind body connection” and while there is little doubt that we have much to learn, I am convinced from observations over the years that couples who find a comfortable environment to receive treatment and develop trust and confidence in the team providing their care, reach their goals more readily. Infertility treatment is a journey that the couple and the team take together. The team must provide the technical expertise, patient education, emotional support, encouragement and a pleasant optimistic environment. The couple receiving treatment should strive to achieve a level of trust in the team, remain optimistic in the face of short term failure , and realize that they and their team are doing all that they can possibly do to achieve their goal. There is a “relaxation and peace” that couples achieve when they realize that they truly have a team that cares about them as individuals and is in their corner every step of the way. Pregnancy is most likely to be achieved when the “infertility team” and the “couple” are working closely together toward the same goal.
