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Infertility Is... A Good Reason To Get Healthy
a blog by Serena H. Chen, M.D., IRMS Reproductive Medicine at Saint Barnabas, April 22, 2013
It is National Infertility Awareness Week now: April 21 to 27, 2013. Why should we be aware of infertility? It affects millions of Americans and causes mental stress and anguish at the same level as a cancer diagnosis, most likely because it makes sufferers feel a loss of control about something so basic – reproduction, having a family.
That is the bad news.
The good news is that modern infertility treatment is usually successful. Advances have come so far in the last few years that having a healthy pregnancy may be more challenging than getting pregnant for many people.
As an infertility specialist practicing for more than 20 years, it is wonderful to be able to say to most of my patients that they have a good chance for getting pregnant, even if they have suffered from infertility for years. It is even more wonderful to be able to use the motivation that arises from that suffering to help people change their lives by getting healthier.
Don’t let infertility knock you down. This is a great time to see your doctor and have an honest discussion about the things you could be doing to become healthier in mind and body. We are seeing more and more data that supports that becoming healthier can directly improve fertility. Quit smoking, take your vitamins, lose that excess weight, take up yoga and or meditation, see the psychotherapist and work on that anxiety and depression. You will improve your chances of success with your fertility treatment and improve your health and the health of your future family. Some specifics:
Smoking is so harmful to the ovaries that it can cause you to go through menopause earlier than you would if you did not smoke. Even second hand smoke can affect fertility. If either partner is regularly exposed to second hand smoke that couple has a significantly higher rate of experiencing infertility, miscarriages or birth defects. These effects are in addition to the higher rates of heart attack, stroke, cancer and death seen in both smokers and those regularly exposed to second hand smoke. This is a no-brainer – Quit Smoking! Talk with your doctor about help quitting – I would rather have a patient on a nicotine supplement than cigarettes. Just because you are trying to conceive does not mean you cannot get help with quitting smoking. Just make sure your doctor is aware of and approves of any smoking cessation aids or programs.
Take Your Vitamins
Folic acid or Folate is a type of B vitamin that actually lower the risk for having a child with certain types of birth defects – Neural Tube Defects or Spina Bifida – a potentially serious or fatal malformation of the spine and/or brain. A recent study even demonstrated a lower risk for having a child with autism in women taking Folate compared to women who did not. For most women trying to conceive taking just 0.4 milligrams (400 micrograms) a day of Folate, starting 4 weeks before conceiving and through pregnancy will dramatically lower the risk for Neural Tube Defects. If you are overweight, with a BMI (body mass index) of 35 or above, or if you have a history of a pregnancy with a neural tube defect or any family history, or if you are on anti-seizure or other medications you may require higher doses of Folic Acid. Please review exact doses with your doctor.
Get to a Healthy Weight
Obesity adversely affects every organ in your body and is responsible for multiple medical issues including male and female infertility. In addition, obesity increases the risks for complications of pregnancy, leading to higher rates of miscarriages, birth defects, diabetes, hypertension, and even fetal death. Even a small amount of weight loss – 5 to 15 pounds – can make a significant difference in your insulin levels and blood pressure. A 10% weight loss in obese patients is associated with better outcomes and an improved response to fertility medications. A low glycemic index diet – heavy on the vegetables, fruits and whole grains and very light on sugars and processed foods is associated with higher rates of fertility in women according to a large study out of Harvard. For overweight women, weight during gain should be limited to 11 to 20 pounds, according to the Institute of Medicine (IOM) weight gain guidelines for pregnancy. For women of normal weight, weight gain should be no more than 25 to 30 pounds. Staying within the IOM guidelines leads to lower risk pregnancies and healthier moms and babies.
Get Better at Managing Your Stress
Stress does not cause infertility. This is an unhelpful myth that just makes people with infertility feel guilty and more stressed! We do know that managing your stress in a healthy way can improve your mental and physical health and may even lead to higher pregnancy rates with fertility treatment. Not managing your stress can be disastrous – higher rates of anxiety, depression, marital issues, and physical illness. There are many different, healthy ways of managing stress. People that see a psychotherapist regularly have lower stress levels and lower rates of anxiety and depression. Regular exercise is a great stress reducer. Women who are on fertility drugs can still exercise – just clear it with your doctor – avoid getting overheated, drink plenty of water and avoid high impact activities that may cause your enlarged ovaries to bounce around. ACOG, the American College of Obstetricians and Gynecologists recommends that all pregnant women get regular. Again, seek the guidance of your doctor before proceeding with an exercise program. Meditation for just a few minutes a day can significantly reduce stress. There is even a study demonstrating that laughter may improve implantation rates after embryo transfer.
Be aware that that infertility has a silver lining – Infertility can be a good motivator to getting healthy – the payoff will be worth the effort. Let National Infertility Awareness Week 2013 be the start of a healthier you and eventually, a healthy family.