Not All Infertility News Is Bad News!

I realized the other day that my most recent blogposts were presenting nothing but the "bad news" about trying to get pregnant. Lots of "don't do this" and "here's something else to avoid" can add up in a fertility patient's mind to "Well, what's the use in trying?!"

I was browsing the Internet for topics of interest to my blog readers when I stumbled on this: "Women ditched me because I was infertile" (It sounds like an ad, but it's an article on the Daily Mirror.)
 The young man's story perfectly illustrates so many aspects of why we do what we do at Houston Fertility Center.

Image: FreeDigitalPhotos.net

Not many men feel secure enough to reveal their deepest emotions about their infertility, and particularly in the way that this semi-pro football player in Great Britain did. His loss of a testicle to cancer -- without fertility preservation efforts prior to cancer treatment -- resulted in a distressing mix of relief from being a survivor and embarassment at "losing his manhood". He even felt that his diagnosed inability to father a child kept women from wanting to be his partner.

I won't reveal the whole story to you -- it really is a sweetly romantic tale worthy of a screenplay, and I encourage you to read it on the Daily Mirror's website.

It's important to stay on top of new research findings, as well as all of the fertility basics that are already known to optimize your chances at pregnancy. But now and then, it's also good to just bask in the hope of others' true stories.

~ Dr. Sonja Kristiansen MD

How Much Activity Enhances Fertility? A New Study Says...

Balance is one of the hardest things to achieve in life, and it seems like that's especially true for women who are trying to get pregnant. You know that overall health and fitness play a role in fertility, but you've also heard that there really can be too much of a good thing. Trying to keep up with the "do this, do that" of research data can make you want to throw your hands up and say "I quit!"

Image: Ambro / FreeDigitalPhotos.net 

But you don't have to be an exercise physiologist or a registered dietitian to understand a few simple points amid the building database of knowledge about fertility's connections to weight and physical activity.

And here's the latest: Moderate activity wins the game. Again.

A just-released study (from Fertility & Sterility) of more than 3,000 Danish and U.S. women ages 18 to 40 found that moderate levels of physical activity resulted in "small decreases in time to pregnancy" for women of all body mass index (BMI) levels.

If you're struggling to get pregnant, that finding may not seem so exciting. But factor in the rest of the story and fertility patients may feel a little uplifted by this study.

Importantly, the subjects in this study were drawn from the general population, not from among fertility patients. Requirements of participation included:

• being in a stable relationship with a male partner
• planning to get pregnant
• not receiving fertility treatment

Participants were followed for a year or until they conceived. The researchers looked at several variables, including differences in length of time to conception for women throughout the BMI range. They found that vigorous physical activity either works against you (for women of "normal weight," BMI under 25) or doesn't do anything for you (for overweight or obese women, BMI of 25 or above) in terms of time it took to get pregnant.

In this study, vigorous activity included running, fast cycling, aerobics, gymnastics, and swimming.

The "winners" -- in this case, those who took the shortest amount of time to pregnancy -- were women who engaged in 20 to 39 MET hours (total metabolic equivalents assigned to different kinds of activity) per week of physical activity. And moderate activity was key.

Though the authors concede more data is warranted to investigate different types of physical activity in relation to fertility, their study suggests that overweight or obese women might benefit from any physical activity and lean women will likely enhance their fertility by switching to moderate, rather than vigorous, activity.

So what's moderate?

Brisk walking, leisurely cycling, golfing and gardening.


Source: A prospective cohort study of physical activity and time to pregnancy
             L. A. Wise et al., Fertil Steril 2012

Get Your OB On Board: Regular Menstruation Does NOT Equal Fertility

"Getting your period" is a big event for girls. And many a parent or counselor has tried to console young women's related worries by offering comments that equate menstruation with motherhood. It's understandable that so many of my patients at Houston Fertility Center grew up with the message that if you're menstruating, you can get pregnant.

Your OB/Gyn may even tell you something similar. After all, it's basically true for the average woman with average fertility. But if you're one of the many women who has regular menstrual periods but can't seem to get pregnant, you might be feeling dismissed by your primary care doctor's casually hopeful remarks.

