If you’re one of my patients, you’ve probably heard me mention probably most of the things on my blog…..including the one thing I say over and over: it takes 3 things to have a baby: eggs, sperm and tubes that are open. Learn about all 3 and you can figure out why a couple is having a problem conceiving. I’d like to officially add emotional health to the list……I think that emotional health is essential when trying to conceive and if you don’t have emotional health, that in and of itself could possibly affect your chances of conceiving.

People who are emotionally healthy are in control of their emotions and their behavior. When bad things happen, they’re able to bounce back and move on. Mental and emotional health takes an effort to build and maintain. As couples are trying to conceive, they should not only spend energy on their physical health but do things to boost their mood, build resilience, and get more enjoyment out of life.  Every patient of mine will have their own ideas about how they can build and maintain their emotional health.

Here are some tips:
1. Take care of your physical health: eat right and maintain your weight.

2. Do things for fun! Remember when you were dating? You did things that were fun for both of you. Talk about those things and start doing them more often. Go to a funny movie, take a walk on the beach, listen to music, go to a concert or theater show, or get together with friends. Doing things just because they are fun is no indulgence. Play is an emotional and mental health necessity.

3. Make time for deep thought and appreciation.  Think about the things you’re grateful for. Mediate, pray, enjoy the sunset, or simply take a moment to pay attention to what is good, positive, and beautiful as you go about your day. If you don’t have time to see a psychologist and/or hypnotherapist, you can go to www.circlebloom.com for meditations that can take you through your fertility treatments.

Hope this helps!

The answer is no. I read a great article in Reviews in Obstetrics and Gynecology. Take the time to read it because it talks about how one important difference among prenatals is the source of folic acid.

Just click here and you can read it: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250974/

Then after reading it, you’re going to do what I did and you’re going to ask, which prenatals contain L-Methylfolate? So then I foudn this source: http://www.empr.com/prenatal-vitamins/article/125903/. You can find the prenatals that contain L-methylfolate. Or you can just buy L-methylfolate separate from your prenatal.

Hope this article helps!

Really cool new way to monitor ovulation is coming to the US. This device has been available in Europe since 2009. Check out this Youtube video to watch a demonstration: http://youtu.be/Eu70WJ_k4Aw

A sensor is worn under the armpit and measures subtle changes in basal body temperature which is indicative of ovulation. The reader wirelessly receives the sensor data and predicts when you are most likely to become pregnant up to six days in advance. A number of additional parameters can also be entered into the reader unit to improve the prediction quality. The recorded data can be visualized by connecting the reader unit into your computer. Cool stuff!

It’s not easy getting pregnant. It gets harder when you’re over 40.

If you’re thinking of waiting to get pregnant until you’re 40 (something I hear over and over) or you are trying already and you’re over 40, take the time to read these two articles. These articles are must reads:

http://www.parentcentral.ca/parent/babiespregnancy/pregnancy/article/1110159–motherhood-after-40-ethical-debate-rages-over-how-old-is-too-old-to-become-a-mother

http://www.huffingtonpost.com/glenn-d-braunstein-md/why-women-men-shouldnt-ta_b_1179850.html

The most recent celebrity mom over 40 is Robert DeNiro’s wife who had a baby through a gestational carrier at age 56. They haven’t confirmed whether donor eggs were used but if the embryos used were created recently, they weren’t created with her own eggs. Before you consider trying over age 40, start off by seeing an infertility doc. Don’t wait to see the fertility doc after several months of not conceiving. Your fertility doc will be able to talk to you about your fertile potential and give you the best plan of action to help you meet your goals.

Happy 2012! This will be your best year ever. If you’ve started fertility treatments and haven’t gotten pregnant yet, it may be time to go back to your Doctor and ask “Do you know who I am?” I don’t mean literally but figuratively. This is a good time for you to reconnect and say, “I’d like to review my history with you and see if you’d like to order any other tests that could potentially help us improve our chances of conceiving.”

I personally have a one year rule on everything. If it’s been one year and you haven’t had your thyroid levels checked or had a repeat semen analysis  or a cavity or tubal evaluation – it’s time. I’ve also seen plenty of patients who have been down the fertility treatment path without ever having had a pelvic ultrasound, only to find out after years of trying that a fibroid (benign tumor in the uterus) was the reason behind their fertility problems.

So take the time to either see a Reproductive Endocrinology and infertility specialist for the first time this year or just go back in and ask your doctor to review your entire fertility chart  to make sure that all the testing has been done and is up to date.  If there is a concern about ovarian aging, repeat levels like FSH and AMH and an antral follicle count just so that you can understand more about your body.

Take charge of your health this year and keep all medical records in a file at home and understand why each test is being done and what it means for you.

I ask all my patients, “Do you know why things haven’t clicked yet?” The reason why I ask this question is because I want all my patients to know and understand their fertility issues so that they feel like they understand why I’m guiding them along a particular path of treatment. If you’re confused about why something is being done – just ask.

As always, I hope this helps

There’s a lot about fertility  we are yet to discover. Scientists are discovering more every single day about what it takes for a sperm cell to fertilize an egg. This year, UCSF scientists uncovered hoe progesterone switches on a sperm’s internal electricity which is involved in giving the sperm enough power to push toward the egg. This discovery could lead to understanding more about fertilization. Fertilization problems are difficult to diagnose. 

Two recent articles in the scientific journal Nature — one by Lishko and Kirichok, another by researchers in Germany — provide the first evidence that progesterone activates sperm tails by binding to a protein on the sperm’s surface, called CatSper. Scientists have long suspected that progesterone from around the egg triggers sperm tails to pump harder in the final stages of fertilization. The tail’s normal undulations switch to a one-sided flicking motion, like a whip being cracked against the ground.

