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The Most Common Fertility Mistakes You (And Your Doctor) Could Be Making

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Aug 04, 2009
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Nobody's perfect, and when it comes to making a baby, there are some common mistakes that couples make, and even some common mistakes that doctors make. Don't let these fixable errors get in the way of trying to get pregnant.

When Elizabeth Potts Weinstein, a financial adviser and author in San Jose, California, got married in 2004, she assumed she and her husband would conceive in no time. “After all, my sister and friends all got pregnant in just a month or two of trying, and I was just 29 at the time,” she says. So she was stunned when things didn’t go according to plan. 

Weinstein picked up a book on charting her body’s fertility signs, and quickly homed in on the problem: She was ovulating at a different time every cycle. Because the couple had focused their lovemaking around the middle of a prototypical 28-day cycle—Day 14—they were missing Elizabeth’s fertile window every month. Armed with the new information, the Weinsteins conceived their daughter, Grace, about six months later.

“I knew that my periods fluctuated all over the place, but it didn’t occur to me that it meant my ovulation fluctuated,” Weinstein, now 34, muses. “Obvious when you think about it, but it didn’t occur to me. Who knew you could ovulate on Day 20?!” 

Fertility specialists say that thousands of couples may be sabotaging their best efforts at conception with simple errors like this, and some doctors may unwittingly play a role in the mistakes, too. Luckily, many of these goofs are not only fixable but don’t require a high-tech or pricey solution. Here are the most common blunders specialists see. 

Mistakes Couples Make

Using a lubricant

There’s little less spontaneous than having sex for the purpose of making a baby. So many couples reach for a lubricant to facilitate intercourse. Yet, “People are rarely told that almost all lubricants—even saliva—can impede sperm,” says Toni Weschler, M.P.H. And using oils can increase the chance of getting a vaginal infection, she adds. The exceptions: New “sperm-friendly” lubricants, such as Pre-Seed and Conceive Plus, specially developed not to impede the sperm’s journey. Visit preseed.com or conceiveplus.com for more information.













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Waiting too long to see a specialist
Used to be, patients were referred to a fertility specialist, such as a reproductive endocrinologist, if they were unable to conceive within a year. This still makes sense for people under 35, but if there are hidden fertility issues (even obvious issues like previous surgery), waiting a full year can set you back unnecessarily, heightening your anxiety and squandering precious time.

If you’re over 35, see a specialist after six months of trying to conceive. And if you’re over 40, “There’s nothing wrong with checking in immediately,” says John D. Gordon, M.D.

Women who have had a prior pregnancy are particularly likely to wait longer than they should. “They assume if they were fertile in the past, they don’t have fertility problems,” says Alice Domar, Ph.D. “But we see a lot of secondary infertility—the inability to conceive or bear a subsequent child. Remember, you’re older now than when you had the first pregnancy—and your eggs are older, too.”

Assuming that regular periods equal fertility

Just because you have a period does not mean you are ovulating or that the eggs you release are of a high enough quality to ensure pregnancy. “This myth is often held among women of older reproductive age,” says Hugh S. Taylor, M.D., chief of reproductive endocrinology and infertility at Yale School of Medicine. “Women think they must be fertile if they’re cycling. But women can go on having periods as much as a decade after they’ve stopped producing good, healthy eggs.” 

Women of any age can experience so-called “anovulatory” cycles, during which no egg is released, meaning pregnancy can’t occur. Such cycles can produce some bleeding, which results from a buildup of the uterine lining.

To be sure your periods are the real thing, confirm you are ovulating from the get-go. You can use an ovulation prediction kit, which includes urine test strips to track rises in luteinizing hormone (LH), signaling impending ovulation. Or try fertility awareness techniques: charting your basal body temperature (your temperature upon waking in the morning) and checking the consistency of your cervical fluid day to day, suggests Weschler, who outlines the specifics in Taking Charge of Your Fertility (Collins Living, 10th anniversary edition 2006).

Not ovulating can be a result of several underlying health problems, including a thyroid disorder or polycystic ovary syndrome. Any failure to ovulate warrants further investigation and treatment.

Believing that good health habits will extend your pregnancy prospects
Fertility declines with age: A healthy 25-year-old engaging in unprotected sex has about a 20 to 25 percent change of conceiving in any given month; a 30-year-old’s chances are 10 to 15 percent; by age 40 it’s down to 4 to 8 percent; and over age 43 it’s less than 2 percent. Yet many women believe that their healthy ways will help them beat their declining odds regardless of age. “I’ve had patients in their late 30s or early 40s come in and say they’ve taken care of themselves, never smoked, and eat well. They’ve just gotten married and are shocked that they can’t accomplish their goal of starting a family,” says Dr. Gordon, co-director of Dominion Fertility in Arlington, Virginia, and co-author of 100 Questions and Answers About Infertility (Jones and Bartlett, 2007). Taking care of yourself is important for optimizing your fertility, but “it won’t make your eggs younger or guarantee a pregnancy at age 42,” says Domar, executive director of the Domar Center for Mind/Body Health at Boston IVF in Waltham, Massachusetts.

Missing a woman's "fertile window"
Many couples may not be conceiving because they’re missing their prime baby-making opportunities. “Either a couple thinks every woman ovulates on Day 14 of the cycle or they have no idea when the woman is most fertile,” Domar says. According to one study presented at the World Congress on Fertility and Sterility, 20 percent of couples seeking help for infertility do so unnecessarily—they just have the timing wrong.

Truth is, not all women ovulate exactly on Day 14, as many women—and even some doctors—believe. Ovulation times vary from woman to woman and also in the same woman from cycle to cycle.

Normal cycles can range from 21 to 35 days, and “normal healthy women ovulate about 14 days before they get their period,” says Domar. Do the math: If you have a 22-day cycle, you probably ovulate around Day 8; if you have a 34-day cycle you probably ovulate on Day 20. Use ovulation prediction kits or fertility awareness methods to pinpoint the event, then let nature take its course.


























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