conception

How to Get Pregnant — Coaching Topic #1

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So let’s get on with the top­ic of How to Get Preg­nant, start­ing with why do we need to know this?

In the past few decades, the aver­age age for a first preg­nan­cy in the U.S. has moved from the mid twen­ties into the mid thir­ties. In the same time peri­od, the facts of con­cep­tion — sperm enters egg released in mid cycle, then zygote implants in the uterus, along with how sex allows this to hap­pen and how to pre­vent it — seems to have dis­ap­peared from mid­dle and high school health class­es. If that weren’t enough, as women have become more and more essen­tial in the work force, the cost of hav­ing chil­dren as well as start­ing lat­er, have dri­ven down the birth rate. Sim­i­lar con­di­tions exist in most devel­oped nations, although teen preg­nan­cy rates are low­er every­where else.

The birthing pop­u­la­tion has bifur­cat­ed — we see old­er women (over 35) and teens as the major groups hav­ing chil­dren. On the one hand we have been work­ing to reduce teen preg­nan­cy while help­ing old­er and old­er women become first time moms. To a cer­tain extent, they need the same infor­ma­tion; its just that with teens we use this infor­ma­tion to pre­vent preg­nan­cy and with old­er women we use infor­ma­tion to help them increase their odds of get­ting preg­nant.

Under­stand­ing the men­stru­al cycle, ovu­la­tion, chart­ing tem­per­a­ture — all the basic tech­niques of using the “nat­ur­al” method of birth con­trol — have become the first steps of the how-to-get-preg­nant coach­es. Beyond this, a num­ber of sites have their own essen­tial lists to help women be healthy and ready. Sites such as gettingpregnant.com, pregnancy.org/getting-pregnant, and storknet.com/cubbies/preconception/ pro­vide addi­tion­al infor­ma­tion. Many sug­ges­tions — things to avoid eat­ing, what pro­teins are need­ed for ovu­la­tion, how to reduce stress, what to do if there are sperm prob­lems, how to find IVF clin­ics, donors and sur­ro­gates — are addressed.

How effec­tive are these sug­ges­tions? Well, research tells us they are some­what effec­tive. None of the sites I con­tact­ed answered my query about how they mea­sure or assess con­sumer out­comes when fol­low­ing their sug­ges­tions.

An inter­est­ing arti­cle in the NY Times 9/1/2011, enti­tled Are You as Fer­tile as You Look? openened with this sen­tence: “FORTY may be the new 30, but try telling that to your ovaries.” The real­i­ty is that being under 35 is still the best pre­dic­tor of how dif­fi­cult it may be for you to become preg­nant. As the arti­cle makes clear, look­ing 30 and being 30 are not the same thing. Even healthy liv­ing does not pre­vent the loss of good eggs.

So, what con­clu­sions can we draw? First, even if you come from a “fer­tile fam­i­ly,” it may behoove you to have your chil­dren in your late 20s or ear­ly 30s. Sec­ond, if you are putting off hav­ing chil­dren beyond that time, ask your­self what extremes you are will­ing to go to to have your own bio­log­i­cal off­spring. And, third, con­sid­er adop­tion. Frankly, it would be won­der­ful if adop­tion were eas­i­er, but in the dri­ve to con­ceive at lat­er and lat­er ages we see the hand of biol­o­gy and under­stand why adop­tion is not easy:  Our own off­spring — our own DNA out there in the world — is a heady moti­va­tion.

If you are on the path­way of becom­ing preg­nant, being under 35 is the best ally you have. If not, maybe some of the sug­ges­tions on the web will work for you. What­ev­er you decide, all the best.

One part­ing com­ment:  Reg­u­lar mod­er­ate exer­cise — while it helps you stay young and healthy — will not pre­vent your eggs from being popped out every month. It will help you have a healthy preg­nan­cy if you con­ceive, so stay with it!

Pregnancy Pathway…Important Notes from Wonderrobyn

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The fol­low­ing are notes from co-author Robyn Bran­ca­to, CNM (cer­ti­fied nurse mid­wife) who prac­tices in New York City, or, as she is know here: Won­der­robyn! You can read about both authors in the About tab above. Here they are on the beach in San Diego, when they gave a talk at con­fer­ence there a cou­ple years ago. Robyn on the left, Ann on the right.

