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| The miracle of life - and how to make it happen |
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Written by Dr Hilary Jones
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So complex are the biological mechanisms through which pregnancy
takes place that conception really is a miracle of life.
Although most of us
take fertility for granted, for any given couple planning to have a baby there
is a certain level of hormonal, anatomical and physiological health required in
order for it to happen.
With the stresses and strains imposed on our bodies by
today's hectic and often unhealthy lifestyles it is little wonder that one
quarter of all couples wanting to start a family have trouble conceiving.
Thankfully there are many positive steps any couple can take themselves,
without medical interference, to significantly boost their chances of
conceiving.
How does conception occur?
Conception, the beginning of life, takes place when one sperm
cell from the male partner fertilizes one ovum (egg) from the female partner
and becomes an embryo. This occurs in one of the woman's Fallopian tubes and
provided the embryo is then transported to the uterus for implantation,
pregnancy begins.
It may sound simple and straightforward but the process
demands fine and delicate biological tuning. An ovum needs to be regularly
released each month from the ovary, a process that can only proceed if a
complicated cascade of hormonal events takes place without interference. This
egg then needs to be able to move freely along an unblocked Fallopian tube
where it can be fertilized by a sperm and then reach the womb.
The sperm have
to be healthy, motile and numerous, although only one will ultimately penetrate
the egg and form an embryo with it. Then the lining of the womb must also be
receptive to this embryo so that it can embed itself within it and begin to
produce the hormones necessary to maintain the pregnancy thereafter. Any one of
these sensitive but essential components of fertility can easily be upset by a
number of unfavourable factors. Many, however, are within your
control.
Before you start
There is little point taking pains to ensure you conceive if
the conditions required to produce a healthy baby once you do succeed have not
first been met.
So begin with a bit of ‘pre-conceptual care’ at least three
months before trying for a baby. You need to plan ahead because by far the most
vulnerable time for the baby is in the very first days and weeks of its life
and only measures taken in advance of the pregnancy will offer the necessary
degree of protection.
Take extra folic acid routinely
A daily dose of 400mcg significantly reduces the risk of
spina bifida. That dose should increase to 600mcg if a previous baby has been
born with this or any related condition.
Check your rubella immunity
Most women are immunised against German measles (rubella) as
part of the infant immunisation programme or while at school, but some will
miss out and in a very few the vaccination fails to work.
Since rubella can
seriously affect your baby's sight and hearing as well as causing brain and
heart defects when caught in the first four months of pregnancy, any woman who
is unsure of her immunity is best advised to have a blood test to find out and
then, if required, a vaccination at least three months prior to
conceiving.
Other checks
Any concerns you might have as a couple planning a family are
often best addressed before pregnancy begins. This means that any environmental
or lifestyle hazards, any inherited conditions or any worries about
prescription medicines, previous sexually transmitted diseases or AIDS can be
put into perspective.
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Talk to your doctor before planning a baby if you suffer from
any long-standing problem.
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Wait for three months after stopping the pill before trying
for a baby.
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Give up smoking.
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Cut down on alcohol.
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Go for genetic counselling if any inherited disorder exists
in either family.
How to boost fertility naturally
It takes the average couple between one year and 18 months of
normal ‘trying’ to conceive. However, for those who are impatient or anxious
when pregnancy does not happen immediately, and for all those who postpone
seeking medical help after that duration of time, there are certainly a number
of things to consider to help boost fertility naturally.
Your age
While late motherhood has much to recommend it, the older you
get the less fertile you become – it’s as simple as that. This goes for men as
well as women.
For women, this is mainly because all the eggs ever released
from her ovaries have been there since she was born. With increasing age there
is a progressive reduction in the quantity and quality of those eggs and this
affects fertility, which significantly begins to fall after the age of 35.
While men are capable of fathering children into their 70s, most men over 55
experience a gradual reduction in sperm and testosterone production with age
and the proportion of men with erectile dysfunction increases too, which only
makes love-making more problematical. Therefore, it is advisable not to leave
it too long if you are worried about your fertility.
Your lovemaking
How often you have sex is another critical factor in
fertility. If the frequency is often less than once a week, the chances of
pregnancy are very much reduced.
Also, sex needs to involve deep vaginal
penetration in order to ensure that the sperm are deposited near to or on the
cervix.
The timing is critical too. Fertilization can only happen if lovemaking
occurs near the time of ovulation. The egg is released 14 days before the first
day of the next expected period (if your periods are regular) and survives for
up to 24 hours.
