Getting Ready for Pregnancy

Are You Pregnant?

As your infertility testing and treatment progresses from one menstrual cycle to the next it is important for us to know if you are pregnant. If your menstrual period is not normal, in any way, a blood pregnancy test should be performed by your local doctor or in our office. Rarely, what seems to be a normal menstrual period is actually bleeding in early pregnancy-sometimes it could be a sign of tubal pregnancy. To avoid exposure to any medications or procedures (like intrauterine insemination or hysterosalpingograms), it is our policy for you to do a home pregnancy test at the end of each cycle. This should be done during your menstrual period. If your home pregnancy test is positive blood test confirmation should be performed.

About 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.

About Vitamins, Antioxidants for the Male

There is some evidence that male infertility 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, Vitamin E 400 mg, selenium 200 micrograms. 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 more costly (about $91 per month) than the regimen above. Fertile One can be purchased via the company web site: ceresfertility.com or by calling 1-877-237-3748.

Another product commercially available for men is Conception XR by Fertility Sciences – go to www.conceptionxr.com for more information and pricing.

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 by the husband and wife while trying to conceive.