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Lifestyles
of the Fit and Fertile
How To Reach - And Hang On To - Your Reproductive Prime
Some
people will instruct you, "Just relax." Others will
give you tips on coital position, recipes for ancient herbal
potions or slip you the feng shui guide to interior design
for fertility. Once they get wind of your efforts to conceive,
family, friends, mere acquaintances and near-strangers will
freely dispense their (usually) unsolicited advice on the
"sure-fire" way to get pregnant.
And
you may be tempted to try one or two of these well-intentioned
but off-the-wall suggestions. Especially when pregnancy isn't
happening as fast as you think it should and you'd swear that
every other couple at the mall is expecting.
Resist
that temptation. There's no evidence that hanging from gravity
boots for an hour after intercourse or chomping Saw Palmetto
(alleged to promote male potency) increase the odds of pregnancy.
There is evidence, though, that something less exotic, maybe
even mundane, does work: A sensible, healthy lifestyle.
It
is a fact of reproductive life that what you eat, how much
you weigh, the exercise you do, the colas and coffee you slug
and the cigarettes you light up - just to name a few things
- can profoundly affect your ability to make a baby.
While
lip service about the high road to health comes easy, getting
there typically isn't. You need discipline, support and, above
all, the desire. Moreover, the steps to that good-for-your-fertility
lifestyle aren't always obvious. Most of us could use a good
road map that keeps us on the path. So here's one to help
you figure out where you are and how to get where you need
to go.
Living
La Vida Healthy: Max Out Your Pregnancy Potential
To
a greater degree than most people imagine, you can manage
your reproductive destiny. Start with a candid assessment
of the way you live day-to-day, your physical and psychological
self. Unless you're flawless (and who can make that claim
and be called sane?), there's a good chance you'll have to
make at least a few changes. Some are simple adjustments.
Others are a test of will even for the strongest. Be prepared.
Weighty
Issues
You
can be too thin. Or too fat. It is one of nature's crueler
quirks that weight will affect a woman's reproductive capacity
more than a man's. The female body is at it's baby-making
best when it is within 15% the ideal weight. Ideal, in this
context, is not about Hollywood aesthetics. It is about the
weight at which your body and its hormonal systems run as
smoothly as a well-oiled Mercedes. Although it's a highly
individualized matter, many women begin experiencing problems
when they're less than 95% or more than 125% of that weight.
- BMI
and the Ideal. What you're looking for is a body mass index
(BMI), the standardized measure of the ratio of height to
weight, of between 24 and 30. To calculate your BMI, multiply
your weight by 703 and divide that by the square of your
height in inches. Not the complicated calculus it first
appears. Really.
Say
you're 66 inches tall and weigh 155 pounds. The equation
looks like this:
155
x 703 = 108,965
66 x 66 = 4,356
108,965/4,356 = 25.01
That
won't get you the cover of Vogue, but it's smack in the
middle of the "ideal" weight range.
- The
Thin Risk. This is a hard one, for men as well as women,
because we've lost all perspective. And, okay, it's not
the most common problem. But five minutes watching an episode
of "Friends," and we're all checking ourselves
for excess flesh. Skinny comes with a high cost. Underweight
women can stop ovulating, having regular periods or any
periods at all. Men with a BMI below 18 often can't find
their libidos, their sperm are less active and have shorter
lives than men in normal BMI range.
- Overweight
and Overwhelmed. This is the biggie, the problem that afflicts
most people. Indeed, between 4%-to-5% of women of reproductive
age have Polycystic Ovarian Syndrome, a common cause of
female infertility, which is exacerbated by obesity. It's
not known exactly how excess poundage interferes with conception,
but it is associated with long gaps between menstrual periods
and an overabundance of certain hormones that inhibit ovulation.
Too much body fat contributes to insulin resistance and
may also indicate underlying problems such as Polycystic
Ovarian Syndrome.
Should
you find yourself at either weight extreme, consult your doctor
and a nutritionist. Not to belabor the obvious, but avoid
crash or fad diets to gain or lose girth. It's not only about
achieving a pregnancy, but sustaining a healthy one as well.
Feeding
Your Desires: Feast for Fertility
It's simple.
Eat all the things you know you should but probably don't.
That's right. Lots of fruits, vegetables and low-fat protein.
Make sure to have at least three nutrient-laden meals daily
and treat yourself to snacks. Not a bowl of ice cream. Something
more along the lines of cottage cheese with a few crackers
or fruit. If you're trying to shed a few pounds, don't skip
meals, limit portion size and take time to savor the tastes.
Vegetarians
need to take extra care to get sufficient protein when trying
to boost fertility. Without it, estrogen metabolizes into
inactive (products) more rapidly and menstrual cycles become
longer.
Despite
your best intentions, it's sometimes impossible to get all
the vitamins and minerals from food alone. Both partners should
take a good multivitamin and mineral supplement. A women's
supplement should contain 400 units micrograms of folic acid
which helps prevent birth defects of the brain and spinal
chord that occur within 30 days of fertilization. Zinc may
be especially important for men to produce healthy sperm and
for normal testicular function.
Whatever
you do, avoid vitamin megadoses, especially A and D. The body
doesn't quickly excrete these fat-soluble vitamins allowing
them to build to toxic levels.
And no herbs. These are unregulated substances, mostly untested
and unregulated. And there is evidence some can cause problems.
