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FERTILITY EVALUATION

PREPARING FOR PREGNANCY

Intercourse Timing

In general, intercourse every other day through the mid cycle (days 12-18 for most women) will hit one of the days of the best fertility potential.  If you wish to use an ovulation predictor kit that may provide further information, we recommend the “Clear Blue Digital” which can be purchased over-the-counter.  The instructions are easy to follow.  When the “smiley face” appears, so called “peak”, that day and the following day are the best times for intercourse.  There are other versions of this kit, “Clear Blue Advanced” and “Clear Blue Monitor”, these things cost more, do not provide more meaningful information and tend to cause confusion.  The information provided that you have “high” fertility is of no real value.  “High” means ovulation is approaching. The valuable information is identifying the 1 or 2 days prior to ovulation called “peak”.  If you already have one of these other kits, you may use them but be mindful of the above information.

Intercourse TimingAbout Vitamins-for the female

There is medical evidence that supplemental folic acid may help prevent neural tube birth defects (spina bifida).  To be effective this treatment should begin prior to conception.  We recommend that you take a multivitamin containing 0.4 mg (400 micrograms) of folic acid daily.  This is available over the counter.  The supplemental folic acid treatment will continue during pregnancy.

There is recent information that supplemental Vitamin A taken in amounts that exceed the FDA recommended 100% requirement might cause birth defects.  We caution you about this risk.

Intercourse TimingAbout Vitamins, Antioxidants for the male

There is some evidence that male fertility may be improved by taking over the counter medications-vitamins and antioxidants.  The research on this issue is inconclusive.  A combination of these over-the-counter drugs, that does no harm, and may improve male fertility includes:  a multivitamin with zinc (without iron), Vitamin C 500 mg, Carnitine 1000 mgm daily, and Coenzyme Q10 200 mgm daily.  Even men with “normal” sperm counts may benefit.  This treatment is inexpensive-a few dollars a month and can easily be purchased at nutrition stores. 

Another more complicated formulation for men is called “Fertile One.”  It contains the above ingredients and more-some amino acids (the building blocks of protein) that have long been thought to be responsible for improving sperm movement.  Medical research on this product is promising but incomplete at this time and it is costlier the regimen above.  Another product commercially available for men is Conception XR by Fertility Sciences.

We Think of Everything…

Many times sonograms are performed around mid-cycle (at ovulation).  The lubricant gel we use for the scanner has been tested in our lab regarding effects on sperm.  Sperm are unaffected by our ultrasound gel.

Herbal Treatments

There is animal and human experimental evidence that St. John’s Wort, Echinacea Purpura, and Ginkgo Bilboba have ill effects on sperm and/or eggs.  We recommend that neither the husband nor the wife take these herbal products while trying to conceive.

Tobacco and Caffeine

There is clear medical evidence that tobacco use, by either partner, reduces the chance for pregnancy. Tobacco use by the male reduces IVF pregnancy rates by as much as 50%. The degree of effect relates to the amount of tobacco use - the less you use the better - none is best.  Tobacco use in the male may increase the risk of childhood cancer in offspring.

Caffeine also causes a decrease in fertility - again related to amount.  The equivalent of three 6-oz. cups of coffee, taken daily, has been shown to reduce fertility.  One cup may cause a slight affect - moderation is the key.  Remember that other things contain caffeine.

Prostaglandin Inhibitors

Prostaglandin inhibitors (e.g. Motrin, Anaprox, Advil) are commonly used for menstrual pain.  We caution you against using these drugs around the time of ovulation – this may interfere with egg release.

Alcohol

A recent publication suggests that alcohol ingestion, even in small amounts, by either partner significantly reduces in vitro fertilization pregnancy rates and increases pregnancy loss rates.  It is reasonable to infer that alcohol consumption by either partner reduces fertility in regard to all forms of infertility treatment.  We suggest complete abstinence from alcohol-husband and wife- while trying to conceive.