TIPS FOR BOTH “HIM” AND “HER” TO ENHANCE LIKELIHOOD OF PREGNANCY

Question: My husband and I have been trying to get pregnant for about 4 months. I think he may be the problem, but he won’t go to the doctor. He says it would be too expensive. We’re both in our late 20s. Can you give me some advice on getting pregnant?

Answer: Let me give you some general information about fertility that you might find helpful. Fertility for women peaks in the early twenties and declines with age after that. Women over 30, without using fertility drugs have a 75 percent chance of getting pregnant within one year and a 90 percent chance of getting pregnant in four years. By age 40, 44 percent of women trying to conceive will do so within one year, and 64 percent within four years. Generally, younger couples who desire a pregnancy and are not using birth control should try for at least a year before considering medical intervention. That is provided that you and your partner have no children together already. If you are over 35, you should seek medical advice after six months of trying.

Some general information about conception. The timing of intercourse as it relates to your menstrual cycle is the first place to start. You normally ovulate about the 14th day of your cycle. Your cycle starts on the first day that you bleed. You count this as day one. You should have intercourse not more that once a day from about day 10 to day 18. Some sources even recommend intercourse every other day only during that time of the cycle.

If your menstrual cycles are not regular, you might want to consider taking your temperature every morning to determine when you are ovulating. This is because when your body releases an egg, it stimulates the production of the hormone progesterone, which raises body temperature. Usually the temperature rise is between 0.4 and 1.0 degrees. There are over-the-counter ovulation test kits as well that can help you time when to try.

If either of you have chronic medical conditions like diabetes, hypertension or thyroid conditions, be sure these are well controlled as they can affect fertility.
If your husband uses the sauna or hot tub a lot, you might want to have him avoid these for a few months. There is some evidence that excessive heat exposure can lower the sperm count and have a negative impact on fertility.

There are also several physical factors that can lead to a low sperm count. A condition where the valves within the veins along the spermatic cord don't work properly -- called varicocele -- is a common cause, as is an undescended testicle. Infection from a sexually transmitted disease or underdeveloped testicles can also cause decreased sperm production.

Smoking a pack a day of cigarettes has been shown to decrease sperm production. Alcohol consumption also lowers production. Fatigue and poor health can be factors.

My advice would be to stop worrying and try for a while longer. Sooner or later you will need to go to the doctor, either because you have become pregnant and need to start prenatal care, or because you are not pregnant and want to know what to do next.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.