Some of the treatments for male infertility actually mirror the treatments for female infertility. For instance, in vitro fertilization can be used to weed out the stronger sperm, fertilize the woman’s eggs in an external environment, and then implant them. In vitro fertilization remains the best medical treatment for a couple trying to conceive when male infertility is an issue.

IUI fertilization

Intrauterine insemination, too, is sometimes used for men with poor sperm quality. By implanting “washed” sperm directly into the woman during her ovulation period, IUI has an average pregnancy success rate of between 6 and 25%. Success rates at or above the higher end of this range occur when the sperm count is between 20 to 30 million per ejaculation and are reduced significantly when the count falls below 5 to 10 million.

IUI is typically not successful in cases of:

• Low sperm count

• Low sperm motility

Clomid

In April 2009, the journal Fertility and Sterility published a study that found that men who took Clomiphene citrate (Clomid) along with vitamin E for six months showed an increase in both sperm count and motility. The men in the study had a 37% success rate of impregnating their partners versus men who took a placebo. Those in the placebo group had a 13% success rate. A study by the World Health Organization several years ago did not show a great increase in fertility in men taking Clomid vs a control group taking a placebo, so it appears that the combination of vitamin E and the Clomid hormone makes the difference.

Natural Fertility Treatments

In many cases, natural fertility treatments can be performed at home such as changes in diet, exercise routines and general health will increase a man’s sperm count and motility.

Decrease temperature of sperm

Sperm do not thrive in constant, overly warm temperatures. Therefore, a man trying to conceive should avoid hot tubs, prolonged warm temperatures and heated blankets. Also, avoid sitting with a laptop on your lap for long periods. (Purchasing a cooling fan that fits under the laptop and runs on power from the PC will protect your sperm count and your computer.)

Many medical professionals say the “boxers or briefs” choice makes little difference, but like many natural treatments, switching to boxers while TTC couldn’t hurt.

Lifestyle changes

In general, any lifestyle changes that positively impact a man’s health can also impact his sperm production. Quitting smoking, limiting alcohol, avoiding illegal drugs, keeping your weight in check, and engaging in moderate exercise can all help increase sperm production and energy levels.

Excessive bicycling – for more than three hours a week – on a narrow bicycle seat can lead to reproductive problems. Avid cyclists need not give up their habit, though, as cycling is a healthy lifestyle choice. Simply invest in a wider, cushioned seat, and stand frequently to shift your weight.

Vitamins
Certain vitamin deficiencies can lead to low sperm count and motility. For improved reproductive health, men should take vitamin supplements and eat a diet rich in the following nutrients:

• Zinc

• Vitamin E

• Vitamin C

• Vitamin B12

• Selenium

• Flaxseed oil

You may find a blend of these vitamins in natural fertility supplements designed for men.

Herbs can increase sperm production

As herbal remedies grow in popularity, more reputable companies are introducing herbal supplements. However, herbs have no FDA regulation, and you can’t always determine the potency or reliability of an herbal supplement. Do your research to insure you’re purchasing from a reputable source and you’re not just wasting your money on what are, essentially, sugar pills.

Additionally, take herbs with caution, following the manufacturer’s recommended dosage. As with any medicine or supplement, do not take more than the recommended dose. Pay close attention to your body and stop taking the supplement if you experience any unusual side effects. Ask your doctor or pharmacist about any interactions between herbs or with any prescription drugs.

Popular herbs to improve fertility in men include:

• Ginseng or Panax Ginseng

• Astralagus

• Saw palmetto

Stress Reduction

Coping with infertility can lead to additional stress on top of life’s everyday stressors. A couple trying to conceive can learn methods to cope with stress together. If you recently experienced a major, life-changing event that causes stress, such as a death in your family, job loss, purchasing a home or moving, you may want to cut back on the TTC efforts for a while. In other words, “stop trying,” have sex regularly and only when you feel like it for fun, and wait until the emotional ordeal passes to renew your efforts.

