Dreaming of a Baby, Maybe?

How to Protect Your Fertility Until You Decide

Introduction

"Marriage, a house, a baby"—a traditional chain of events that many young people dream about for the future. Now, added to the puzzle of finding the right mate and affordable real estate, infertility may become another problem on the way to that dream.

For a man, fertility means the ability to impregnate a woman; for a woman it is the ability to conceive and bear a child. We take fertility for granted and indeed, five out of six couples will get pregnant within a year of trying. But the final proof of fertility—a baby in your arms—is an unrealized goal that sends over one million people a year into infertility treatment.

Infertility in Women

Many factors influence fertility. Women's problems account for about 35%. The woman's part in conception is to supply the eggs. She does not need to manufacture them—she has all she will ever need at birth. Every baby girl carries the seeds of her future family with her when she is born, in the form of thousands of eggs in her ovaries.

After puberty, a mature egg is released each month at ovulation. The egg then goes through the fallopian tubes to the uterus. If it is fertilized, it implants in the uterine wall; if not, it is discharged during menstruation.

Failure to ovulate is the most common cause of infertility in women. Irregularities in ovulation and menstruation increase with age, as does the chance that the tubes are blocked due to earlier pelvic surgery or disease. A woman's fertility is at its peak in her 20s. It slowly diminishes until she reaches 35 and drops rapidly for the rest of her child-bearing years.

Infertility in Men

Male infertility is involved an equal 35% of the time. A man's role in conception is to supply the sperm. The major cause of infertility in men is the failure to produce healthy sperm that are plentiful and mobile.

Sperm have a short life span and must be continually manufactured in the testes. Because the testes are extremely sensitive, a man's fertility is threatened by a variety of external factors, including environmental toxins and high temperatures. Another cause of male infertility is the blockage of passages that carry the sperm, again the result of previous surgery or disease.

Protecting Your Fertility

Will infertility affect your dreams? What can you do to give yourself the best possible chance of having a baby, when and if you decide it's time?

The following risk factors are based on medical evidence of circumstances associated with infertility. Many of these conditions can be successfully treated; many of these dangers can be successfully avoided. If you recognize a risk factor in yourself, consult your doctor and ask for more complete advice.

For Women

Normal body weight is important. If the percentage of body fat is too high or too low, estrogen levels may change and affect normal ovulation.

A delay of several years in the time of the first menstrual period or infrequent menstruation—that is, less frequent than once every 40 days—may indicate a problem with ovulation.

Painful menstrual cramps, heavy menstrual flow, or painful intercourse are all signs of a puzzling disease called endometriosis, which has been linked with infertility. It can occur in menstruating women of any age and tends to run in families. Prompt and early treatment may preserve fertility.

Vaginal discharge, bleeding, fever, and pain are symptoms of pelvic inflammatory disease (PID) and sexually transmitted disease (STD), which can cause scarring or blocking of the fallopian tubes.

Pelvic surgery for an ovarian cyst, ruptured appendix, or tubal pregnancy sometimes results in adhesions or scarring of the fallopian tubes.

The use of an intrauterine device (IUD) increases the risk of pelvic infections leading to blocked tubes.

When a cervical problem is identified by an abnormal Pap smear, the required treatment may disturb the cervical mucous secretions needed for the survival of the sperm.

For Men

A man is far more at risk from environmental toxins than a woman because he must continually make new sperm. Exposure to pesticides and chemicals, such as lead and mercury, can be poisonous to sperm.

Pain with urination, sores on the genitals, or discharge from the urethra may be signs of infection that can block the passages that carry the sperm.

A varicocele is a varicose vein above one or both testicles. Fertility is reduced in many men when a varicocele is present. They can, however, be surgically treated.

Injury to the testes may be prevented if protective athletic cups are worn.

Hot tubs and tight underwear that raise the temperature of the testes may lower sperm count and mobility.

Radioactivity and X-rays may cause sterility and abnormal sperm.

The use of cocaine and marijuana have been linked with decreased fertility.

Poor nutrition affects the quality of sperm. Foods rich in zinc and vitamin C are important to male fertility.

Permanent damage to a man's ability to produce sperm may result from a hernia operation or an undescended testicle that was not corrected in infancy.

Mumps after puberty can destroy the sperm-producing cells.

For Couples

Cigarette smoking and heavy use of alcohol have been linked with decreased fertility rates in both women and men.

Certain diseases and/or the prescription medicines used to treat them may affect both male and female fertility.

People born between 1941 and 1971 may have been exposed to diethylstilbestrol (DES) "in utero." Exposure to DES can cause pregnancy complications and abnormalities of the testes.

When to Go for Help

When deciding to see a doctor, sooner is better than later. The causes of infertility can be identified in 90% of all cases and successfully treated in half. Starting early not only increases treatment options, it gives those who will not conceive time to consider other choices, including adoption and child-free living.