Is it really possible to pre-determine or, more accurately, to select, the gender of your child? Several medical experts say that it is.

These are a few methods currently used for gender selection.

The Ericsson Method – This medical procedure can be pricey, but it is effective about 75% of the time when selecting a boy and about 70% to 72% of the time if the couple is trying for a girl. The use of the fertility drug Clomid increases the odds of bearing a girl if sperm bearing the X chromosome are used for insemination.

The Ericsson Method entails artificial insemination, where the sperm are first separated and those bearing the male (Y) chromosome or bearing the female (X) chromosome only are used to fertilize the eggs, depending on the patient’s choice.

PGD (Preimplantation genetic diagnosis) – PGD combines in vitro fertilization with the Ericsson Method of sperm selection, so that only embryos fertilized with sperm bearing either the X or Y chromosome, depending on the patient’s choice, get implanted into the mother. Because the embryos are first fertilized with selected sperm and then checked for gender prior to implantation, this combination yields even higher success rates than the Ericsson Method alone.

If you are using gender selection to avoid passing on gender-related genetic diseases, or if you feel you absolutely could not accept a child of the gender not of your choosing, this medical method has the most proven track record, according to many accounts.

Intercourse -Timed Gender Selection – In the 1970s, two doctors released two different books offering directions on how to conceive a baby with the gender of your choice. In 1971, Dr. Landrum Shettles and David Rorvik wrote “How to Choose the Sex of Your Baby,” and revealed that sperm with male (Y) chromosomes move faster than sperm with X (female) chromosomes but do not live as long.

To conceive a boy, have intercourse on the day of ovulation or one day after. To conceive a girl, have sex two to four days prior to ovulation.

Use any number of methods, such as:

• tracking your natural fertility signs such as: basal body temperature, your cervical mucus, and your cervical position

• using an ovulation predictor kit

• using an ovulation tracker/calculator

Shettles offers other tips for tipping the scales when it comes to conceiving a baby boy, too.

• Have sex in a position that encourages deep penetration to deposit the weaker “boy” sperm closer to the cervix

• When a woman orgasms, it changes the pH level in the vagina to be more alkaline, an environment where the Y-chromosome sperm thrive

• Create an alkaline or acidic environment for the sperm by douching with a special solution prior to intercourse

• The prospective father-to-be should drink coffee prior to intercourse

Elizabeth Whelan’s method – outlined in her mid-seventies book “Boy or Girl,” contradicts the Shettles Method. She says that biochemical changes in a woman’s body prior to ovulation make the environment more friendly to Y-chromosome sperm. To conceive a boy, she says, have sex six to four days prior to ovulation, and to have a girl, wait until two or three days prior to ovulation.

Whelan’s technique, however, has lost validity over the years, while many people still rely on the Shettles Method. The Shettles Method, when done correctly, offers a 75% success rate for both genders, making the technique as reliable as medically-assisted methods. The Whelan’s method offers only a 68% success rate for boys and 56% for girls; only 6% higher than the natural 50% odds of having a girl without doing anything prior to or during conception to influence the gender.

GenSelect Gender Selection Kit – Kits such as the Genselect Gender Selection Kit also consider the pH level of the vagina, and offer special douching solutions to create an acidic or alkaline environment, friendly to x- or y-chromosome sperm, respectively.

This kit, which touts a 96% success rate, combines intercourse timing with diet and all-natural nutriceutical supplements with douches to adjust the acidity of the vagina.

Diet – A recent study suggests that women who eat a high-calorie diet tend to conceive boys more frequently – specifically, in a sampling of 740 women, 56% of the women who ate a diet high in carbohydrates and who consumed more calories conceived a boy, compared with 45% who ate a lower calorie diet. Additionally, starting the day with a bowl of cereal increased the odds of having a boy. 59% of women who ate cereal daily had boys, compared to 43% who ate cereal less frequently than once a week.

Experts attribute the increase in males conceived by women who eat a healthier, heartier diet to an increase in blood sugar levels. Also, the study seems to lend credence to the old belief that a diet high in salt increases the odds of conceiving a boy. In the study sample, a higher intake of sodium, potassium and calcium seemed to favor conceiving a boy.

It’s important to note, however, that a change in diet alone only increased the odds by a mere 9% (at best) over the natural 50-50 chance of having a boy.

Many people view the ideal family as “one boy, one girl.” And parents with two children of the same gender often get the question “Are you going to try for a boy/girl?”

These ideas may help you conceive your gender of choice. But let’s be honest: When all is said and done, most people don’t really care whether they have a boy or girl, so long as the baby is healthy. Even if you are hoping against hope for one or the other, as soon as you see that wonderful baby you created, the gender probably won’t matter.

Author: Dawn Allcot

Many methods exist for tracking your dates of ovulation. Some, such as tracking changes in your cervical mucus or using an ovulation calculator, are free. But many women rely on over-the-counter ovulation predictor kits, which can be purchased at drugstores like CVS, Rite-aid and Walgreens, and at retailers like Wal-mart, K-Mart, and Target. You can also find ovulation calculators online at Amazon.com. They run about $15 to $40, and you can save money by purchasing in bulk online.

Two types of ovulation predictor kits exist – those that measure the luteining hormone in your urine and those that measure estrogen in your saliva. This article explains how to use both and evaluates some of the more popular brands.

Ovulation Predictor Test Strips

Ovulation predictor test strips measure the amount of LH (luteining hormone) in your urine. LH peaks right before you ovulate, giving most women a 36-hour window to try to conceive before they ovulate, and another 24 hours while they are ovulating. While you may get pregnant up to 24 hours after you ovulate, because an egg lives for 24 hours, the best time to try to conceive is the few days prior to ovulation.

Many fertility specialists say that Ovulation Predictor Kits (OPKs) are more reliable than other ways of tracking your fertility. Your results may vary, though, if you have an irregular cycle. Additionally, if you have a long cycle, using an OPK every day until you ovulate, starting on day 10 of your cycle, gets expensive.

Additionally, OPKs only detect the hormone surge that precedes ovulation; they can’t tell if you will actually release an egg during your cycle.

To get the best results, follow the directions in the package for your specific test precisely. Keep in mind, polycystic ovarian syndrome (PCOS), a common cause of infertility, may affect the results of the test, as will certain fertility drugs, including Clomid.

How to Use an Ovulation Predictor Kit

Much like an over-the counter pregnancy test, you simply urinate (mid-stream) on the test strip. In most tests, you will see a control line and then a line that indicates the amount of LH in your urine. If the test result line is the same color or darker than the control line, you are experiencing the hormone surge that indicates you will ovulate soon—usually within 12 to 36 hours of the surge.