Sperm survive for two to four days inside a woman's body and
are most numerous if the man only makes love every second day, so sex every
other day from day 11 to 16 of the cycle will maximise fertility.
How can you tell whether you are ovulating?
Ovulation is fairly predictable with a regular menstrual cycle, but
knowing that it happens 14 days before the next period is useless if the cycle
is not regular. You can fine-tune the timing of your lovemaking by employing
one of the following three methods of discovering when you are
ovulating.
Temperature method
A slight temperature rise around mid-cycle can confirm that
ovulation has occurred, although it cannot predict it in advance. Electronic
digital thermometers allow you to monitor temperatures taken first thing in the
morning over a period of time so that lovemaking can be planned at the right
time in future cycles.
Cervical mucus method
When a woman is most fertile she will feel wetter vaginally
and can test her discharge with her fingers as it changes from dry, lumpy or
sticky to watery, clear and very stretchy. This situation lasts for just two or
three days each month and this is the time to plan your lovemaking.
DIY ovulation kit method
These kits can be bought over the counter at chemists and
measure a hormone surge in an early morning urine sample. A change in colour of
the dipstick indicates a hormone surge and predicts ovulation in the next 24 to
36 hours, during which time intercourse should take place.
Not drinking
Excess alcohol can cause impotence and reduced sperm counts
in men, while increasing the risk of infertility and miscarriage in women.
Giving up alcohol at least four months prior to conception is
recommended.
Not smoking
Cigarette smoke is toxic to both eggs and sperm as well as to
the developing embryo in pregnancy. So much so that smokers take about 30 per
cent longer to conceive than non-smokers and have less successful IVF
treatments should they become necessary - so quit now rather than
later!
Not using other drugs
Recreational drugs such as marijuana, cocaine and heroin can
all decrease sex hormone levels and make miscarriage, malformation and
stillbirth more likely.
Your diet
A healthy diet begun at least four months before you want to
conceive will spring-clean your body and correct any nutritional deficiencies.
Eat plenty of unsaturated fats, oily fish, high-fibre foods, complex
carbohydrates and non-GM organic soya. Eliminate all drinks containing
caffeine, all stimulants and refined sugars. Herbal teas, spring water and
diluted pure fruit juices are better.
Supplements
As well as taking folic acid, add zinc (30mg a day), selenium
(100mcg per day), essential fatty acids in the form of linseed oil (1000mg per
day) and vitamin B complex to your diet. Vitamin E, C, A and iron are useful
too. It sounds a lot, but taking a single multivitamin and mineral supplement
designed especially for pregnancy is all that is needed.
Exercise
Regular moderate exercise confers many health benefits.
However, remember that excessive and vigorous exercise and skin-tight nylon
shorts can reduce male fertility, while marathon cycling sessions on hard
racing saddles can occasionally cause temporary impotence.
Avoiding stress
Too much stress can undoubtedly upset sex hormone levels and
the normal menstrual cycle. Failure to conceive can in turn lead to tension and
further stress. Try to identify and avoid any obvious sources of stress and
talk to your doctor if your infertility worries are taking over your
life.
Control your weight
Being overweight or underweight can seriously handicap your
fertility. Also, changing the quality or quantity of your diet when already
pregnant could potentially be harmful to mother and baby, so try to make sure
your weight is in the ideal range for your height before you become
pregnant.
When to see your doctor
For most couples the chance of conceiving in each monthly cycle
is about 1 in 5 or 6 - the same odds as throwing a six with a dice. If you keep
throwing a dice, or your keep trying for a baby every month, your chances of
conception increase accordingly. Your GP can also offer advice on any regular
medicines you might be taking as some may reduce fertility or have a
potentially harmful effect on an embryo, and all are best avoided if at all
possible when planning to start a family.
Beginning investigations
Most NHS clinics provide a comprehensive range of basic tests
to discover why you cannot conceive.
GPs can themselves initiate the simplest
tests and then refer if and when appropriate to the specialist hospital
clinics.
Many fertility treatments such as tubal surgery or ovulation induction
are offered under the NHS and some go further and provide a limited amount of
IVF treatment depending on funding. In some cases, however, private clinics may
be the only realistic option. To find out more about investigations and
treatment please read our factsheet on infertility and assisted conception.
Good luck with your plans to start a family, and whatever you do, enjoy the
practice!
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Last updated 11.11.2005
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