KNOWLEDGE AND ACTION: THE FIRST STEPS TO BETTER HEALTH

As with any medical condition, educating yourself is one of the keys to enhancing your fertility. Becoming familiar with the basics of reproduction and the wide variety of both alternative and conventional treatments will relieve some of the fear and powerless that go along with infertility. You'll also be able to make more informed choices about treatment that take into account not only the question of pregnancy but your overall health and well-being.

While there's no reason to panic if you're having trouble conceiving, it makes sense to take control of the situation. Many couples have a hard time admitting that they have a fertility problem. After each attempt, they tell themselves that maybe they will conceive the next time. Rushing to the doctor after 1 or 2 months is premature, but if pregnancy hasn't occurred withing 6 months or so of concerted effort, it's time to take stock of the situation. Focusing on the information in this post and/or consulting a professional are options. If you are over 30 years old and have a history of pelvic inflammatory infection, endometriosis, painful periods, miscarriage or irregular menstrual cycles, you may want to seek help sooner. The same is true if you know that your partner has a low sperm count or other related condition.

Factors That Affect Fertility
Roughly one in five cases of infertility cannot be traced to any known medical condition. However, many women who have been told they are infertile due to a specific physical problem get pregnant without any treatment.

The most common reasons for infertility are:

• Irregular ovulation
• Endometriosis
• History of pelvic infection from an intrauterine device (IUD) or other source, causing scarring of the fallopian tubes
• Stress
• Immune system problems
• Low sperm counts

Here we consider some of the broader issues that affect fertility.

Age
The dramatic trend toward delaying childbearing is perhaps the single greatest factor contributing to infertility. The older a woman is before having her first child, the greater the risk that she will have trouble conceiving and/or carrying a pregnancy to term.

In the past, a woman might have had fewer than 40 menstrual cycles before pregnancy, whereas now there might be 12 years of monthly periods before a woman decides to have a child. Unfortunately, when that occurs, it creates several problems. First, (women's) bodies may not be in great health when they are ready to have a child, and it may be difficult for them to get pregnant. Sometimes their hormones may be out of balance and they may already have fibroid or endometriosis problems, which further inhibits them from getting pregnant.

There are many reasons why couples are waiting to have children. For women, the sexual revolution of the 1960s and 1970s led to unprecedented freedoms, both in their personal and professional lives., The availability of cheap, reliable contraceptives allowed women to enjoy a new level of sexual liberty without the overriding fear of an unwanted pregnancy. At the same time, the idea for women pursuing full-fledged careers became accepted.

The effect of these two transformative social developments was to change the way both men and women approached the issue of parenting. Instead of marrying and starting a family in their 20s, millions of people put off such commitments until their 30s. This shift in priorities continues today, with many women trying to become pregnant for the first time at age 35 or older.

Although many doctors will counsel their patients that they can have a baby anytime-certainly well into their 40s-this advice can be very misleading. A woman has an excellent chance of conceiving throughout her 20s, and though fertility begins to decline after age 30, prospects for conception are still good in the absence of serious problems. Most experts agree, however, that a woman's fertility drops sharply after age 35, so by her late 30s she is about 30% less fertile than in her early 20s. At age 4o and beyond, pregnancy attempts are frequently unsuccessful and require a greater degree of medical intervention.

Although more and more women are conceiving and giving birth in their late 30s and 40s, many of these babies are the result of assisted reproductive technology (ART) procedures such as vitro fertilization and egg donation. These techniques do work for some women, but there are physical, emotional and monetary prices. And in many cases, they do not lead to the birth of a child, leaving couples financially depleted and psychologically drained.

Environment
Although rarely discussed by conventional fertility specialists, environmental contaminants are considered by many leading alternative practitioners and researchers to pose a serious threat to procreation. New studies have raised troubling questions about how reproduction is affected by pesticides, hormones, household chemicals, air and water pollution.

Nutrition
Every aspect of human health is impacted by what we eat, and fertility is no exception. Few of us get the nutrients we need from our diet. On the contrary, we may fill our plates with high-fat, high-sugar, low-fiber foods. These consumption habits do little to maintain our reproductive systems, and in fact can compromise fertility.

Digestion and Elimination
In many alternative healing traditions, the digestion and elimination organs are regarded as central to reproduction. Without proper digestion, the body does not get the nutrition it needs to support conception and pregnancy. And if wastes are not eliminated efficiently, the resulting buildup of toxins can lead to infections and other conditions that may compromise fertility.

Weight
Obesity is on the rise and the health implications are grave. One of the best-documented effects is the disruption of normal menstrual and hormonal function, which can lead directly to infertility. In contrast, inadequate body fat can also interfere with the menstrual cycle and hormonal balance, producing the same results. Women with eating disorders have a disproportionately high rate of fertility, as do some female athletes such as long-distance runners.

Caffeine, Alcohol, Tobacco and Drug Use
These stimulants are all associated with a drop in fertility. In the case of caffeine and alcohol, small amounts may not pose much of a threat, but the safety threshold is low. Tobacco and drugs in even tiny doses can jeopardize the chances of getting pregnant as well as having a healthy baby.

Thyroid Problem
Thyroid dysfunction is a major factor in infertility. An underactive thyroid gland can result in hormonal imbalances, which in turn may block conception or lead to miscarriage.

Sexual Dysfunction
A variety of conditions ranging from sexually transmitted diseases to excessive masturbation by men can prevent conception. The same is true of infrequent intercourse.

Stress and Depression
Alternative physicians believe that stress, anxiety and depression can have a significant negative effect on conception. Recent studies have confirmed this conviction, showing a correlation between successful treatment of mood disorders and increased pregnancy.