Unlike a pregnancy test, you don’t use an OPK with your first-morning urine. Instead, wait until about 2 PM – anytime after noon may be okay. You may have a hormone surge in the morning, but it takes 4 hours to show up in your urine. You may also want to test twice a day, once in the afternoon and once in the evening, to make sure you don’t “miss” the surge.

Since ovulation times vary, you should begin testing on day 10 of your cycle, which is approximately five days after the start of your period. These numbers may vary if you have an exceptionally long or exceptionally short cycle. Continue testing until you detect the LH surge.

Ovulation Kits That Measure Saliva

The QTest, Ovuscope, MaybeBaby and Fertile-Focus saliva ovulation test kits are just a few examples of kits which test for estrogen, rather than LH, to determine time of ovulation. Most of these kits are about $20 to $30, although others exist that are much more expensive.

A saliva ovulation test kit is essentially a small, re-useable 40X to 60X microscope. Some kits work with a supply of slides, while others, which are more expensive, let you test right on the lens. Tests are approximately deemed 98 percent accurate and capable of detecting ovulation up to 72 hours in advance.

As your body nears the time of ovulation, in addition to an LH surge you will experience an estrogen surge. This surge manifests in saline in your saliva. Saliva Ovulation Predictor Kits detect this saline, which shows up as a fern-like pattern on the microscope slide.

How to Use a Saliva Ovulation Predictor Kit

You can use the test first thing in the morning, or anytime during the day, as long as you have not eaten or drank anything, brushed your teeth or smoked for at least two hours before testing.

Use fresh saliva to test; swish your saliva around in your mouth and apply fresh saliva from under your tongue to the test slide.

If you are near the time of ovulation, you will see a fern-like pattern on the slide. During the transition phase, the slide will contain a mixture of ferns and small bubbles. You are not ovulating or in transitions if you see only tiny bubbles.

Keep in mind, smoking, eating, drinking or brushing your teeth up to two hours before taking the test could affect the results. Pregnancy, recent pregnancy, menopause, hormone-based birth control methods and hormone replacement therapy may also affect the test.

You may have to test for a few months before you begin to plan your pregnancy to recognize the fern pattern. Keep track of your cycle by marking every menstrual period on a calendar, too, so that you can begin testing just prior to your most likely time of ovulation. You may want to test at other times of month, too, for a comparison.

If, after several months, you are seeing ferns all the time, or not seeing any ferns around your suspected time of ovulation, check with your doctor. You may be producing estrogen all month, perhaps due to a lack of the hormone progesterone, or you may not be producing enough estrogen to conceive.

Author: Dawn Allcot

One way to increase your odds of conceiving quickly is to make sure you are having sex during the most fertile part of your cycle — the days just before, during and after ovulation.

Because sperm can live in the body for up to five days, but an unfertilized egg dies after 24 hours, you increase the odds of having sperm and egg meet by having sex just prior to ovulation. But how do you know when you are ovulating?

If your periods are very regular, and come consistently anywhere from 21 to 35 days apart, you can also use our ovulation calculator to predict when you are fertile.

But by tracking the physical signs of fertility, you will get more exact results, even if your cycle varies slightly each month. You can track your fertility by charting your Basal Body Temperature (BBT), Cervical Fluid, and Cervical Position.

Basal Body Temperature
BBT is the temperature of your body before any activity—your body’s baseline temperature. Your BBT rises slightly on the day of ovulation and remains elevated until just before your next period starts. To track your BBT, take your temperature orally with a BBT thermometer (they sell for about $10 at any drug store) every morning before you get out of bed and chart the results. A BBT thermometer only registers temperatures between 96 to 100 degrees F. and can detect very slight changes in your temperature. Most women have a BBT of 96 to 98 degrees normally before ovulation and 97 to 99 after ovulation.

Cervical Fluid
Cervical fluid, sometimes called cervical mucus, is produced by the lining of a woman’s cervical canal and varies in consistency, color, and amount based on where you are in your monthly cycle.

As you get closer to your time of ovulation, your cervical mucus will change in order to better permit the transfer of sperm into your cervix.

To get a good sample of your cervical mucus at any time, place your fingers (make sure they are clean) inside your vagina. When you pull your fingers out, examine the sample you’ve obtained, noting its consistency and color.
Immediately after menstruation, you will have several “dry days,” where there is very little fluid at all.  What is there may be white or opaque and thick and sticky. As you approach mid-cycle, you will note more moistness, and the fluid will be thin, and possibly cloudy. If you hold some between your fingers, it will be slightly stretchy.
In the few days just before ovulation, which is when you are most fertile, your cervical fluid will be copious, thin and transparent. It will be very stretchy, almost the consistency of egg whites.

Just as your cervical fluid changes throughout your cycle, so does the position of your cervix in order to facilitate the transportation of the sperm and fertilization of the egg during your fertile time. Monitoring the position of your cervix is another way to track your ovulation times. Using these three methods combined will give you the most accurate results.

Begin by checking your cervical position at the end of your period, and check it daily until you reach your time of ovulation. You should do this at the same time each day, and in the same position each time. You can check your cervical position while sitting on the toilet, or it may be easier to place on foot on the toilet and keep one on the floor. Move your middle finger all the way up into your vagina until you hit your cervix, which will feel like a rounded cylinder.

At the beginning of your cycle, your cervix will be low and easier to reach. During ovulation, it will rise to a higher position, and may even be difficult to reach with your middle finger. It will drop back down to a place where it is easier to touch after you ovulate.

Author: Dawn Allcot

Ovulation occurs when a woman’s ripened egg, or ovum, is released from one of two ovaries, making the journey down the respective fallopian tube and into the uterus. By this time, the uterus lining has thickened to prepare to protect the egg if it becomes fertilized and turns into an embryo. If the egg is not fertilized, it is absorbed into the uterine lining and then expelled along with the lining during menstruation.

If an egg is fertilized by a sperm, it implants into the uterus and pregnancy begins! Some women experience implantation bleeding: light bleeding that occurs when the egg implants. This often happens 6 to 12 days after fertilization, sometimes right around the time a woman would be expecting her next menstrual period, and is nothing to be concerned about.

Women are born with 1 to 2 million follicles, or immature eggs, in the ovaries. By puberty, only about 400,000 remain. With each menstrual cycle, approximately 1,000 follicles are lost, with only one maturing into an egg.

