“When are you ever going to begin having children?” For the millions of people struggling to get pregnant or carry a baby to term, this is one question that is as dreaded as the plague. It is essentially a painful reminder that without knowing it, infertility could often be ignored,, misunderstood and even dismissed by those who haven’t experienced it. But for those who know better, infertility is a very real medical condition. It is one that can often be of no known cause or traceable to certain lifestyle habits and issues that result in specific problems in the reproductive system.

For instance, if we look at the relationship between stress, anxiety, depression and infertility, well find that is all too familiar. No doubt, infertility is emotionally distressing and the amount of distress varies from one person to the other. Ironically treatment sometime increases this distress. Time management, financial, and work issues also play a role. While it is true that stress could interfere with ovulation, the reverse can also be true because infertility can and does cause stress. This is so because infertility is really a symptom of an underlying disease or structural problem and to suggest that relaxation is all that is required for a woman to become pregnant unfairly minimizes the seriousness of what is strictly a medical problem.

What we are going to do in this write-up is have a brief discussion of some of the details that couples and individuals can use to improve their chances of becoming pregnant. For many questions that couples under treatment for infertility ask, there are not always good scientifically-derived answers. The optimum approach is to make the same lifestyle choices that you would make during pregnancy, while you are trying to get pregnant. For example, for you as a woman, you need to be aware that sugar or excessive artificial sweetener consumption might not be a good idea.

The same can be said about caffeine, so cutting down on coffee and tea is highly recommended. But while there are no absolute data, the assumption is that caffeine prolongs the time it takes for a woman to achieve pregnancy. So I would recommend that you avoid high caffeine intake or avoid any intake of caffeine altogether around the time of ovulation.

Alcohol intake is another point of interest. If you must know, even modest alcohol intake (say one or two glasses of beer or wine per week) makes it more difficult to achieve pregnancy. This may seem like a relatively mild impact, but if you wish to do everything possible to become pregnant, you are better off avoiding intake of all alcohol completely. Although the most likely impact of alcohol on getting pregnant would be from mid-cycle to the time of the expected period, it is safer to steer clear completely while expecting conception.

We cannot talk about alcohol without mentioning smoking. Tobacco is the only substance that causes grievous harm even when used as directed. Women who smoke have a lot more difficulty becoming pregnant even under normal circumstances. Tobacco is known to have both long-term and short term toxic effects on the ovaries. For instance, tobacco doubles the risk of miscarriage, ectopic pregnancy (pregnancy outside the uterus) and decreases the amount of blood flowing to the uterus. Stopping smoking in some instances can double or triple chances of having  baby.

One of the most topical lifestyles issues associated with infertility is body weight. Women (and men) who are significantly over-(or under-) weight are more likely to have difficulty conceiving. However, severe calorie restricted diets should not be used while trying to get pregnant (or during pregnancy). But weight control is very much desirable for a woman who is trying to achieve pregnancy. The impact of age is usually more important than taking the time to lose/gain a large amount of weight.

Nevertheless, weight loss/gain is a good approach for the younger woman. It is often recommended that all women wishing to get pregnant should take enough  folate (folic acid), vitamin C and calcium in their diet. Many women undergoing fertility treatment are prescribed a multivitamin or prenatal (multivitamin with extra folate, calcium and possibly iron).

Herbal medications specially prepared for maintaining conception are all over the place these days. Personally I would recommend avoidance of herbal medications or fertility supplements containing things other than food products. Supplements that are intended to effect female hormone  production either don’t work or interfere with the complex regulatory mechanisms that we are trying to utilize to help you get pregnant.

Generally our knowledge of non-pharmacy products is limited, but there is clearly no “magic bullet” for fertility and it is likely that there will never be one. Fever and any illness that causes elevated body temperature does not appear to be good for an establishing pregnancy. I would recommend use of a safe and tested analgesic if you appear to be developing a fever at the time of conception or in early pregnancy. Also do what you can to avoid becoming sicker by taking plenty of fluids and getting enough rest.

As a rule of the thumb, most non-steroidal anti-inflammatory medications can prevent ovulation if taken at mid-cycle. If you need something for pain during mid-cycle, seek the advice of a physician before you take any drug, just to be on the safe side. In the first part of the menstrual cycle, you may continue any exercise that you are used to. If you are on a therapy that enlarges your ovaries, there is a theoretical risk of some types of exercise either rupturing a cyst or twisting an ovary (which could cause the loss of that ovary). From conception to early pregnancy, I recommend not increasing your internal temperature significantly.

Thanks to progress in medication, surgery and test-tube fertilization, more than half the patients who seek fertility treatment today, can expect a successful pregnancy. Depending on the problem, individuals and couples with problem of infertility can be treated by specialists including obstetricians/gynecologists to urologists and reproductive endocrinologists/infertility specialists.

Like I said in a previous article, the first step for infertile couples should be to educate themselves. Infertility can cause feelings of isolation and loss of control but getting the facts about treatment options and knowing when to seek help empowers the affected persons/couples to take that control back. Let us begin by looking at some of the basic but essential knowledge about infertility. As a rule, I would advise every couple or individual to test their knowledge regularly. For instance, it is expected that every couple seeking infertility care, should have attempted to conceive on their own for at least a year.

But this is one rule that may not be applicable to everyone. While it may be sound advice for an otherwise healthy couple in their 20s, for some women, it could be a delay to vital evaluation and treatment. Take a woman who is 35 or older, has had two or more miscarriages, or has a history of irregular menstrual cycles, pelvic inflammatory disease or pelvic surgery, certainly a year would be too long to wait for her assessment. In cases like this, a couple who fails to conceive after six months of unprotected, well-timed intercourse should see a doctor, irrespective of the one-year rule of the thumb.