by Dr. Cynthia Paulis
Wherever you go now, there seem to an explosion of babies in buggies, two, sometimes three to a stroller—but for those couples who are trying to get pregnant and can’t, you’re not alone. About one in 10 couples in the Unites States is infertile.
Infertility is a disease or condition of the reproductive system and can be present in the woman, the man or both. Certain health conditions and factors, such as age, can affect a woman’s ability to conceive. A healthy 30-year-old woman has about a 20 percent chance of getting pregnant every month, but that percentage drops by age 40, when her chances are about 5 percent each month. Infertility can affect women regardless of age and background.
When you look at the process of conception, it is remarkable that pregnancy happens at all. When a man ejaculates, 200 million sperm are mixed with semen. In most men, only 15 to 45 million of those sperm will be healthy enough to fertilize an egg, and only 400 of those will survive after a man ejaculates. Traveling up the vagina, which is hostile to sperm as well as the toxic environment of the semen, only around 40 of the 400 will reach the vicinity of the egg. Then, only one sperm will be able to drill through the tough layer of the egg to fertilize it, and voilà, a baby is on the way—well, maybe. There are other circumstances that can end the pregnancy.
For sperm to make it to the end goal, three factors come into play: quantity, quality and movement. Conception is a numbers game, so the more semen discharged in an ejaculation, the better. The quality of the sperm—with an oval head and long tail—is important, as is the ability to move quickly through a hostile environment.
Certain factors can create problems for sperm, with the No. 1 problem being temperature. Increased scrotal temperature can interfere with sperm production. If you are trying for a family, avoid hot tubs, saunas and steam baths. Even though exercise is important, bike riding or remaining seated for long periods at a time can interfere with sperm production. Tight-fitting clothes such as briefs or athletic shorts will increase your body temperature, so switch to boxers.
Sperm movement and shape can be altered by smoking and marijuana, cocaine and heroin use. Excessive alcohol consumption can reduce the quantity and quality of the sperm produced. Lubricants, such as KY and skin lotions, will slow down the movement of sperm so they never reach the egg. Certain medications can also contribute to infertility issues, such as calcium channel blockers, tricyclic antidepressants, steroids, chemotherapy and radiation treatment.
For women, infertility issues are more likely structural or age-related problems. Damage or blockage in the fallopian tube caused by inflammation can prevent the egg from moving down to the uterus. The most common cause of this is chlamydia, a sexually transmitted infection that can affect both men and women. Uterine fibroids, tumors in the uterus, and endometriosis, uterine tissue implants growing outside of the uterus, can affect the function of the egg, ovaries, uterus and fallopian tubes.
Another cause of infertility is polycystic ovarian syndrome, in which the body produces too much androgen, a hormone that in turn causes ovulation problems. Pelvic adhesions secondary to pelvic infections, appendicitis, pelvic and abdominal surgery can also impair fertility.
Medications, thyroid problems and cancer treatments can also affect fertility.
Fertility for women starts to decline after age 30, whereas men can maintain their fertility well past 40. For both sexes, it is important to maintain a healthy body. Stop smoking and use alcohol in moderation. A healthy weight is important, but too much exercise can be associated with ovulation problems. A sedentary lifestyle, which can contribute to obesity, can also be a contributing factor to infertility.
For those couples who are infertile, there is still hope. Through in vitro fertilization (IVF), many couples have gone on to have successful pregnancies. Another option that may help that many specialists now recognize is acupuncture.
Mary Sabo, one of the clinical directors at the Yinova Center on 11th Street and Broadway, uses acupuncture to support IVF. “When couples come in to us, we look at their entire bodies and see how they are functioning,” she said. “If they have a diagnosis from their gynecologist or endocrinologist, we can help. If the uterine lining is too thin or if the blood flow to the uterus or ovaries is not ideal, we can increase the blood flow, relax the uterus before transfer in an IVF and help balance the hormones to improve fertility. The leading reproductive endocrinologists in the city are now recognizing the importance of acupuncture.”
If you are experiencing problems with infertility, don’t despair: Reproductive medicine has advanced over the years and it is still possible for you to have a child or, sometimes with fertility clinics, multiple children. Then you can buy one of those double-wide buggies and get a nice house in Brooklyn.
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