In healthy women, both ovaries can release eggs, but they do not alternate consistently, with the right ovary releasing an egg one month and the left releasing an egg the next month. Even healthy women can occasionally have cycles in which they don’t ovulate, and they will still get their period on schedule. This can be caused by stress, rapid weight loss or gain, illness, change in diet or exercise routine, or medications.

Having sex a few days before, during and directly after ovulation is the best way to try to conceive. Because you can ovulate without a menstrual period, or have a menstrual period without ovulating, calculating from period to period is not always reliable, but it is one easy and free method. There are several different methods that can be used to predict when you are ovulating and to determine your next ovulation date.

• Ovulation Calculator

• Natural methods to track your fertility, which include charting your basal body temperature, cervical mucus and cervical position

• Over-the-counter or prescription ovulation predictor kit.

Finally, some women can actually feel themselves ovulate. They will experience a sharp pain on one side of their abdomen, or experience a feeling similar to menstrual cramps. This is called “mittleschmerz,” literally translated from German to mean “middle pain.” For some, this pain is fleeting, for others it can last a few hours.

Using one or any combination of these methods will help you predict your time of ovulation.

Author: Dawn Allcot

Infertility has several different causes. Many couples may experience more than one cause. Some infertility causes can be overcome through lifestyle changes, hormone therapy and/or medical intervention such as in vitro fertilization, while other couples may need to take other measures, such as a surrogate mother or even adoption.

Whatever your choice, remember that if you and your partner want a baby, there is one for you, just waiting to be chosen or conceived, taken home and loved.

This article outlines several common causes for infertility and possible treatments. It explains the concepts without jargon so you can have an educated discussion with your doctor about your challenges in trying to conceive.

* Ovulation Factors

Ovulation – the release of an egg into the fallopian tube – is required for conception. Most women ovulate about once a month or approximately every 28 to 31 days.

Oligoovulation means a woman ovulates irregularly. If you suffer from oligoovulation, it will be hard to predict your ovulation by tracking your menstrual cycle, but measuring basal body temperature along with tracking cervical mucus changes may be more effective, as will over-the-counter ovulation predictor kits.

Anovulation means a woman isn’t ovulating at all – either permanently or temporarily. Drastic changes in diet or eating disorders such as anorexia and bulimia can cause temporary anovulation, as can excessive exercise, stress, and breastfeeding. Amenorrhea, also caused by these factors, refers to a lack of a menstrual cycle. Every so often, a woman can get her period but not release an egg during that cycle. This is called an anovulatory cycle.

Some diseases also cause anovulation. These include:

• Pituitary problems

• Polycystic ovarian syndrome (PCOS)

• Hypothalamic dysfunction

• Luteal phase defects

• Pituitary gland, adrenal gland or ovarian tumors

Hormonal imbalances are the number one cause of anovulatory cycles.

Replacement hormones and drug therapy can often induce ovulation, but in some cases, lifestyle changes – such as stress management, reducing strenuous exercise, or stopping breastfeeding – will bring back a normal menstrual cycle complete with regular ovulation.

* Cervical / Uterine Factors

If a woman is diagnosed with cervical infertility – usually done by means of a cervical exam – it means sperm is unable to pass through the cervix and into the uterus. Cervical infertility may be caused by:

• Cervical mucus too thick to allow sperm to pass through;

• A lack of cervical mucus to transport sperm;

• A narrow cervix, also called “stenosis”;

• A cervix infection, sometimes caused by sexually transmitted diseases;

• A sperm “allergy,” where the woman’s immune system attacks the sperm as a foreign body.

Uterine abnormalities are not a common cause of infertility; they are more closely associated with recurrent miscarriages. However, a number of uterine abnormalities may contribute to infertility. Often, these are not the primary cause of infertility but a factor to consider during in vitro fertilization to avoid pre-term pregnancy or miscarriage.

Abnormalities your doctor may check for include:

• congenital malformations;

• leiomyomas (fibroids);

• intrauterine adhesions (scarring)

• endometrial polyps.

* Tubal & Peritoneal Factors

• Completely blocked fallopian tubes

• One blocked tube

• Tubal scarring

• Tubal damage

• Tubal ligation (performed intentionally as permanent birth control)

A tubal blockage located close to the uterus is called “proximal” tubal blockage, while a blockage locating further away is called distal tubal blockage.

Making up about 25 percent of all infertility cases, tubal damage or blockage is one of the most prevalent causes of infertility. It is often caused by pelvic infections, including pelvic inflammatory disease (PID) or pelvic endometriosis, but can also be caused by scar tissue that forms after pelvic surgery. Some STDs, including gonorrhea and Chlamydia, cause pelvic infections that lead to tubal blockages.

Since tubal damage is such a common cause of infertility, most doctors will test for it using a special X-ray called a hysterosalpingogram (HSG) and/or a diagnostic laparoscopy.

Most blockages can be treated with surgery – even in the case of previous tubal ligation patients – but if surgery doesn’t work, in vitro fertilization remains an option for women with tubal infertility issues.

The peritoneum is a thin membrane that lines the pelvic cavity. Problems with this membrane, sometimes caused by endometriosis, ruptured appendicitis, pelvic inflammatory disease and scar tissue, can contribute to infertility.

*Immunological Factors

Several immunological factors may lead to infertility. They include anti-sperm antibodies present in the male or female partner.

These anti-bodies can:

• immobilize sperm;

• make them clump together;

• limit their ability to pass through the cervical mucus or

• stop them from binding to and penetrating the egg.

In vitro fertilization using ICSI (injecting a sperm directly into an egg) has the highest success rate of any current treatments;

A woman’s body rejects the fetus as foreign tissue.

Clinics report a 70 percent success rate when treating this form of infertility by injecting the partner’s white blood cells into the woman prior to conception. When successful, the woman’s body begins to “recognize” the cells, and therefore, later identifies the fetus as “friendly.”

Antibodies in mother produce blood clots.

The prospective mother-to-be produces antibodies that cause clotting in blood vessels that lead to the fetus. Deprived of nutrients, the fetus dies in utero, triggering a spontaneous abortion or miscarriage.

* Endometriosis

Endometriosis afflicts more than 5.5 million American women and girls, and contributes to 25 to 50 percent of all infertility cases. Thirty to 40 percent of women suffering from endometriosis are infertile, so this is an important factor to look at if you have been trying unsuccessfully to conceive.

The Endometriosis Association lists several symptoms of the disease, but the disease may be asymptomic in mild cases.