St. John's Wort, a commonly used remedy for depression, for
example, has an adverse affect on male fertility. The solution
- stay away.
Limit
caffeine and alcohol intake. One cup of coffee a day should
suffice. A glass of wine might not hurt, but moderate to heavy
drinking takes its toll on male (sperm shape and motility)
and female (ovulatory dysfunction) fertility and has a deleterious
effect on embryos and fetuses.
Exercising
Your Rights
All right.
You've got the good-eating thing knocked. The next part of
your reproductive plan is to bend, stretch, run, lift weights,
take yoga and maybe a bit of Pilates for good measure. You
can overdo it.
Exercise
devotees and serious athletes who train hard may find their
fertility plummeting. Among women who log more than 30 or
40 miles a week running, the risks are high for amenorrhea
(no periods). Even when periods seem normal (not too light
or far apart), heavy exercise can diminish progesterone levels
so that an embryo might not be able to implant.
Men are
less vulnerable to the side effects of uber-workouts. But
not immune. Those who do endurance training may find a drop
in sex drive, testosterone levels and sperm health. Dedicated
cyclists risk flattening the artery that brings blood to the
penis without a bike saddle that's got a cutout in the middle.
Give up bicycle shorts, or any snug pants, for that matter.
Heat is bad for sperm and testosterone production. That also
means limiting hot showers, Jacuzzis, saunas, steam rooms.
Up
In Smoke
There
is no wiggle room on this. Smoking will stunt your procreative
capabilities. Stop it. Now. It poisons gonads and increases
susceptibility to sexually transmitted diseases in both men
and women. Smoking ups the likelihood of a tubal pregnancies,
cervical cancer and pelvic infections. Some studies show that
in vitro fertilization, the leading assisted reproductive
technology, has a lower success rate among smokers than non-smokers.
Environmental
Hazards
Let your
lawn go weedy. If you're rebuilding your deck, give it a rest.
Pesticides, weedkillers, paint thinners and the like can have
a deleterious effect on male sexual function and sperm production.
Women working with chemical solvents, nitrous oxide, vinyl
chloride, for instance, may be at risk for early miscarriage.
Wear protective gear when working with these substances, particularly
if there's regular exposure at your workplace.
The
Drug Bazaar: A Stone Drag On Your Fertility
At first
blush, this appears to be a no-brainer. Yes, of course, marijuana
and cocaine are trouble. And those body-bulking anabolic steroids
interfere with sperm production. But there's a subtler, more
difficult drug use to confront. These drugs are legal and
are found in some of the best-known treatments for a variety
of diseases or conditions.
- Sulfasalazine,
a component of some medications for irritable bowel syndrome,
colitis or Crohn's disease, has a negative impact on sperm
development.
- Cimetidine,
the key ingredient in some ulcer drugs, is linked to impotence
and semen abnormalities.
- Spironolactone,
found in many hypertension prescriptions, may interfere
with testosterone and sperm production.
- Non-prescription
anti-inflammatory drugs taken at the time of ovulation can
stymie embryo implantation.
- Prescription
psychotropics can interfere with ovulation.
In many
instances there are prescription alternatives, so check your
meds and consult with your doctor as soon as you're thinking
of having a baby.
Stress
and, Um, More Stress: The Stuff That Makes You Nuts
There's
no doubt that attempting to create a new life adds a hefty
amount of anxiety to yours. It's ironic how many people who've
spent their entire adulthoods trying to avoid pregnancy are
suddenly reading how-to manuals. If conception doesn't happen
in the first month or two, they worry that they're inept,
or their bodies or brains have failed them.
Achieving
a pregnancy typically takes some time. Unless there's a known
medical condition that may compromise fertility, or you've
been having unprotected intercourse for a year without conceiving
(6 months if you're 35 or older) there's no real reason for
concern.
Sure,
you'll be regaled with stories about how sex in the back seat
of a '57 Chevy is the ultimate fertility enhancer. Or that
instant conception is a mystical byproduct of giving up and
going the adoption route. Don't believe any of it. The only
proven result of these shopworn tales is a dose of "what's
wrong with us" angst, which you don't need. There are
enough social pressures.
If you're
in the prime childbearing years, there's a good chance people
in your circle are either pregnant or dealing with babies
and toddlers of their own. Tell your friends and family that
you're in family-building mode, and brace yourself for the
onslaught of suggestions. Including the proposal that you
take their kids for a weekend if you think parenthood is so
great. Unintentionally hurtful and utterly bone-headed.
Also be
prepared for their palpable discomfort if conception takes
longer than you - or they - think it should. Aspiring parents-to-be
report that baby shower and infant birthday party invitations
come less frequently - a double-edged knife, and that family
gatherings become touchy and difficult affairs.
On the
other hand, keeping your decision private is not always a
simple proposition. It's surprising how uninhibited your own
parents, siblings or associates can be about asking why there
are no children or when you're planning to get on the stick.
Regardless
of your choice, the most important
stress buffer is your partner. Keep
your shared goal - a biological
child - in mind and approach this
as an unwavering, mutually supportive
collaboration. Seek reassurance
from health care professionals or
patient advocacy groups. Nothing
soothes like the balm of clear-headed,
objective information. That's why
the American Fertility Association
is here. Please call for support
and informationt toll free at (888)
917-3777. We've been there and we
know.
By
Michael Steinkampf, M.D. and Karen Hammond, M.S.N., C.R.N.P.
With The American Fertility Association
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