Once you have reason to understand more than the average woman about menstruation, you'll find that the connection between periods and fertility is a bit more complicated. Your OB/Gyn might do a great job of providing you with that in-depth education about the reproductive details of menstruation -- but you'll probably first have to request more explanation. And never hesitate to ask! You definitely won't be the first patient in my office to say with great frustration, "But, Dr. Kristiansen, I have a period every month!"

Your body's menstrual and ovulatory cycles are absolutely linked, but they are also separate. Both cycles are the result of communication between several organs and glands which emit different levels of various hormones, producing a cascade effect that's supposed to be ongoing. There are so many different points along the path where something can go wrong. A small, seemingly insignificant glitch in one spot -- whether it's a gland that produces too much or too little of a hormone, or an organ that isn't responding to its cues -- winds up disrupting the whole fertility process.

Simply put, and as many Houston Fertility Center patients will attest, women can have regular periods and still be infertile, for many reasons -- some structural (as in blocked fallopian tubes), some hormonal (sometimes resulting in anovulatory bleeding, in which no eggs are being released).

It's pretty complicated. And if your OB/Gyn is more OB than Gyn (they're really not all the same!), then their focus in both training and, more importantly, experience may be on helping women manage their pregnancies and deliver their babies -- not on the many things that can go wrong when you're trying to get pregnant.

So if you've heard "If you're having a period, you have nothing to worry about" from your doctor, he or she may not be putting you off or ignoring your worries. It might just not be their area of expertise.

This is the 3rd post in a series called Is Your OB On Board With Baby-Making?
Also see: Get Your OB On Board: Time Is (Almost) Everything

~ Dr. Sonja Kristiansen M.D.

Some Folks Will Do Anything to Get Pregnant

You've probably caught yourself saying things like "I'd stand on my head if it would help me have a baby!" A recently published study from Israel of 219 women going through IVF found that bringing in the clowns can help.

It sounds pretty funny, but this was bona fide research published in Fertility & Sterility, the journal of my esteemed colleagues, the American Society for Reproductive Medicine.

The clinic employed the services of a "medical clown" who performed a standardized routine for each patient on some days. Women who attended clinic on a "non-clown" day were less likely to get pregnant, even taking into consideration factors like age, infertility cause, and the number of embryos transferred.

Like the lead researcher, Dr. Shevach Friedler, says, it's "one of the least hazardous interventions" for IVF patients.

While I'm sorry to say that we don't have a clown on staff here at Houston Fertility Center (yet), we do take pretty seriously the growing body of research that points to connections between stress and treatment success. Besides offering a soothing environment at our clinics with staff members who are sensitive to your worries, we refer patients to massage, acupuncture, and counseling professionals, all of whom specialize in the needs of fertility patients. I'm a believer in the value of learning personal stress management and the positive impact on infertility and treatment.

You never know what people will try next. So the next time you're at our place for an appointment, don't be surprised if you hear laughter. After all, helping people make their dreams come true can be pretty fun!

Getting Through the Holidays with Infertility However You Can

Seasonal holidays are tough on the spirit when you're trying to get pregnant and can't. The Web is full of places you can go to and read or chat with others about ways to cope. Here are a few that I recommend:

Thanksgiving: To Attend or Not To Attend: That Is the Question
The title says "Thanksgiving," but this piece by Lori Shandle-Fox on Fertility Blogs covers all family gatherings with a light heart.

Infertility and Holidays: Don't Just Survive - Thrive!
Tracy Morris on FertilityCommunity covers a lot of different emotional tactics that can help you view holidays from a different perspective.

The Season of Giving
An interview with Kathy Stern of Southwest Surrogacy Associates, LLC about the role of giving in third-party reproductive treatment, during the holidays and beyond.

The Perfect Storm of Holidays: Infertility and Christmas
Melissa Ford taps into a perfect analogy with "The Great Peanut Day". Use it to explain your emotions to those who just don't seem to 'get it.'

Tips for Facing Infertility During the Holidays
On ParentDish, Mary Beth Sammons interviews a woman who's been going through fertility treatment for six years. Her personal advice - "what helps most is 'to know that I'm not alone.'"

There are plenty more out there -- just search for "holidays and infertility" and you'll see that, indeed, you're not the only one.

A Little Education For Concerned Onlookers

This quick-hit on MomLogic provides a good sampling of the things that
women who are struggling to get pregnant do NOT want to hear. Might be a
nice link to post on certain friends' Facebook walls...

10 Things Never to Say to a Woman Trying to Conceive