Infertility
Infertility
An Action-Oriented Approach
Sometimes you wonder why you spent all those years worrying about getting pregnant, because now you want to have a baby, but nothing is happening. Infertility is of particular concern among women over age 35, the age at which the female reproductive system starts showing signs of decline, from having fewer healthy eggs to producing less of the female hormone estrogen. Infertility can be hard on your emotions, too. A group of women in one survey reported that they felt more depression and anxiety going through the experience of infertility than they had at any other time in their lives.
IF AT FIRST YOU DON'T SUCCEED . . .
Couples are considered infertile if they have been having unprotected intercourse for a year and no pregnancy results. The cause varies from couple to couple. Whether you're working with an infertility specialist or not, here are some things that women doctors say you can do to help yourself.
Buy a test kit. Knowing when your ovaries are about to release an egg will give you a clue as to the best time to try to conceive, says Susan Treiser, M.D., Ph.D., co-director of In Vitro Fertilization (IVF) New Jersey in Somerset and co-author of A Woman Doctor's Guide to Infertility. Your best bet is an ovulation test kit, available from a drugstore. Use it around the eleventh day of your menstrual cycle, and follow the directions on the package.
Mind your mucus. Another ovulation clue: Cervical mucus in your vagina is normally sticky and opaque. Around mid-cycle, it becomes stretchy and clear, similar to the consistency of egg whites. This is a signal that you'll ovulate within about 36 hours, says Marilyn R. Richardson, M.D., clinical assistant professor of reproductive endocrinology at the University of Texas Southwestern Medical School and in practice with Reproductive Medicine Associates, both in Dallas. Cervical mucus aids the process of conception by collecting sperm in a sticky reservoir within the cervix and then transporting it into the uterus and fallopian tubes on something of a time-release basis, increasing the odds of fertilization.
You've probably seen cervical mucus when you wiped yourself after using the toilet, but just never paid attention to it. The best way to check on the status of your cervical mucus is to examine the toilet paper used after you urinate, says Charanjeet Ray, M.D., an obstetrician/gynecologist and associate professor in the Department of Obstetrics and Gynecology at Rush Medical College of Rush University and attending physician at Illinois Masonic Hospital, both in Chicago. Or take a piece of tissue and gently wipe yourself, whether you've urinated or not. If the mucus is clear and stretchy and there's a lot of it, you're probably about to ovulate, she says.
Try three days off and three days on. Inundating the cervix and fallopian tubes with sperm will increase the chances that one of these guys will fertilize an egg. So when you're about to ovulate, Dr. Treiser suggests having sex daily for three days. To increase the odds still further, abstain from sex for two or three days prior: That way, your partner's sperm levels will be higher than usual.
Use a new approach. A study at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina, suggests that a woman's fertile time actually ends with ovulation. Researchers found that the women who got pregnant during the course of the study conceived when they had intercourse during a six-day period ending on the day of ovulation.
What Women Doctors Do
Bond with Others Bethany Hampton, Ph.D. A few years ago, Bethany Hampton, Ph.D., associate professor of psychology at Texas Woman's University in Denton, experienced infertility herself. She joined RESOLVE, a national organization with local support-group meetings, where women share their experiences and feelings. "For infertile women the world looks so fertile. It looks as though everyone is having babies, and it eats them up," she recalls. "It's important to see that other women who have gone through this are functioning well. I think that was critical to my getting through it." Dr. Hampton has since become the biological mother of two. And she made some friends at RESOLVE with whom she is still very close. For more information, Dr. Hampton recommends contacting RESOLVE at 1310 Broadway, Somerville, MA 02144-1731.
|
When To See A Doctor
Infertility tends to increase as you age. A woman is born with all the eggs that she will ever have, and their quantity and quality diminish with the passing years. Consult a physician if you are under the age of 35 and have tried unsuccessfully to conceive for a year, or if you are over 35 and have tried for six months. Any woman with problems such as irregular menstrual periods, endometriosis, fibroid tumors or a history of a pelvic infection should seek assistance sooner rather than later, since these may reduce her chances of becoming pregnant. Time is of the essence, says Susan Treiser, M.D., Ph.D., co-director of In Vitro Fertilization New Jersey in Somerset and co-author of A Woman Doctor's Guide to Infertility. "It's important that you seek the help of an infertility specialist."
|
Or, have sex every other day. If you're not tracking ovulation, have intercourse every other day--particularly on days 8, 10, 12, 14, 16, 18 and 20 after the first day of your last period--says Dr. Treiser. This will ensure that when you do release an egg, there is sperm (which can survive for up to three days) in your fallopian tubes.
Lie still after sex. Standing up or running to the bathroom right after intercourse allows some semen to run out, says Dr. Richardson. Instead, lie back and wait for at least 10 to 15 minutes.
Use over-the-counter drugs selectively, if at all. Nonsteroidal anti-inflammatory drugs such as ibuprofen may compromise ovulation as well as implantation of the embryo to your uterus, says Dr. Richardson. If you need a painkiller around that time of the month, take aspirin or acetaminophen instead. Steer clear of antihistamines and decongestants, too, as they may reduce secretion of cervical mucus.
Stay away from smoke. Smokers, on average, take longer to conceive and have a higher incidence of miscarriage, says Dr. Treiser. Also, their eggs are less likely to succeed in IVF, in which a woman's eggs are removed, fertilized in the laboratory and returned to her uterus.
(For more advice from women doctors about your biological clock, and on dealing with the emotional fallout of delayed conception, see page 55.)
