Monday, November 23, 2009

Health

Fighting Infertility May Be Easier Than You Think

By Deborah Kotz
Posted 4/29/07

Tracy Ryan had given up hope of having a second child. Two years of trying to conceive, including three failed artificial inseminations, had finally culminated in a successful in vitro fertilization–and 2-year-old Christopher. But further attempts at in vitro had left Ryan, 35, disappointed and exhausted. Desperate to feel better, the stay-at-home mom from Fair Haven, N.J. decided to try acupuncture, kick her six-can-a-day Diet Pepsi habit, and eat more fish, fruits, and vegetables. Eight weeks later and slimmer by 7 pounds, Ryan was shocked to discover that she was pregnant. "I was literally shaking when I saw the pregnancy test," she says. "My husband made me buy a different brand to verify it."

Ryan can't know whether to thank coincidence or her lifestyle changes for 9-month-old Brendan. But a growing body of evidence suggests that controllable health habits (and not just a delay in child bearing) may be a reason 1 in 8 couples can't conceive. Success depends on the delicately timed release of four reproductive hormones, and all sorts of factors–too little iron in the blood, too much or too little body fat, too much exercise–can throw the sequence out of whack.

"We're finding that everything matters–and moderation in terms of stress, body weight, diet, and physical activity is what's important," says Joel Evans, assistant clinical professor of obstetrics, gynecology, and women's health at the Albert Einstein College of Medicine and author of The Whole Pregnancy Handbook.

No one is talking about magic bullets. Some women will do everything right and still get the maddening diagnosis of "unexplained infertility." But institutions as well regarded as Duke University and Beth Israel Medical Center in New York are so convinced of the possibilities that they've recently opened "holistic fertility care" centers that offer women trying to conceive acupuncture, nutrition counseling, and relaxation classes. A growing number of IVF clinics now host on-site yoga classes. At the very least, making healthful changes in the hope of improving your odds of a baby is bound to pay off in other ways.

Get ready. Sometimes, the body's refusal to get pregnant can be a sign of its wisdom, says Tracy Gaudet, an obstetrician-gynecologist and executive director of Duke Integrative Medicine. Being overweight, for instance, puts a woman at risk of such pregnancy complications as high blood pressure, diabetes, and an abnormally large baby. So it may be no accident that excess estrogen produced by body fat interferes with ovulation. The body also may be saying "whoa" when a woman carries too little fat to sustain a growing baby: In underweight women, the pituitary gland releases less of the ovulation hormones FSH and LH.

Research from Harvard Medical School suggests that being at either end of the weight spectrum accounts for nearly 40 percent of failures to ovulate. Gaudet advises aiming for a body fat percentage in the range of 20 to 25 percent and a body mass index–a measure relating weight to height–of 20 to 25. That would equal about 117 to 145 pounds for someone 5 feet, 4 inches tall.

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