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January 31, 2009

Fertility 101

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Photo Credit: Kenji Toma

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TRUTH OR MYTH: WHAT REALLY AFFECTS FERTILITY?
The Pill — MYTH. It's entirely possible to get pregnant during your first cycle off the Pill, says Dr. Mary Jane Minkin, a professor of obstetrics and gynecology at the Yale School of Medicine. "There's even some evidence that women who go off the Pill have a slightly higher incidence of twins if they conceive that first month," she says. Post-Pill babies face no extra health risks.

Polycystic ovarian syndrome (PCOS) — TRUTH. Also known as Syndrome O, PCOS is one of the most common causes of infertility — the syndrome is accompanied by hormonal fluctuations or imbalances that can interfere with ovulation. Symptoms include irregular periods and increased hair growth on the face, stomach, and back, as well as acne and weight gain.

Previous births — MYTH. Having already had a baby doesn't guarantee that you have viable eggs remaining. "About one in 10 women who already has a baby will have difficulty conceiving a second time," says Adamson.

Endometriosis — TRUTH. A condition that occurs when endometrial tissue grows outside of its normal boundaries, endometriosis can lead to infertility if these rogue endometrial cells block the fallopian tubes or prevent normal ovulation or implantation.

Abortion — MYTH. An abortion does not alter your ability to have a healthy child later, unless you experienced complications that scarred the uterus.

Cancer treatment — TRUTH. Depending on dose and duration, some radiation and chemotherapy can lead to infertility.

Diet — MYTH. While a healthy diet is important, no experts — not even Harvard physicians Jorge Chavarro and Walter Willett, coauthors of The Fertility Diet — believe diet alone can make an infertile couple conceive. "There are some people with certain disorders who, no matter how many changes to diet or lifestyle, still won't get pregnant," says Chavarro, who admits that his book's program has never been tested on women already experiencing fertility problems.

A PRODUCT OF YOUR ENVIRONMENT
The science on toxins and fertility is still in its infancy, but studies that have examined exposure on jobs to certain chemicals, such as pesticides, have found a link to fertility problems. How that translates into normal life exposure remains uncertain. Early studies are hinting that mercury, flame retardants, and some chemicals found in plastics (such as phthalates) might impair fertility — although to what extent we don't yet know. For now, says Swan, "The rule of thumb with chemicals and plastics is, if you don't need it, don't use it." Avoid plastics numbered 3, 6, and 7 and limit your exposure to chemicals. Last, "Don't microwave in plastic," Swan says. Go to the Institute for Agriculture and Trade Policy Website (iatp.org/foodandhealth) for guides to safe plastics.

HOW CONDOMS KEEP YOU FERTILE
By protecting you from STDs now, a condom can prevent infertility later. Left untreated, something like chlamydia can damage your reproductive organs and lead to pelvic inflammatory disease, which can scar or block the fallopian tubes.

PARTICIPATE IN A SCIENTIFIC STUDY
Pregnant — or have plans to be? If you want to contribute to medical history, take note of the National Children's Study, the most comprehensive project yet on kids' (and their pregnant mothers') health. What they need: tens of thousands of babies across the country whose vital stats will be tracked from their time in the womb to age 21. Find out more by logging on to nationalchildrensstudy.gov.

SCI-FI FERTILITY
Be forewarned: There's a limit to the miracles science can perform. "Assisted reproduction techniques, such as in vitro fertilization, can only help eggs and sperm reach their natural potential," says Dr. David Adamson. "They can't change the number or quality of your eggs or his sperm."

Only 35 percent of attempts at assisted reproduction produce a pregnancy, and the odds get worse with age. While it's possible to freeze unfertilized eggs for later, success rates are as low as 2 percent per egg.

WANT A BABY? WE'RE HERE TO HELP...
Once upon a time, procreation required only a man and a woman. Today, an entire industry is standing by to help you create the baby of your dreams.

WHO: Conception coach
CLAIM: This personal adviser promises to develop a game plan for navigating the emotional ups and downs of getting pregnant (conceivecoaching.com).
COST: $125 to $175 per session

WHO: Acupuncturist
CLAIM: A fertility acupuncture regimen focuses on points related to the ovaries and uterus along with those that induce relaxation. About a dozen studies have shown that acupuncture can improve fertility rates in IVF patients.
COST: $75 to $125 per session

WHO: Fertility counselor
CLAIM: Stress is the top reason that couples drop out of fertility treatments. Ease the tension with the help of a specialized therapist.
COST: $100 to $180 per session

Christie Aschwanden is a freelance writer whose work has appeared in the New York Times and the Washington Post.


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