 Called “hyperactivation,” the whipping motion is thought to give sperm a last-minute boost to the egg and help one lucky winner poke through the egg’s protective vestments. In fact, in vitro experiments show that fertilization cannot happen without hyperactivation. But until now, researchers couldn’t explain how progesterone transmits its signal. Read the rest of this entry »

If you’re interested in adoption please click here for a local resource in the Bay Area:

http://www.adopt-now.com/

This is the thing, your doctor doesn’t want to tell you to lose weight. Weight is a very personal thing and it isn’t easy when you’re dealing with the heartache of infertility to then also deal with your doctor harping on your about your weight….so honestly, most docs won’t talk about it but in a society that continues to get heavier, it’s time to be honest about your weight.

This is what you should know:

1. Calculate your BMI here so you can understand more about your weight and whether you should consider losing or gaining weight: http://www.nhlbisupport.com/bmi/

2. Obesity and fertility isn’t something we worry about just in women. A recent study showed that obese men are more likely to have lower semen volume and fewer normally shaped sperm  than men with normal BMI. Read the study here: http://www.rbmojournal.com/article/S1472-6483(11)00474-3/abstract

3. We see in study after study evaluating the association between BMI and IVF outcomes that women who are underweight  have consistently lower pregnancy rates. Read one of the studies here: http://www.rbmojournal.com/article/S1472-6483(11)00351-8/abstract.  The reason why underweight women have lower IVF outcomes?  One theory, the researchers note, is that in very thin women, low levels of the chemical leptin, a natural regulator of body weight released by fat cells, may affect the discharge of eggs from the ovaries. If you have low fat stores, you’ll have low levels of leptin, which won’t allow for normal communication between brain and pituitary and will cause problems for ovulation. Very thin women may want to cut back on their fitness regimes and try to increase their body weight

4. We also see in studies that women who are overweight have lower pregnancy rates as well: The reason why? The ovaries of overweight women don’t respond as well to hormones as those who are normal weight.
In overweight women, one possibility is that “metabolic derangements” or problems associated with obesity, such as high cholesterol, heart disease and diabetes, affect fertility. So one would think that pregnancy would be an additional demand on them and they would be more prone to failure.  Overweight women could experience improvements in their fertility if they can lose 10 to 15 percent of their body weight in some circumstances from dieting and exercise. Maybe it’s just simply too much estrogen. Your fat is directly related to your estradiols, which are a form of estrogen. We hear so many conflicting reports about exercise and fertility. Strenuous exercise has been shown to decrease fertility but in the overweight, the fact is that strenuous exercise may be the path to success.

For folks living in the East Bay check out: www.jumpstartmd.com. My patients have achieved tremendous success through their programs.

Hope this helps!

How much do you know about Birth Control pills?  Test your knowledge here. There is so much misinformation out there, I just wanted to take a few moments to dispell some myths:

1. Fact or Fiction:  If a woman takes birth control pills every month and has a period every month, it means she is fertile. 

FICTION! Just because you have a period while on birth control does not mean that when you stop the pill that your periods will be regular. I have had a number of patients under the impression that periods while taking birth control pills has some sort of relationship to fertility. This is untrue. Even a menopausal woman can take birth control pills and have periods. A woman with absent ovaries can also take pills and have periods. Whether you have periods or not on birth control does not a relationship with your fertility.

2. If a woman takes birth control pills, she needs to be off of them the same period of time to let them wash out of her system:

FICTION! Birth control pills are out of your system rapidly, that’s why you have to take them daily. There’s no such thing as giving your body a break off of pills before trying to get pregnant. If you’re having irregular cycles after you stop your pills, it has nothing to do with being on the pill. See your ObGyn or local fertility specialist.

3. Taking birth control pills before trying to conceive causes birth defects so you need to stop them for awhile before trying to conceive.

FICTION! Bith control pills prior to conceiving do not cause birth defects.

So if you’re on birth control pills and you’re thinking about stopping in order to start making a baby, talk to your doctor about any rumors you’ve heard so you go into baby making fully informed.

What do we all want? We all want a healthy baby. Most of my patients bring up preventing autism at some point in one of our discussions about treatment and pregnancy. Technology allows us to screen the genetic make-up of an embryo for diseases like Cystic Fibrosis and chromosomal abnormalities like Down Syndrome but we are unable to tell if an embryo will turn into a child with autism or not. A recent study has shown a possisble link between antidepressant use and autism. Approximately 25% of my patients take antidepressants so I’m particularly sensitive to the study findings published in the Archives of General Psychiatry.

This is what the researchers found:
1. the type of antidepressants that they found may increase the chance of developing autism spectrum disorder (ASD) was a type called selective serotonin reuptake inhibitors (SSRISs). SSRISs include meds like Zoloft and Prozac.

2. SSRI treatment during the beginning of pregnancy (first trimester) had the strongest link to ASD.

3. Children whose mothers took an antidepressant in the year before delivery were twice as likely to develop ASD than the children whose mothers did not.

4. No association was found between having an ASD and exposure to other types of non-SSRI antidepressants.

Read more about the study here: http://www.medpagetoday.com/tbprint.cfm?tbid=27403

and talk to your own doc about whether taking your SSRI in pregnancy is right for you.

I have written about autism before in my blog so read more about autism here:
http://draimee.org/fertility-treatment-and-autism-risk/

http://draimee.org/austism/

http://draimee.org/recent-study-shows-increased-risk-of-autism-for-moms-over-40/

As always, I hope this helps.