• Pain before and during periods

• Pain during sex

• Infertility

• Fatigue

• Painful urination during periods

• Painful bowel movements during periods

• Other Gastrointestinal upsets such as diarrhea, constipation, nausea.

What exactly is endometriosis? The Endo-Association defines it as a chronic disease that occurs “when tissue like that which lines the uterus (endometrium) is found outside the uterus, usually in the abdomen on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity.”

The tissue develops into growths or legions that—like the uterine lining—builds up, breaks down and sheds during a woman’s menstrual cycle. Since this lining has no way to leave the body, it results in internal bleeding, breakdown of the blood and tissue and painful inflammation.

*Treatment of Endometriosis

Although endometriosis has no cure, several different treatment options are available to reduce pain and symptoms, slow or shrink growths and preserve or restore fertility.

Medication: In mild cases, over-the-counter pain relievers such as aspirin and acetaminophen (Tylenol) and prostaglandin inhibitors such as ibuprofen (Advil and Motrin) can relieve pain and slow growth.

Hormone therapy: Stopping ovulation through oral contraceptives or other hormone therapy will also stop the build up and break down of legions. Obviously, this isn’t a desirable treatment option for women trying to conceive and may also cause side effects.

Surgery: Surgery – usually laparoscopy, an outpatient procedure in which surgery occurs through the belly button – can remove or destroy the growths and relieve pain. Pregnancy can often occur after such surgery. A more extensive procedure with a longer recovery time – laparotomy – involves a full incision, but is still considered “conservative” surgery, versus the alternative of a hysterectomy with removal of all growths and the ovaries.

Alternative / Natural Medicine: As with most diseases, alternative and natural treatments also exist. These can be used with traditional Western medicine treatments or alone and may include:

• nutritional changes

• homeopathic treatments

• immune therapy

• allergy management

• traditional Chinese medicine such as acupuncture and acupressure

* Pelvic Inflammatory Disease

Most infertility causes are not preventable, but Pelvic Inflammatory Disease, a bacterial infection in the upper genital tract, can be prevented by preventing STDs, including Chlamydia and Gonorrhea. A PID typically affects the uterus, fallopian tubes and ovaries and can lead to infertility. It is also the most important risk factor for ectopic pregnancies leading to miscarriages.

Since Chlamydia and Gonorrhea are transmitted through unprotected sex, use of a condom in any non-monogamous relationship can prevent the diseases and help prevent PID. If you are in a monogamous relationship, both partners should be tested to make sure they are free of STDs before they begin having unprotected sex.

Symptoms of PID include:

• fever;

• chills;

• lower abdominal and pelvic pain

• vaginal discharge or bleeding.

Symptoms may begin a few days after the start of your period.

When symptoms are present, doctors can diagnose PID through a bacterial culture of cervical discharge and a white blood cell count test. (Elevated levels may indicate the infection.)

PID is sometimes confused with appendicitis or a ruptured ovarian cyst, in which case a laparoscopy can confirm PID. It can be cured with antibiotics.

Only 10 to 25 percent of all single cases of PID (that is, not a recurring infection) result in damage to the fallopian tubes that cause infertility, and prompt treatment increases the odds that there will be no enduring side effects.

* Polycystic Ovarian Syndrome

The single-most common cause of female infertility, according to Women’s Health, the Federal Government Source for Women’s Health Information, is Polycystic Ovarian Syndrome. PCOS afflicts one in 10 women of childbearing age, although it can begin in young girls as early as age 11.

The syndrome occurs due to high levels of androgens (male hormones, although females also produce them in smaller quantities) in the body, leading to missed or irregular periods, baldness, excessive facial and/or body hair, cysts in the ovaries, and often, infertility.

A number of other symptoms and disorders are linked to the disease, including:

• obesity

• pelvic pain

• sleep apnea

PCOS also carries with it an increased risk of:

• Type 2 diabetes

• high cholesterol

• high blood pressure

• heart disease

Why DOES PCOS cause infertility?

The follicles within a woman’s ovaries contain fluid and multiple eggs, which begin to mature each month. Usually only one egg matures fully, and the follicle breaks open to release the egg, which travels down the fallopian tube ready to be fertilized. This process is called ovulation.

PCOS prevents the ovary from making all the hormones it needs for an egg to fully mature. Instead, follicles grow and build up fluid, remaining as cysts. Without ovulation, the woman’s body doesn’t produce progesterone, and the menstrual cycle become irregular or non-existent (called anovulation). Obviously, without ovulation, pregnancy cannot occur by natural methods.

Treatments for PCOS

No cure exists for the syndrome but treatment and lifestyle changes designed to manage the illness can reduce the risk of complications, minimize symptoms and also increase the chances of a successful conception and pregnancy.

Unfortunately, one of the most common forms of PCOS treatment is the use of birth control pills to regulate menstrual cycles and reduce the presence of male hormones. This is not a permanent fix, however, and lasts only as long as the woman is on the Pill, so is not a desired treatment for women trying to conceive.

Diabetes medications: Diabetes medications, including Glucophage (metformin) lowers testosterone production and controls the way the insulin controls blood sugar levels. PCOS is linked to insulin production, making this an effective treatment. Glucophage, according to an article in the New England Journal of Medicine, was recently found safe for pregnant women to treat gestational diabetes, and so may be a good option to discuss with your doctor if you trying to conceive with PCOS.

Fertility medications: Since anovulation causes infertility – and is a common symptom of PCOS – medicines designed to stimulate ovulation may help a woman with PCOS become pregnant. Clomiphene citrate, under the brand names Clomid or Serophene, usually works. Sometimes metformin will be added, which may help a woman ovulate with on a lower dose of both medications. Gonadrotropins – a fertility medicine taken by injection – may also be used, but carries a greater risk of multiple births. Finally, in vitro fertilization remains an option for women trying to conceive with PCOS.

Surgery: When fertility medicines don’t work, “ovarian drilling” – a laparoscopic procedure – may be used as a last effort to stimulate ovulation. The surgeon punctures an ovary with a small needle and uses an electric current to destroy a small portion of the ovary. There is a risk of scar tissue developing on the ovary, but the surgery may lower male hormone levels, stimulating ovulation. Effects may last a few months, creating a small window during which a woman may conceive naturally or through artificial insemination. The treatment typically doesn’t help with cosmetic symptoms of PCOS, such as baldness or body and facial hair growth.

Lifestyle modification: Often, women can manage the symptoms and risks of PCOS with lifestyle changes, including regular exercise and a healthy diet rich in fruits, vegetables and whole-grain products. By following a diet similar to what a diabetic should eat, a woman with PCOS can improve her body’s use of insulin and normalize hormone levels, which may stimulate ovulation and even create regular menstrual cycles, leading to the possibility of a healthy pregnancy.

