[beginning fertility issues]

Information for TTC Couples...

Written by TTC Couples.

 

Low-Tech Ways to Help You Conceive

Frequently-asked questions on ways to improve the odds of conceiving a baby without medical assistance or intervention.


TABLE OF CONTENTS + OUTLINE/SUMMARY OF RECOMMENDATIONS

    1. THE PRELIMINARIES

      1.1 Authorship, Disclaimer, Acknowledgments, and Legal Sludge in General

      1.2 What's This FAQ About?

      1.3 Where Did This FAQ Come From?

      1.4 How's This FAQ Organized?

    2. OVERALL RECOMMENDATIONS FOR COUPLES (COMBINATIONS OF METHODS)

      2.1 Some General Recommendations

      2.2 Some Real-Life Success Stories

      2.3 Tales from the ONNA (Oh No, Not [my period] Again!) list

      2.4 The 1995 New England Journal of Medicine (NEJM) Report on Maximizing Fertility

      2.5 Other Overall or Miscellaneous Methods for Both Partners

    3. OVERALL OR COMBINATION METHODS FOR FEMALES

    4. OVERALL OR COMBINATION METHODS FOR MALES

    5. SOME BASIC STUFF ABOUT HOW CONCEPTION HAPPENS

    6. HOW LONG IS IT "SUPPOSED" TO TAKE TO GET PREGNANT?

      6.1 General

      6.2 For Women Over 40

    7. LIFESTYLE AND ENVIRONMENT

      7.1 Did either take any particular vitamins or minerals (e.g., extra zinc; extra vitamin C; l_arginine)? In what dosages? [certain vitamins and minerals apparently can help enhance fertility in both men and women]

      7.2 Did either avoid, or cut down on, alcohol? tobacco? other drugs? [recommended to enhance fertility]

      7.3 Did either avoid, or cut down on, caffeine? [recommended by some sources to enhance fertility]

      7.4 Did either follow any particular fertility-related dietary guidelines? If so, what? [too many to summarize here!]

      7.5 Did either make use of any fertility-related herbs or herbal treatments, internally or externally? What were they? [too many to summarize here!]

      7.6 Did either exercise moderately? Strenuously? What exercise? [moderate exercise is good; strenuous exercise may cause decreased fertility in women; little data on fertility in men, except for heat-effect on testicles as noted below]

      7.7 Did either or both have a normal body-fat ratio (around 20-28 percent?) [too-low or too-high body fat may cause decreased fertility in women; unknown effects on men]

      7.8 Has either ever had any STDs (sexually-transmitted diseases)? How long ago, and what STD? Are you aware of any lingering effects (e.g., scar tissue)? [certain STDs are known to decrease or even eliminate fertility]

      7.9 Did she have an abortion(s) prior to attempting to conceive? [there is little evidence to suggest this reduces fertility, under ordinary circumstances]

      7.10 Was undue stress an element in her life? [some evidence exists that unusually-high stress may interfere with or delay ovulation; effects less clear for male fertility; NEVER say "just relax" to anyone trying to conceive!]

      7.11 Did she try taking Robitussin (guaifenesin) cough syrup? [believed to help by thinning the cervical fluid]

      7.12 Did she use any douches at or near the times of (attempted) conception? What was used as a douche? [can alter pH or other chemical environment in the vagina and/or uterus; generally not recommended]

      7.13 Does she have a retrodisplaced or "tipped" uterus? [may possibly make conception more difficult; intercourse in rear-entry position may help]

      7.14 What kind of underwear did he usually wear? (boxers / briefs / bikinis / none) Did he switch to a different type before conception? How long before? [sperm count and quality is known to be inhibited by high temperatures in testicles, associated with wearing tight underwear; the single most-common fertility recommendation for men is "wear boxers, not briefs"]

      7.15 Did he often wear other tight clothing around the genitals (e.g., Levis, compression shorts for exercise)? [as with tight underwear, this is known to inhibit sperm count and quality]

      7.16 Did he often take hot baths / hot tubs / saunas? [advice for men is to avoid, or limit duration to a few minutes, in order to maintain sperm count and quality; effects on women's fertility are uncertain, but probably less than effects on men]

      7.17 Does his occupation require him to sit in one position for long periods? [can also cause higher-than-normal testicle heat]

      7.18 Did he avoid excessive heat at night (e.g., sleep naked, avoid electric blankets)? [can also cause higher-than-normal testicle heat]

      7.19 Did he often take lengthy bicycle rides? [thought to decrease fertility, by heat on testicles and pressure in genital area from bike seat]

      7.20 Did he try "artificially" cooling his testicles? How long? [might help to counteract effects of heat on sperm count and quality, but only over a 70-80 day period; cooling the testicles with an icepack is probably a little extreme]

      7.21 Did he often eat non-organically-grown bananas? [suspected by some of bearing pesticides that could reduce male fertility]

    8. BIRTH CONTROL:

      8.1 What form of contraception was used before conceiving or trying to conceive (if any)? [some types, esp. chemical types, can cause continued (but temporary) lower fertility after discontinuance]

      8.2 How long in advance of trying to conceive was contraception abandoned? For those who have conceived, how long in advance of actual conception was contraception abandoned (if it was abandoned)? [there is controversy over how long chemical methods should be discontinued prior to conception; recommendations range from no delay, to six months or more]

    9. MENSTRUAL / OVULATORY CYCLE:

      9.1 Are her periods typically regular? If so, what is the typical cycle length (from beginning of period, through the day before beginning of next period)? [cycles of irregular length can make it more difficult to predict timing of ovulation; there is little or no evidence that long cycles are linked to fertility problem, but shorter cycles may be a problem -- see "luteal phase" section below]