Author: Dawn Allcot

Trying to conceive? If you’re not already eating a nutritious diet and exercising regularly, now is the best time to change your diet, and possibly even your lifestyle, to help insure not only a successful conception but a healthy pregnancy. By learning more about nutrition and developing good habits now, you’ll be in a good position to instill healthy eating habits in your child, too.

Pre-conception Doctor’s Appointment
You may even want to visit your doctor before you conceive. He or she can advise you on a healthy diet, evaluate your overall health, and let you know if you should lose or gain weight before you begin trying to conceive. You can find out your ideal healthy weight by calculating your BMI (body mass index). Being overweight can decrease your chances of conception by as much as 29 percent.

Eliminate Fast Food
For many people, step one toward a healthier diet is to eliminate fast food from your weekly menu. Pricey, fried, loaded with trans fats, and mostly devoid of nutrients, fast food offers few benefits beyond convenience. If you find yourself at a fast food restaurant, order a salad with grilled chicken on top, and use dressing sparingly. This is a lifestyle change that will benefit your unborn baby and your infant. Some of the benefits of breastfeeding are negated if you eat fast food more than once or twice a week while breastfeeding.

Eat a Balanced Diet
A balanced diet consists of plenty of whole grains, at least five servings of fruits and vegetables, at least three servings of non-fat or low-fat dairy products, and small portions of lean proteins, such as chicken and fish. Don’t forget the healthy fats, too, such as those found in olive oil (and other nut and seed oils) and foods like avocado.

You can find out more about the USDA Food Pyramid and smart food choices at www.mypyramid.gov.

Pregnant women and those TTC need more folic acid (otherwise known as Folate or vitamin B9) in their diets and should be sure they are getting enough calcium and Vitamin D. Taking in no less than 400 mcg of folic acid per day can reduce the risk of serious neural tube birth defects such as spinal bifida. You can get folic acid from sources such as dark leafy vegetables like spinach, citrus fruits, and fortified breads and cereals.

The Good and Bad of Fish: DHA and Mercury
Studies show that DHA, an Omega-3 fatty acid, is important in the development of the brains of fetuses as well as infants and toddlers. DHA can be found in foods such as flax, pumpkin seeds and avocado, but one of the best sources of DHA is coldwater fish, including tuna and salmon.

Unfortunately, fish also contain levels of mercury, which has been linked to nervous system disorders. So, what’s a woman who’s TTC, pregnant or breastfeeding to do? Eat fish shown to have the lowest levels of mercury in moderation by following the EPA guidelines for fish consumption in pregnant and lactating women.

As a general guideline, stay away from tuna steaks, swordfish, and shark, which are high in mercury and limit consumption of low-mercury level fish, including salmon, shrimp, chunk light tuna (not albacore) to 12 oz. per week.

Get the balance of your DHA by taking a pre-natal multivitamin enhanced with DHA or taking a separate DHA supplement.

Pre-natal Vitamins
Most people’s diets don’t contain enough Vitamin D, folic acid, or DHA, along with many other essential nutrients. Even if you eat a balanced diet, it can be challenging to get sufficient quantities of these vitamins and nutrients every day. Your doctor may prescribe a pre-natal vitamin during your pre-conception check-up, but you’ll probably find prescription pre-natals don’t differ much from over-the-counter supplements.
Pre-natal vitamins should contain:

• Vitamin A

• Vitamin C

• Vitamin D

• Vitamin E

• Thiamin

• Riboflavin

• Niacin

• Vitamin B6

• Folic Acid

• Vitamin B12

• Calcium

• Iron

• Zinc

Take pre-natal vitamins with a meal or a glass of milk, as they may cause nausea on an empty stomach. If your pre-natals are causing constipation or an upset stomach, you may want to experiment with different brands. Again, it is better to start your vitamins while you are TTC, so that you know that any side effects are caused by the vitamins and not by pregnancy.