*Premature Ovarian Failure

According to the International Premature Ovarian Failure Association, approximately one to four percent of the female population suffers from Premature Ovarian Failure, sometimes called premature menopause.

More information about PCOS

Premature Ovarian Failure typically occurs in women under 40; it can happen as early as the teen years. POF may be caused by certain syndromes, diseases, genetic disorders or even radiation treatment or chemotherapy, although in many patients, doctors can’t identify a specific cause at all.

If you are not pregnant, breastfeeding or menopausal and your periods have stopped or become irregular, it could be due to POF. You may also experience other symptoms of menopause, including:

• Hot flashes

• Vaginal dryness

• Lack of sex drive

• Painful sex

• Bladder control problems

• Mood swings

• Energy loss

Unfortunately, only about six to eight percent of women with POF will be able to successfully conceive. No treatments exist to restore fertility in women with POF, but you should still seek treatment for the disorder, because it carries several other health risks including an increased risk of osteoporosis, and heart disease.

A doctor may diagnose POF with two FSH tests done approximately a month apart. If FSH (Follicle Stimulating Hormone) levels are normal, it typically indicates the ovaries are working correctly. Women with POF will show FSH levels in the post-menopausal range.

According to the International POF Association, many doctors misdiagnose POF or blame the symptoms on stress. Insist on diagnostic testing to either rule out or diagnose the disorder so that you can begin treatment promptly. Treatment may include hormone replacement therapy and lifestyle changes to manage symptoms and decrease the health risks of complications associated with POF, such as osteoporosis and heart disease.

More information on Premature Ovarian Failure (POF)

* Fibroid Tumors

Fibroid tumors by themselves are a primary cause of fertility in only three to 12 percent of women who have them. If fibroid tumors block the fallopian tubes, they can cause infertility.

However, treatments for fibroid tumors, including myomectomy – a surgical procedure in which fibroids are removed but the uterus remains intact – and hysterectomy can cause permanent infertility. In many cases, fibroid tumors return after a myomectomy and the surgery must be repeated. This repeated procedure can cause uterine scarring leading to infertility. If conception occurs, however, 85 to 90 percent of all women will have a successful pregnancy without complications.

Female Alternative Surgery, which uses lasers to remove the fibroid tumors without damaging the uterus or ovaries and preserving fertility, should be discussed with your doctor, as well.

What are Fibroid Tumors?

Fibroid tumors are benign masses which grow in the uterus. They can be hard and stony or soft and rubbery. Nearly 25 percent of all women of childbearing age have fibroids. They are typically identified during a gynecological exam when a doctor may feel a mass in the uterus; this diagnosis may be confirmed by an ultrasound.

Some women won’t have any symptoms from fibroid tumors and, chances are, without any symptoms, the fibroids also won’t create problems with conception. However, if you are having fertility issues and have any of the following symptoms, fibroid tumors blocking the fallopian tubes may be a cause.

Symptoms of Fibroid Tumors

• Pelvic Pain

• Increased menstrual cramps

• Increased menstrual flow

• Clots

• Irregular or painful periods

• Increased urinary frequency

• Constipation

• Bloating

* Hyperprolactinemia

A hormonal disordered characterized by unusually high levels of prolactin in the blood in non-pregnant, non-breastfeeding women or in men.

This disorder occurs in approximately 10 percent of the population and can result in infertility in males or females. In women, it can cause irregular or non-existent menstrual periods.

Stress, sex, exercise, sleep, nipple stimulation, certain prescription drugs and even eating certain foods can also increase prolactin levels temporarily. If one blood test shows elevated levels of prolactin, a follow-up test should be ordered to confirm the diagnosis.

If hyperprolactinemia is causing infertility, it can be treated with prescription drugs.
* Luteal Phase Defect

The luteal phase of a woman’s menstrual cycle begins immediately after ovulation and continues for approximately 12 to 14 days. If the luteal phase lasts 10 days or less, it is considered a Luteal Phase Defect. Some doctors believe any luteal phase shorter than 12 days can cause problems. This shortened time period may not allow the uterine lining to develop enough for the embryo to fully implant, and often leads to an early miscarriage or a failure to conceive.

LPD occurs because of inadequate progesterone stimulation; it is a hormonal imbalance. You may discover a Luteal Phase Defect while charting your fertility. A time frame between ovulation and menstruation of less than 12 days may indicate an LPD. A doctor can discover an LPD with a simple blood test that detects progesterone levels in your body seven days after ovulation.

It is often treated with vitamin B6 and progesterone cream, which help lengthen the luteal phase.
If over-the-counter treatments don’t work, a reproductive endocrinologist may prescribe Clomid or progesterone suppositories.

* Other Causes of Infertility

Several other causes of infertility exist. A reproductive endocrinologist may explore some of these possible causes with you.

Anything that effects your menstrual cycle, including stress, rapid weight loss or gain, travel, and intense exercise can cause temporary infertility. These are all factors to consider when you are trying to conceive.

Additionally, some medical conditions can lead to infertility. Some diseases associated with infertility, pregnancy complications or miscarriage include:

• Diabetes

• Lupus

• Thyroid Disease

Author: Dawn Allcot

Many women hear the term implantation bleeding used a lot in regards to the early stages of pregnancy, but unless they receive clarification on what this phenomenon actually is then it can be a scary experience. What exactly is implantation bleeding?

During the early stages of pregnancy the ovum, or fertilized egg, attaches itself to the uterine wall. This always occurs within the first trimester and can sometimes cause a little amount of blood to be released. This is the cause of implantation bleeding. The egg actually attaches itself to the mother’s circulatory system via the wall of the uterus, and this is where the blood comes from.

Some women might feel cramping along with implantation. In some instances women have already missed a period and are aware of the pregnancy. Not every woman detects implantation bleeding. Remember that pregnancies can be considered perfectly normal whether there is any bleeding in the early stages or not.

Many women wonder how to tell the difference between implantation bleeding and bleeding that could be a sign of something more serious. If you experience light spotting – such as only enough to wear a panty-liner – then it is most likely implantation bleeding. Additionally, if the spotting is dark and not bright red, and the spotting ends quickly, this points to implantation bleeding as well. Keep in mind that this can be completely normal in the first trimester but you should check always check with your doctor whenever bleeding occurs during a pregnancy.