Robyn and Ann, Pathway authors

Robyn and Ann, Path­way authors

1. Addi­tion to Small Rant: “Resist the temp­ta­tion to watch A Baby Sto­ry on TLC! It does not por­tray birth accu­rate­ly, as they con­dense 15 hours of labor into 30 min­utes and play up the dra­ma so that you will be on the edge of your seat! In the major­i­ty of women, birth is not that dan­ger­ous.”

2. Regard­ing: When does con­cep­tion occur? “This is a real­ly inter­est­ing post… I love the dis­cus­sion about at what point con­cep­tion occurs! Per­son­al­ly, I like the Bib­li­cal notion of quick­en­ing. Even though this varies from woman to woman and can range any­where from 16 to 22 weeks ges­ta­tion, it seems like the most nat­ur­al the­o­ry.”

Dear Read­er:  What do YOU think? Did you read the con­cep­tion post on March 23, ’09?

3. About sperm & preeclamp­sia. “Is the con­nec­tion between bar­ri­er meth­ods and preeclamp­sia actu­al­ly estab­lished? I have read stud­ies stat­ing the con­trary — that bar­ri­er meth­ods have no effect on preeclamp­sia rates.”

HURRAY! THIS REQUIRES FURTHER CONSIDERATION.

More infor­ma­tion: The immune mal­adap­ta­tion the­o­ry sug­gests that tol­er­ance to pater­nal anti­gens, result­ing from pro­longed expo­sure to sperm, pro­tects against the devel­op­ment of preeclamp­sia. Thus, bar­ri­er meth­ods and being young may pre­dis­pose women to this major dis­or­der of preg­nan­cy.

Evi­dence exists on both sides of this the­o­ry. Here are two recent stud­ies (one of each) that read­ers may find help­ful in under­stand­ing this idea. Keep in mind that oth­er fac­tors than just sperm expo­sure may be affect­ing research find­ings. But, it does seem that under some con­di­tions, bar­ri­er meth­ods and amount of expo­sure to sperm can affect the preg­nan­cy itself.

Ness RB,  Markovic N, Harg­er G, Day R. Bar­ri­er meth­ods, length of pre­con­cep­tion inter­course and preeclamp­sia, Jour­nal: Hyper­ten­sion in Preg­nan­cy 23(3):227–235. 2005.  Results did not sup­port the immune mal­adap­tion the­o­ry.

Youse­fi Z, Jafarnezhad F, Nas­rol­lai S, Esmaeeli H. Assess­ment of cor­re­la­tion between unpro­tect­ed coitus and preeclamp­sia, Jour­nal of Research in Med­ical Sci­ences 11(6):370–374. 2006. In a matched con­trols study, women with <4 months cohab­i­ta­tion or who used bar­ri­er meth­ods had high­er risks of devel­op­ing preeclamp­sia than those with >4 months cohab­i­ta­tion. Oral con­tra­cep­tion users had a low­er preeclamp­sia rate than those who used no oral con­tra­cep­tion.

In a com­men­tary arti­cle in OB/GYN News ‚  July 1, 2002, the fol­low­ing note was made by Dr. Jon Einars­son: With insuf­fi­cient expo­sure, preg­nan­cy may induce an immune response and preeclamp­sia in some women with pre­dis­pos­ing fac­tors such as an endothe­li­um that already is sen­si­tive to injury due to age, insulin resis­tance, or pre­ex­ist­ing hyper­ten­sion.

Is there a plain and sim­ple truth about sperm expo­sure and preg­nan­cy risks? Alas, no. But, know your cir­cum­stances. If you are young, pro­tect your­self. Wear a con­dom. When you are ready to be a mom, you will be ready to fig­ure out your risks. So, this, too fol­lows the axiom:

Events in life are rarely plain and nev­er sim­ple.

Pregnancy Pathway, Conception — Review & Small Rant!

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REVIEW: Evi­dence is clear - pre-preg­nan­cy mater­nal health sta­tus, includ­ing phys­i­cal fit­ness, healthy nutri­tion and an uncom­pro­mised immune sys­tem affect the health and well-being of both moth­er and off­spring, in both short and long term.