Exercise
Most doctors will tell you that it’s safe to continue almost any exercise program you were doing with proficiency before you conceived during your pregnancy. This includes bicycling, scuba diving, aerobics, yoga, tennis, weight training and countless other sports and activities. After you get pregnant, however, is not the time to learn a new sport or skill, which is why it’s a good idea to begin an exercise program you love while you are TTC. If you were not exercising regularly before you conceived—or did not have time to grow proficient in your chosen activities before you conceived–stick with walking and swimming, or even water aerobics if swimming is too taxing on your body, during pregnancy.

Author: Dawn Allcot

Dehydration isn’t a big worry for most pregnant women, but for some women, it can become quite dangerous. Dehydration for anyone can cause weakness and sickness, but during pregnancy, it can also cause harm to your unborn baby or a spontaneous miscarriage.

Most of the time, dehydration during pregnancy occurs in the first trimester while the mother-to-be is dealing with morning sickness. When a woman experiences nausea and is unable to keep much of anything she eats down, including water, becoming dehydrated is very easy to do. Vomitting can deprive the body of the fluids and vitamins that it needs in order to stay healthy and to keep the baby hydrated.

Pregnant women will often end up in the hospital, and may need to be hooked up to an IV in order to be rehydrated when they are severely sick. A hospital stay can sometimes run to several days while the doctors try to get her vomiting under control. The biggest fear at this point is there not being enough amniotic fluid for the baby to grow in. Without enough amniotic fluid your baby could have deformities of the feet, legs and arms.

Later in pregnancy, during the second or third trimester, if a woman becomes dehydrated either from being sick, being too active and not drinking enough water, or during the summer months when it is very hot, it can cause different kinds of problems for both the mom-to-be and the baby. Dehydration often leads to premature labor as your uterus will start contracting. If you think this might be the case, try drinking at least two big glasses of water and laying down to rest to see if the contractions stop. Call your doctor or midwife as well to see what they suggest.

It is just as important to drink your eight glasses of water a day while pregnant as it is when you are not pregnant. Not only do you need to do it for your health, but you must do it for the health of your unborn baby as well.

This article originally appeared in the July 1996 FDA Consumer and contains revisions made in February 1999. The article is no longer being updated. For the most recent information on this topic, go to the Center for Food Safety and Applied Nutrition’s “Information for Women Who Are Pregnant” Web page.

 by Paula Kurtzweil

If you plan to have children some day, here’s important information for the future mother-to-be: Think folate now.

Folate is a B vitamin found in a variety of foods and added to many vitamin and mineral supplements as folic acid, a synthetic form of folate. Folate is needed both before and in the first weeks of pregnancy and can help reduce the risk of certain serious and common birth defects called neural tube defects, which affect the brain and spinal cord.

The tricky part is that neural tube defects can occur in an embryo before a woman realizes she’s pregnant. That’s why it’s important for all women of childbearing age (15 to 45) to include folate in their diets: If they get pregnant, it reduces the chance of the baby having a birth defect of the brain or spinal cord.

“Adequate folate should be eaten daily and throughout the childbearing years,” said Elizabeth Yetley, Ph.D., a registered dietitian and director of FDA’s Office of Special Nutritionals.

Folate’s potential to reduce the risk of neural tube defects is so important that the Food and Drug Administration requires food manufacturers to fortify enriched grain products with folic acid. This will give women one way to get sufficient folate: by eating fortified breads and other grain products, such as enriched pasta, rice, waffles and cereal bars.

Other ways to do this are:

• Eat fruits, dark-green leafy vegetables, dried beans and peas, and other foods that are natural sources of folate.
• Eat folic acid-fortified enriched cereal grain products and breakfast cereals.
• Take a vitamin supplement containing folic acid.

Nutrition information on food and dietary supplement labels can help women determine whether they are getting enough folate, which is 400 micrograms (0.4 milligrams) a day before pregnancy and 800 micrograms a day during pregnancy.