There are other explanations if the bleeding is not due to implantation. Bleeding beyond light spotting may be a result of your menstrual cycle, and the lighter flow than normal could be caused by any number of things including stress. Changing your birth control can also cause a change in your bleeding flow and spotting can also be a sign of infection or abrasions from recent intercourse. When in doubt, contact your doctor.

Did you experience implantation bleeding? Please share your story with us.

Question
“I’d like to have a baby. Should I aim for a particular time of the month for intercourse — a particular few days in my menstrual cycle?”

Answer:
It seems funny — or sad — that one couple makes a baby the very first time they have sex (whether they want a baby or not) while another couple can try and try for months without getting the child they want so badly.

People trying to have a baby have often been advised to aim for the woman’s fertile time midway between her periods. They are told to have intercourse on the day the woman ovulates, or a couple of days before or afterward. Our Institute scientists, taking precise data on more than 200 healthy women trying to have a baby, have determined that you’re actually most likely to get pregnant if you have sex the day you ovulate or the five days before.

It seems that a man’s sperm may be longer-lasting than some people previously believed, while a woman’s ovum, or human egg, disappears more quickly.

Three days after intercourse, there might still be active sperm swimming around that can impregnate and fertilize a newly released egg. But if the sperm is not introduced until after the day of ovulation, a two- or three-day-old egg would be unlikely to still be in good enough shape to be fertilized, even by the freshest of sperm.

You will have a problem, however, knowing when you’re five days away from ovulation. There is no test to pinpoint that. A further problem: Your ovulation and fertile “window” – the time when you’re likely to get pregnant – can wander around. It’s like a moving target.

Older guidelines for getting pregnant assumed that the average woman is fertile between days 10 and 17 of her menstrual cycle. But that’s a very rough approximation — an “average” that may not mean much for you as an individual woman.

Seventeen percent of the women were fertile by day seven of their cycle. Two percent of women were fertile by day four!

Our study also showed very late ovulations occur, even in women who said their cycles were usually regular. Because of these late ovulations, 4 to 6 percent of the women were potentially fertile more than 28 days after the start of their cycle.

In fact, even women who regarded their cycles as “regular” had a 1 to 6 percent probability of being fertile on the day their next period was expected.

Question:
If ovulation times vary widely – and you can’t accurately predict them five days ahead of time — what should a healthy young woman do? How, in other words, should you go about trying to get pregnant?

Answer:
Well, the director of our NIEHS study, Allen Wilcox, M.D., Ph.D., suggests many couples are best off forgetting about getting the timing “right.”

Dr. Wilcox says, “If the average healthy couple wants to get pregnant, they are just as well off to relax and forget “fertile windows” and simply engage in unprotected intercourse at least two or three times over the course of each week.”

That’s easy-to-follow advice. And you’re likely to hit “right” two or more times within the fertile days occurring in each of your cycles.

If you don’t conceive the baby you want in a year or so of regular intercourse, talk to your doctor. You may be the one couple in six that has a fertility problem. Simple tests can often pinpoint and help overcome it. The problem can reside in your man about as often as in you, so he will need to be tested too.

At some point, you may be referred to a fertility clinic or specialist. You may be prescribed a drug to trigger ovulation, and your mate’s best sperm will be introduced by the doctor at that time. There are other technologies, too – some of them very expensive. There is also some risk of triggering two or more eggs and having a bigger family than you expected.

Question:
“Will my baby and I be healthier if I see a doctor as soon as I get pregnant?”

Answer:
Certainly, your doctor can increase your chances for a healthy outcome if you see him or her as soon as you’re pregnant. But to get the very best odds for yourself and your baby, you should try to see your doctor well before you get pregnant.

Your doctor will have diet and life-style suggestions that should make for a healthier baby, and a healthier you as well. You shouldn’t wait until you know you’re pregnant to eat well and take vitamins. You should check out what drugs you need to stop to prevent harm to your baby – before you even know you’re pregnant. Also, as mentioned, seeing that you are having trouble getting pregnant, your doctor can help with tests and suggestions that fit your situation.

Even with the best of care, there are hazards ahead.

In an NIEHS study of healthy women who wanted a baby, about one in five fertilized eggs failed to survive six weeks. That would be before you and/or your doctor even would know you are pregnant. It may be Nature’s way of sparing a mother the burden of carrying an embryo that cannot survive. Further along in pregnancy, a much smaller number of additional fetuses are lost in spontaneous miscarriages. That’s always sad, but 95 percent of the women losing a fetus in the study got pregnant within two years afterward.

Most women’s miscarriages, like most birth defects, have no clear cause. But genetic defects have been seen in some lost fetuses. Surely, the environment also plays a role, just as it does in the birth of preemies – early, underweight infants. (The newborns of smokers, for example, are more likely to be born prematurely than the newborns of non-smokers.)

Question:
“How do the things I eat and do affect my child?”

Answer:
What you eat, drink and do during pregnancy and just before pregnancy is vital to your child because, for nine months, your body is your child’s environment. Your circulatory system feeds nutrients to your unborn child’s system through an organ, called the placenta. Your circulatory system also removes waste materials from your child via this organ, which is attached to the wall of your uterus and to the bellybutton of your baby.

We used to think that the placenta kept poisons from reaching the unborn child. That popular idea was dealt a death blow in the late 1950’s and early 1960’s, when many women took a sedative called thalidomide which caused hundreds of children to be born with flipper-like limbs where their arms and legs should be.

Then in 1971, after it was prescribed for more than 20 years to try to prevent miscarriages, diethylstilbestrol, or DES, was found to have produced rare cancers and reproductive abnormalities in “DES daughters,” the daughters born to the women being treated. (At NIEHS, we did some of the research that showed DES’ adverse effects. Later, in test animals, NIEHS scientist Retha R. Newbold also found that harm may extend to “DES granddaughters” and to “DES grandsons.”)

Illegal or “recreational” drugs are risky, too. Cocaine’s use during pregnancy has been shown to increase malformations of the urinary tract five-fold. There are also risks of low birth weight, miscarriage, brain damage and fetal death.

Because the dangers have been publicized, many women who get pregnant know to stay away from illegal drugs, and from many nonprescription and prescription drugs as well.

If you’ve ever taken Accutane (isotretinoin) for very severe acne, you know this drug is an extremely strong cause of gross birth defects. Before taking this drug you must have a test to show you are not pregnant. Then you must take birth control measures beginning a month before you start the acne drug, throughout the treatment period and, because of its persistent effect, for a month after you stop.

Drugs to treat cancer, such as methotrexate, also cause birth defects – and pregnancy should likewise be avoided when getting such treatment.

Even aspirin carries a risk of bleeding complications for mother and child, but it may be prescribed by a doctor under certain conditions.

Thus, the best advice to pregnant women (or women who may become pregnant) is: Ask your physician before taking any prescription or non-prescription drug, including herbal medicines and other “natural” therapies.

But don’t panic unnecessarily. Some drugs have been used in pregnant women for a long time without doctors observing any problems.

If you need a drug to control high blood pressure, asthma, lupus or other chronic problems, don’t stop the moment you find you’re pregnant. Talk the situation over with your doctor first. Talking it over with your doctor before you become pregnant is even better, since the fetus may be particularly susceptible to injury at its early stages, before you even know you’re pregnant.

Epileptic? A pregnant woman’s seizures can cause damage to the unborn baby’s brain. Thus, women with epilepsy and their doctors usually decide that continuing the medication that controls the seizure is the path of less risk.

There’s a similar trade-off for women who must take insulin daily to control their diabetes. They are several times as likely to have a baby with a major defect. However, if a woman stops her insulin, neither she nor her unborn infant may survive. That’s another reason to see a doctor before conceiving a baby — yet only about one woman in four does so.

Increasingly, we are seeing that our unborn babies can also be hurt by what we eat (or don’t eat), what substances we handle at work, at home and in the farm or garden, as well as many other environmental factors. Some of these substances can subtly influence the IQ, health, development and motor skills of children still to be born – still, in some case, to be conceived.

For example, lead may be passed along. It can accumulate in the bones of a young girl exposed to it and be released, years later, exposing her unborn child. The lead can lower the child’s IQ. One study shows lead may even contribute to a child’s chances of getting into trouble with the law.

A mother’s exposure to mercury can delay her child’s development. That may also be true of PCBs, still another NIEHS study suggests. There are undoubtedly other chemicals, metals and other exposures that also produce such effects.

Harm can also result from deficiencies — from substances a pregnant woman fails to get. If you have been eating a diet without sufficient folate or folic acid, a B vitamin found in green leafy vegetables, when you become pregnant there is a greater risk of deformities called neural tube defects of the brain and nervous systems. In these defects, the infant may fail to develop a brain or, more commonly, the spinal column may fail to close around and protect the spinal cord. Without this protection, the baby’s spinal cord may be injured during the upheaval of birth so that the baby may be partially, but permanently, paralyzed.

The Food and Drug Administration now requires that rice and flour products be fortified with folate. It is difficult to get enough from an ordinary diet otherwise. Even with the fortification, government experts and others advise all women of child-bearing age – that is, girls and women from puberty through menopause – to take an ordinary, folate-containing multiple vitamin pill each day. Taking folate after pregnancy starts is not as effective.

In other ways, too, good nutrition when you make your baby may be more important than we generally think. Studies of women giving birth during World War II showed that women who conceived when near starvation were more likely to have babies with malformations than women at near-starvation when they delivered.

The idea that a pregnant woman is eating for two is true. In some cases, Nature may favor the child. The mother’s bones and general health suffer. In other situations, the baby or both mother and child are affected. Talk to your doctor or nurse-midwife about a good pregnancy diet. “Eating for two” does not mean eating twice as much but getting the appropriate amount of nutrition for both you and your unborn child.

Question:
“Will my man make a good father of healthy children – and will I be as good a mother as my Mom was?”

Answer:
You can both be fine parents of fine children — especially if you make sure your environment is free of harmful exposures.

Remarkably, each tiny, one-celled egg or ovum that you produce every month or so has actually been within your body since you yourself were born! As a result, some scientists speculate that environmental influences might impact on those ova at any time over the years they are being carried — in other words, at any time over your lifetime.

Though sperm are produced “fresh,” fathers-to-be aren’t off the hook either. Whereas women used to be more likely to be blamed, the causes of childlessness are now broken down more evenly – about 50/50.

Environmental influences, such as vitamin status, radiation, drugs, diseases, and occupational exposures, can influence the quantity and quality of a man’s sperm. Such exposures can also prevent a man from getting or maintaining an erection. So it isn’t “unmanly” for industrial, medical and agricultural workers to take advantage of lead shields, protective masks and clothing, and after-work showers. Quite the reverse.

Infections, such as mumps, are well-known causes of male infertility, but pesticides and other chemicals can present a risk of infertility and birth defects. These defects may occur if a damaged sperm fertilizes an egg and the egg does not develop properly. The result may be a miscarriage or a potential health problem in the baby later on.

Men and women may track in lead dust from building sites where old, lead-painted buildings have been knocked down, contaminating their homes and exposing their families.

Farm workers risk problems for themselves and their families if they needlessly go into recently sprayed fields and/or don’t wear long-sleeved shirts and other clothing that covers their skin. Family exposures can be minimized if workers strip off contaminated clothes at work or as soon as they return home, and the clothes are promptly washed – separately from other clothes. The exposed workers themselves should also shower promptly.

We all also have habits, good and band. You may also be interested in some NIEHS work that suggests that the old habit of female douching reduces fertility — as may too much coffee.

Alcohol can be harmful. It is regarded by the March of Dimes as the leading cause of preventable mental retardation, as well as the most common known cause of fetal damage. Major physical and mental problems occur in the children of drinking women, especially those who use alcohol a lot. Many doctors recommend you avoid all alcoholic drinks during pregnancy.

Women born with a birth defect themselves often worry that their children will be similarly affected. Working with Norwegian scientists, we studied this risk among a half-million Norwegian women (born with defects between 1967 and 1982) and their offspring. Less than 4 percent of the offspring turned out to have birth defects – and generally only at the same level of risk as other women’s children. The only significant increase in risk was for having the same defect as the mother’s. (In a follow-up study, the offspring of men who had been born with birth defects proved to have an increased risk of the same defect, compared to other men’s children, plus an increase in other birth defects as well.)

Tips

You wouldn’t expect this discussion to end without some do’s and don’ts, would you? So here (at the risk of a little repetition) are some environmental tips if you are of child-bearing age — from your teen years to menopause:

• You should not eat swordfish, shark, king mackerel or tilefish while you are pregnant or can become pregnant. These large, long-lived ocean fish accumulate mercury pollution as they eat smaller fish. If you then eat these fish, the mercury can accumulate in you and hurt the development of nervous system of your unborn child. The Food and Drug Administration also advises you not to eat these big fish when you’re nursing a baby – and not to fee these fish to small children.
• Eat plenty of green, leafy vegetables AND swallow a multi-vitamin containing folate, or folic acid, (a B vitamin) every day, before and during pregnancy.
• Avoid soft cheeses. Those delicious brie and Roquefort cheeses, particularly those famous unpasteurized products, are easily contaminated by a tough bacteria called Listeria. Ordinarily, people are not much affected by Listeria, but in pregnant women the bacteria then can cause violent vomiting, flu-like symptoms and loss of your unborn child. This loss can occur even before you know you’re pregnant.

  Mexican-style soft cheeses such as queso blanco, queso fresco, queso de hoja, queso de crema and asadero are susceptible, as are such other soft cheeses as feta, or goat cheese, brie, Camembert and blue-veined cheeses such as Roquefort. The Food and Drug Administration recommends that pregnant or potentially pregnant women should instead eat hard cheeses made from pasteurized milk or marked as aged for 60 days or longer.

• Take care with all foods. To reduce food poisoning risks, FDA also recommends 1) thoroughly heating meats purchased at deli counters, whether cured (like salami) or not, before you eat them; 2) washing fruits and vegetables with water, 3) keeping your refrigerator, counter top and utensils clean; 4) washing your hands and utensils with warm soapy water after contact with raw foods, especially raw meats, and 5) cooking meat, poultry and seafood thoroughly. Follow “use by” dates and other instructions for refrigerating foods.

  To err on the side of caution, some environmental health experts suggest that pregnant women – despite those infamous cravings we are supposed to get – avoid overdoing any single food or beverage in the diet. Varying your diet guards you against getting a massive dose of a problem substance, if there should be an accident that unexpectedly contaminates a particular food.

• Beware raw meat – and your cat. They may harbor a parasite that causes toxoplasmosis. If you get it while pregnant, your unborn child has about a 40 percent chance of contracting it too. In early pregnancy, this can cause the child to be blind, deaf and mentally retarded.

  The parasite can be found in cat feces, soil and infected meats that have not been thoroughly cooked. Cats get it from eating infected birds, mice and rats. So keep your family cat indoors to reduce its chances of getting the parasite – and have someone else clean its litter box, so that you don’t get it.

• Protect yourself from pesticides and other chemical exposures. We don’t know enough about the safety of home and occupational pesticides and chemicals in pregnancy. So it is a good idea to be cautious. Ask your employer to give you copies of Material Safety Data Sheets (MSDSs) for any hazardous materials in your work, as required. A few substances of concern are lead, carbaryl (Sevin), bromine vapor, carbon disulfide, ethylene dibromide, mercury vapor and styrene and acetone used in plastic production.
• Use farm and industrial materials with caution, following all the precautions on the label
  You can be exposed to chemicals in the air you breath, through your eyes, or in your food and water. So store chemicals in sealed containers when not in use, follow recommendations for ventilation. A major route of contamination is through your skin, so wear protective clothing and gloves. Wash off any spilled materials immediately. Wash your hands before eating, drinking or smoking.

  If you are a farm worker, factory worker or scientist, or you have one as a husband, partner or family member, you and/or that other worker should shower at work at closing time or as soon as you/they get home. Clothes contaminated by pesticides, chemicals or metals should be washed at work, if possible. If they must be washed at home, they should be washed separately from other clothes, and as soon as possible.

  If you are a dentist, dental assistant or hygienist or work with the anesthetic nitrous oxide (N2O) in human or veterinary medicine, you should know be cautious because this gas has been shown to cause defects in the offspring of exposed lab animals. Adequate ventilation, tests for leaks and other guidelines should be followed to limit your exposure. Women working as potters, with solder, or as home remodelers may encounter lead, which has been associated with miscarriages, stillbirths and infertility for more than 100 years. The National Institute of Occupational Safety and Health also warns of reproductive problems among women viscose rayon workers exposed to carbon disulfide (CS2) and among electronic and semi-conductor workers exposed to ethylene glycol ethers such as 2EE and 2ME.

  And if you’re planning to decorate a room as a nursery, why not ask a pro or a partner to do the painting (while you go elsewhere and avoid the fumes.)

• Avoid smoke, as well as smoking. Smoking increases the risks of an underweight baby and of stillbirth, the birth of a dead fetus. Smoking and also passive smoke exposure may double the risk of a rare but devastating condition called persistent pulmonary hypertension of the newborn. In this condition, infants starve for oxygen because blood is not pumped through the lungs to the body but continues to flow as it did before birth and the activation of the lungs. Without successful surgery to correct the flow, the infant may die. Babies born to women who smoked during pregnancy are also more likely to have asthma and other respiratory problems. They also are more likely to die of sudden infant death syndrome – SIDS. SIDS reduction campaigns emphasize positioning infants on their backs for sleeping as well as keeping cigarette, cigar and pipe smoke away.
• Avoid x-rays, hot tubs and saunas. They pose environmental risks for pregnant women. If x-rays are needed for medical reasons, your doctor will shield your abdomen (and thereby your fetus) from the rays. The March of Dimes also suggests pregnant women try to avoid infections. Rubella (German measles) during pregnancy can cause ear, eye and heart abnormalities. You can be tested to see if you’ve been exposed and are immune. If not, you can get vaccinated – but then should wait three months before getting pregnant. For avoiding many infections, frequent hand-washing can help.
• Stay faithful to one, uninfected and equally faithful partner to prevent the tragic consequences of a new-born with HIV or other sexually transmitted diseases. Discuss your own and your mate’s sexual history (and any injected drug use) with your physician – and get tested for HIV or other infections, as appropriate. Even if you have HIV, for example, proper drug treatment can often prevent your child from becoming infected.
• Exercise moderately. Walk, swim, ride a stationary bike and/or join in a special prenatal aerobics class three or more times a week. Even a vigorous workout is ok for most women and may help you carry your baby to full term. Not so advisable: bouncing or jerking movements, toe touches, knee bends and sit-ups. Doctors generally counsel against any vigorous exercise that has you lying on your back after the first three months of pregnancy. Injury-risking sports – skiing, rock-climbing, horseback riding – aren’t good bets. But regular, safe exercise can make labor easier and prepare you to get back in shape afterwards.
• Relax, too. You don’t need a lot of stress during pregnancy, or before pregnancy either! Summing up, you just need a good clean, healthy and uninfected man; a doctor; a good diet; a vitamin pill, and a work and home environment where you won’t be needlessly exposed to tobacco smoke, pesticides, alcohol and other potentially harmful chemicals, drugs, mercury, soft cheese, undercooked meats and kitty litter.

About this Article
Provided by the National Institite of Environmental Health Services.