      9.2 Has she ever gone a significant length of time with no periods (amenorrhea)? [this likely indicates non-ovulation]

      9.3 Did she chart BBT (basal body temperature) accurately? For how long? [usually the first step in determining fertile time of the cycle; helps by establishing ovulation timing in a "typical" cycle; the single most-common initial recommendation for women trying to conceive]

      9.4 Did she typically have a luteal phase (time of elevated BBT between ovulation and beginning of next cycle) of at least 10 days? [a too-short luteal phase can cause problems with implantation of the fertilized zygote]

      9.5 Did she monitor cervical fluid? For how long? [clear, plentiful, and stretchy/stringy "mucus" or fluid usually signals ovulation within 24 hours after first appearing]

      9.6 Did she monitor position of cervix? For how long? [a high, soft, and open cervix usually signals imminent ovulation]

      9.7 Did she use an ovulation predictor kit (OPK)? [kits can detect LH (luteinizing hormone) surge that precedes ovulation by about 24 hours in most women]

      9.8 Did she typically experience mid-cycle spotting of blood from the vagina? [another sign of ovulation in some women]

      9.9 Did she monitor mittelschmerz pain? How often? [some women experience a sharp pain in abdominal area in conjunction with ovulation]

      9.10 Were any other signs of ovulation monitored? For how long? [monitoring other miscellaneous signals has been suggested - e.g., home microscope device to detect "ferning" in saliva]

    10. INTERCOURSE-RELATED QUESTIONS:

      10.1 Does intercourse take place on any usual schedule near the relevant time? If so, what was the frequency (e.g., daily / every other day / 3 times per week)? [the latest evidence suggests daily sex during fertile part of cycle is best for men with normal sperm counts; every-other-day sex is best for men with low or marginal sperm counts]

      10.2 Is intercourse timed to occur in relation to any of the ovulation-prediction methods? If so, what is the time gap between the "signal" and the intercourse (e.g., intercourse one hour after stretchy clear cervical fluid observed; intercourse 3 days in a row before BBT rise.) [latest evidence suggests intercourse within 24 hours before ovulation offers best odds]

      10.3 Does intercourse take place at any particular time of day (e.g., morning)? [some believe that fertility is at maximum upon first awakening]

      10.4 Was any "extra" lubrication used during intercourse? If so, what was it? (e.g., egg whites, Astroglide, KY jelly, saliva [hers/his/both], Vaseline, vegetable oil) [I have arranged these common lubricants in approximate order of most to least "conception-friendly," according to some experts - it's not a complete list, and some are controversial, such as egg whites]

      10.5 What was the position of intercourse? [most evidence suggests that missionary or face-to-face is best; for some, rear-entry is best; female-on-top or standing positions are not recommended]

      10.6 Was there deep penetration into the vagina during ejaculation? In particular, at the beginning of ejaculation? [ideally, sperm should be placed as deep as possible, closest to cervix; semen contains higher proportion of sperms in the first few "spurts"]

      10.7 Did he continue thrusting movements during ejaculation, or stay still? [some believe that continued thrusting can result in a stronger male orgasm, and/or propel sperm closer to cervix; others suggest that staying still and deep is best]

      10.8 How soon did he withdraw after ejaculation? [quick withdrawal may reduce odds by causing spillage of semen; delaying withdrawal can increase odds by blocking sperm from travelling the "wrong way," back down the vagina]

      10.9 Did intercourse take place on a hard or soft surface? (e.g., waterbed versus floor) [can affect depth of penetration; a "firm" surface is usually better]

      10.10 Was intercourse occasionally or typically painful to her? [can indicate fertility problems such as endometriosis]

      10.11 Did she reach orgasm? Was it before / during / after his orgasm? [evidence suggests that the female's orgasm after the male's will draw semen up through cervix into uterus]

      10.12 Was she able to lie down for some time after intercourse? For how long? [sperm shouldn't be fighting gravity!; about 20 minutes is the standard advice]

      10.13 Did she elevate her legs and/or pelvis after intercourse? For how long? [allows sperm a "downhill" path; about 20 minutes is the standard advice]

      10.14 Was any other method used to prevent semen from spilling out afterwards (e.g., keeping legs crossed)? [may help prevent leakage of semen]

      10.15 Did she ordinarily have orgasms in-between acts of intercourse (i.e, without semen present in the vagina)? [these orgasms may propel acidic cervical fluid into the uterus, creating sperm-hostile environment]

      10.16 Can other sexual practices have some effect on conception? [there is controversy about whether women can develop antibodies to sperm through oral sex (fellatio), by swallowing sperm; at present it appears the risk from swallowing sperm is not large; anal sex without a condom should be avoided (contact of sperm with the bloodstream through small tears in the rectum or anus can develop antibodies)]

    11. BREASTFEEDING (FOR THOSE WITH CHILD(REN) ALREADY):

      11.1 Was she breastfeeding at the time of, or recently prior to, conception? Was the child breastfed exclusively / mostly / supplementally only? [breastfeeding is known to prevent or delay return of post-partum fertility; effects are variable from one mother to another]

    12. MISCELLANEOUS METHODS, IDEAS, CAUTIONS

    13. A LITTLE HUMOR NEVER HURTS...

    14. WHEN YOU'VE TRIED EVERYTHING ELSE, AND IT'S TIME TO SEEK MEDICAL ASSISTANCE

    15. SOURCES FOR MORE INFORMATION AND HELP

      15.1 Books

      15.2 Software

      15.3 Internet - WWW Sites

      15.4 Internet - Usenet newsgroups

      15.5 Internet - Email addresses