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'A baby at last!': New couples' guide to getting pregnant (7/3/2010)

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Infertility affects about 7 million Americans -- that's about one in six couples during their childbearing years. There are many reasons for infertility, with equal chances it's his medical issue as it is hers. A new book, "A Baby at Last!: The Couples' Complete Guide to Getting Pregnant" (Fireside Books, Simon and Schuster), points the way for couples to get past the emotionally wrenching obstacle of infertility and finally bring home their bundle of joy.

The book is written by Dr. Zev Rosenwaks and Dr. Marc Goldstein, two world-renowned fertility specialists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. They draw from years of experience to provide guidance and advice to couples, sharing a wealth of information on the most-up-to-date therapies, many of them developed and perfected at NewYork-Presbyterian/Weill Cornell, as well as real stories from their actual patients. The book is co-written with Mark Fuerst.

"The common misconception is that fertility is a woman's issue, but it happens just as frequently in men. This is why a couples-based solution is imperative," says Dr. Rosenwaks, director of The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine and the Revlon Distinguished Professor of Reproductive Medicine in Obstetrics and Gynecology at NewYork-Presbyterian/Weill Cornell. "There are many reasons a couple may find it hard to get pregnant, and these reasons can stem from a problem with either or both partners. In about 40 percent of infertile couples, the man has a problem. In another 40 percent, the woman has a problem. And in 20 percent both partners have a problem."

"Fertility is, on the face of things, a very simple process. It's a matter of getting the sperm and egg together. But the variables are plentiful, and as many couples find, it's easy for something to go wrong. The good news is that couples have more treatment options than ever before," says Dr. Marc Goldstein, director of the Center for Male Reproductive Medicine and Microsurgery and the Hardy Distinguished Professor of Reproductive Medicine and Urology at NewYork-Presbyterian/Weill Cornell.

Only a few decades ago, there were no drugs to induce ovulation, no microsurgical techniques to unclog fallopian tubes in women or blocked ducts in men, and in vitro fertilization was just a dream. Now cutting-edge treatments, including microsurgery for varicoceles (varicose veins in the scrotum), the most common cause of male infertility; intracytoplasmic sperm injection (ICSI) for men with low sperm counts; and endometrial-cell coculture, a special technique for women with poor embryo quality, are further increasing couples' ability to conceive. Nonsurgical methods for improving fertility -- diet, exercise, and other lifestyle adjustments -- are similarly advanced.

The authors also offer advice on when to seek a medical evaluation. If a woman is younger than 35 and hasn't conceived after 12 months of unprotected sex, the couple should consult with their doctor. If the woman is 35 or older, they should wait only six months. If the male has a history of treatment for cancer, surgery for undescended testicles or a varicocele, or if the female has a history of irregular or no menstrual periods, a history of cancer treatments with radiation or chemotherapy, or repeated miscarriages without successful births, the couple should seek help as soon as they start planning to achieve pregnancy.

Fertility Tips

Even in the best of circumstances, the chances that a woman will get pregnant are about one in four each month. Drs. Goldstein and Rosenwaks offer some tips on natural ways to boost fertility:

  • Have sexual intercourse regularly, especially during the woman's most fertile time of the month. Couples seeking to get pregnant should have intercourse two to three times a week. They can also time sex for her most fertile period. As a rule of thumb, if she counts the first day of her period as day one, and she has regular periods every 28 to 30 days, the couple should try every other day starting on day 12 to 16 or so. Use ovulation kits available in pharmacies.

  • Be healthy. Don't smoke, limit alcohol intake, reduce stress, exercise egularly and moderately, eat healthy foods, take vitamins and avoid environmental toxins. Men should avoid excessive heat and tight-fitting shorts. Women should limit caffeine intake and maintain some body fat.

  • Check your meds. Medications like anabolic steroids that contain testosterone can reduce male fertility. Illegal drugs like heroin and cocaine can interfere with ovulation. Some drugs for hair growth, hypertension and Crohn's disease can also affect fertility. Check with your doctor.

Note: This story has been adapted from a news release issued by the New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

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