This is the mes­sage sum­ma­ry from our first two areas of dis­cus­sion:  Pre­con­di­tions and Con­cep­tion — the green and sand col­ored sec­tions on the chart below.

pregnancy_pathway

COMING ATTRACTIONS: We are about to move on to the blue sec­tion — Preg­nan­cy!!  So, book­mark this Blog for future ref­er­ence!

Also, you can sub­scribe to this Blog by click­ing on Blog Info in the upper right cor­ner and then click­ing on Sub­scribe in the drop down menu.

But, yes, you guessed it, first we have a small rant!

SMALL RANT: When we note that fit­ness, nutri­tion and a healthy immune sys­tem play sig­nif­i­cant roles in the out­come of preg­nan­cy and the future health of moth­er and child, we are appeal­ing to young peo­ple of child­bear­ing age to be care­ful about your bod­ies. The alliance of egg and sperm shapes the world. With 6.5 Bil­lion egg/sperm com­bi­na­tions (yes, peo­ple) present­ly liv­ing on earth, our resources are stretched. With time, either we get more picky about doing this, or the 3rd rock from the sun (remem­ber that show?) is cooked.

Humor­ous incur­sion: In case you need fur­ther enlight­en­ment on this whole area, there is a great web­site that will help you out. Be pre­pared to be amused and amazed!

The Truth about Eggs and Sperm

Hope­ful­ly, this gets you in the right mood and keeps you smil­ing. After all, once you actu­al­ly are preg­nant, we have more seri­ous mat­ters to dis­cuss.

Pregnancy Pathway, Conception — Health Status

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Today: How the mother’s health sta­tus at the time of con­cep­tion affects the preg­nan­cy.

For com­plete graph­ic, see Feb. 5 or 23 post.

The Impact of Health Status at the time of conception.

The Impact of Health Sta­tus at the time of con­cep­tion.

When a woman becomes preg­nant, her health can be a major fac­tor how her preg­nan­cy will pro­ceed. If she has been exposed to a vir­u­lent infec­tion, it may have an impact on how well the implan­ta­tion goes. If she has meta­bol­ic syn­drome, she is at risk for com­pli­ca­tions such as ges­ta­tion­al dia­betes.

On the oth­er hand, if she has tak­en care of her­self, is phys­i­cal­ly fit and well nour­ished, is well rest­ed and has not been exposed to ill­ness­es that induce dra­mat­ic changes in her immune sys­tem, she has done her best to cre­ate a sit­u­a­tion in which her body is best pre­pared for the rig­ors of preg­nan­cy.

There are still genet­ic and envi­ron­men­tal fac­tors that can affect the course of the preg­nan­cy, but behav­ior is the one fac­tor that women have con­trol over. At Danc­ing Thru Preg­nan­cy we are fond of the notion that if you know a cer­tain behav­ior is the best for a sit­u­a­tion, it is smart to chose that behav­ior; if you do not, you are sab­o­tag­ing your­self.

So, if preg­nan­cy is in your head­lights, eat right, exer­cise, and be cau­tious about expo­sure to ill­ness and infec­tion. Wash your hands, use one of the hand cleansers, prac­tice safe sex (okay, so if you are try­ing to get pg, this may change, but in the mean­time!).

We wel­come com­ments on what you are doing to be healthy for preg­nan­cy!

Curl-up! Strong abs are part of physical fitness!

Curl-up! Strong abs are part of phys­i­cal fit­ness!

Pregnancy — 50% planned; 50% unplanned

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So…are you plan­ning to become preg­nant? For the last decade, preg­nan­cy has been in a 50/50 sit­u­a­tion. That is, about half the preg­nan­cies occur­ring in the U.S. are planned. The rest? Well, not nec­es­sar­i­ly unwel­come, but def­i­nite­ly unplanned.

Will this change in the cur­rent reces­sion (or as a friend said today, Let us just call it a depres­sion and move on)? So far, it is clear that preg­nan­cy rates are not drop­ping, despite an unwill­ing­ness to spend mon­ey on many oth­er things. What does this say?

Once again, despite liv­ing in a high tech world, hav­ing babies is a pri­mal expe­ri­ence. It does not dimin­ish when resources are scarce.

So, plan to or not, if you have a baby dur­ing this depres­sion, do not waste your mon­ey. Fig­ure out how to have a healthy preg­nan­cy.

Next on the Preg­nan­cy Path­way: the act of con­cep­tion.