Neural Tube Birth Defects
The technical names of the two major neural tube birth defects reduced by adequate folate intake are anencephaly and spina bifida. Babies with anencephaly do not develop a brain and are stillborn or die shortly after birth. Those with spina bifida have a defect of the spinal column that can result in varying degrees of handicap, from mild and hardly noticeable cases of scoliosis (a sideways bending of the spine) to paralysis and bladder or bowel incontinence. With proper medical treatment, most babies born with spina bifida can survive to adulthood. But they may require leg braces, crutches, and other devices to help them walk, and they may have learning disabilities. About 30 percent have slight to severe mental retardation.

The national Centers for Disease Control and Prevention estimate that about 2,500 infants with spina bifida and anencephaly are born each year in the United States.

Other maternal factors also may contribute to the development of neural tube defects. These include:

• family history of neural tube defects
• prior neural tube defect-affected pregnancy
• use of certain antiseizure medications
• severe overweight
• hot tub use in early pregnancy
• fever during early pregnancy
• diabetes.

Any woman concerned about these factors should consult her doctor.

Folate Link
Scientists first suggested a link between neural tube birth defects and diet in the 1950s. The incidence of these conditions has always been higher in low socioeconomic groups in which women may have poorer diets. Also, babies conceived in the winter and early spring are more likely to be born with spina bifida, perhaps because the mother’s diet lacks fresh fruits and vegetables–which are good sources of folate–during the early weeks of pregnancy.

In 1991, British researchers found that 72 percent of women who had one pregnancy with a neural tube birth defect had a lower risk of having another child with this birth defect when they took prescription doses of folic acid before and during early pregnancy.

Another study looked at folic acid intake in Hungarian women. The evidence indicated that mothers who had never given birth to babies with neural tube defects and who took a multivitamin and mineral supplement with folic acid had less risk in subsequent pregnancies for having babies with neural tube defects than women given a placebo.

These studies led the U.S. Public Health Service in September 1992 to recommend that all women of childbearing age capable of becoming pregnant consume 0.4 mg of folate daily to reduce their risk of having a pregnancy affected with spina bifida or other neural tube defects.

That corresponds to FDA’s Daily Value for folic acid, which is 400 micrograms for nonpregnant women, as well as children 4 and older and adult men. For pregnant women, the Daily Value jumps to 800 micrograms. Daily Values are dietary reference numbers used on the Nutrition Facts panel on food labels to show the amounts of various nutrients in a serving of food.

Many women between 19 and 50 consume much less than 400 micrograms of folate a day, according to the U.S. Department of Agriculture.

Folate Sources
Folate occurs naturally in a variety of foods, including liver; dark-green leafy vegetables such as collards, turnip greens, and Romaine lettuce; broccoli and asparagus; citrus fruits and juices; whole-grain products; wheat germ; and dried beans and peas, such as pinto, navy and lima beans, and chickpeas and black-eyed peas.

Under FDA’s folic acid fortification program, which became effective January 1998, the agency requires manufacturers to add from 0.43 mg to 1.4 mg of folic acid per pound of product to enriched flour, bread, rolls and buns, farina, corn grits, cornmeal, rice, and noodle products. A serving of each product will provide about 10 percent of the Daily Value for folic acid. Whole-grain products do not have to be enriched because they contain natural folate. Some of the natural folate in non-whole-grain products is lost in the process of refining whole grains.

Folate also can be obtained from dietary supplements, such as folic acid tablets and multivitamins with folic acid, and from fortified breakfast cereals.

A report recently released by the Institute of Medicine indicates that the evidence suggests that folic acid, the synthetic form of folate, may be better absorbed than folate found naturally in foods. The report also points out that, if taken in adequate amounts, food folate may eventually be demonstrated to be as effective as folic acid.

Some Good Sources of Folate
(The table below is also available as text for browsers that don’t support tables and as a 7K PDF file).

* based on Daily Value for folate of 400 micrograms
(Source: Food Values of Portions Commonly Used, 16th edition)

Finding Foods with Folate
Certain information on food and dietary supplement labels can help women spot foods containing substantial amounts of folate. Some labels may claim that the product is “high in folate or folic acid,” which means a serving of the food provides 20 percent or more of the Daily Value for folic acid. Or the label may say the food is a “good source” of folate, which means a serving of the food provides 10 to 19 percent of the Daily Value for folic acid. The exact amount will be given in the label’s Nutrition Facts panel.

Some food and dietary supplement labels may carry a longer claim that says adequate folate intake may reduce the risk of neural tube birth defects. Products carrying this claim must:

• provide 10 percent or more of the Daily Value for folic acid per serving
• not contain more than 100 percent of the Daily Value for vitamins A and D per serving because high intakes of these vitamins are associated with other birth defects
• carry a caution on the label about excess folic acid intake, if a serving of food provides more than 100 percent of the Daily Value for folic acid. FDA has set 1 mg (or 1,000 micrograms) of folate daily as the maximum safe level. There are limited data on the safety of consuming more than 1 mg daily, and there may be a risk for people with low amounts of vitamin B12 in their bodies–for example, older people with malabsorption problems, and people on certain anticancer drugs or drugs for epilepsy whose effectiveness can diminish when taken with high intakes of folate.
• list on the label’s Nutrition or Supplement Facts panel the amount by weight in micrograms and the %Daily Value of folate per serving of the product. This information, which appears toward the bottom of the panel, along with the listing of other vitamins and minerals, can be used to compare folate levels in various foods and supplements.

Optional information may appear with the health claim to let consumers know about other risks associated with neural tube birth defects, when to consult a doctor, other foods that are good sources of folate, and other important messages about neural tube defects.

Other Considerations
The claim about folate cannot imply that adequate folate intake alone will ensure a healthy baby, since so many factors can affect a pregnancy.

Women should bear this in mind when contemplating pregnancy, advises Jeanne Latham, a registered dietitian and consumer safety officer in FDA’s Office of Special Nutritionals. “Folate can make a significant contribution,” she said, “many factors, including an overall good diet, are involved in having a healthy baby.”

Genetics plays a role, as do other healthful prenatal practices, such as eating an all-around good diet. But unlike genetics, diet is a risk factor women can modify to their–and their baby’s–advantage, said Jeanne Rader, Ph.D., director of the division of science and applied technology in FDA’s Office of Food Labeling.

“Folic acid is one of many nutrients needed in a healthy diet for women of childbearing age,” she said. “A well-balanced diet with a variety of foods can provide all those nutrients, including adequate amounts of folate.”

Women have options for reaching the folate intake goal: They can get the necessary nutrients and calories both before and during pregnancy by eating a well-balanced diet, keeping in mind folate-rich foods, nutrition experts say. Folic acid-fortified grain products, including breakfast cereals, will help, too. Dietary supplements are another source of folate. Any one or a combination of these options for ensuring adequate folate can help assure women of childbearing age that, if they become pregnant, their babies will be off to a healthy start.

Paula Kurtzweil is a member of FDA’s public affairs staff.

Maternal and Child Health Clearinghouse
5600 Fishers Lane, Room 18A-55
Rockville, MD 20857
(703) 821-8955

March of Dimes Birth Defects Foundation
1275 Mamaroneck Ave.
White Plains, NY 10605
(914) 428-7100
Voice mail only: (914) 997-4750
World Wide Web: http://www.modimes.org/

Publication No. (FDA) 98-2306

By Dori StehlinBreast cancer. Osteoporosis. Iron deficiency. Weight reduction. What do these things have in common? They are either unique to women, or are more prevalent in women. And they affect current recommendations on what women should eat for optimum health.

While new information on what’s good and what’s bad seems to surface almost daily, some basic guidelines have taken root over the past several years.

The bottom line (also known as the Dietary Guidelines for Americans, from the Departments of Health and Human Services and Agriculture) is: