On The Cutting Edge

Father’s Day is just around the corner, and although you may still be on your fertility journey, it is an opportunity to celebrate the father-to-be in your life. Remember why you partnered with him to build a life together. Find the activity or relaxation technique that gives him the most joy, and create a time to do that with him.

Our next issue will feature a segment by a fertility psychologist on keeping your relationship healthy during your fertility treatment. We will also highlight additional insurance updates. We will have an article on the predictors of fertility success. Our patient story will feature a couple who has struggled with weight on their fertility journey. We will also feature the latest information on the benefits of vitamin D and DHEA as supplements to your fertility treatment.

As always, we are eager for your feedback. Please use our Facebook page or email contact to make suggestions and let us know how we are doing.

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Having Sex

By : Jennifer Agard, M.D.

“Daily intercourse has been shown to decrease the amount of quality of his sperm”

I remember watching All My Children as a young girl in my great-grandmother’s house. It was a small black and white television, but on it was a couple trying to get pregnant. After having sex, the woman spent the rest of the episode lying on a bed with her hips elevated on a pillow. When did sex get so complicated?

Trying to do the right thing can make couples go crazy with all the advice. Have you tried standing on your head afterwards? Raising your pelvis? We’ve all heard it, and much more.

Here is a simple guide on the do’s and dont’s of Timed Intercourse, so that you can calm your mind. We have highlighted the things that matter so that you can let all the other suggestions wash away.

1 . Should we have sex every day?

No. Men make sperm every day, but having intercourse daily has been shown to decrease the amount and quality of his sperm. In addition, sperm survive for up to 72 hours inside a woman’s body. Plan to have intercourse during your peak fertility window every other day.

2. When should we have sex?

Your peak fertility window is prior to and during ovulation. In a classic 28-day cycle, a woman ovulates on cycle day 14. The exact day that you ovulate can vary from month to month, and this is important to know. However, without this prior information, start having intercourse on cycle day 10, and continue every other day until ovulation and for one session of intercourse after ovulation. For example, if you ovulate on cycle day #15,
begin intercourse on day 10 and continue on day 12, 14, and 16.

3. How should I detect when I ovulate?

Ovulation predictor kits are the best way to detect when you actually ovulate in real time. Basal body temperature charting also informs you of ovulation, but your temperature rises after ovulation has already occurred. Therefore, it is difficult to use to plan intercourse in a given cycle. Luteal phase (or Cycle day 21) progesterone blood levels lets you know whether you ovulated or not, however, it does not tell you when you ovulated.

For women that have a typical 28-35 day cycle, start using ovulation predictor kits to test on cycle day 10 and continue until you get a positive result.

4. Are there certain positions that improve the sperm’s ability to find the egg?

No. There are no positions that improve pregnancy rates and there are also no positions which predict the gender of the baby. Further, there are no successful ways of processing sperm that improve the ability to detect the gender of the baby.

5. How long should we have sex before getting help?

According to the American Society for Reproductive Medicine, if a woman is less than 35 years old, couples can try for a year, if no complicating factors are known. Complicating factors include low sperm count, blocked fallopian tubes, fibroids, irregular menstrual cycles and known family history of early maternal menopause. If a woman is 35 or older, the couple can try for 6 months before seeking help with a Reproductive Endocrinologist. For a woman 40 years of age or older, it is appropriate to immediately seek help from a reproductive endocrinologist.

Now you’re ready! One of the most important things to remember is to keep this stress free and fun, which is not easy to do. Remember that there are many benefits to refreshing and maintaining a good relationship with your partner. And always try to remember why you wanted to start a family with your partner.

 

ABOUT THE AUTHOR

JenniferJennifer Agard, MD, Reproductive Endocrinology and Infertility Specialist. Dr. Agard completed her medical training at UCLA, Saint Barnabas Medical Cen-ter, and Eastern Virginia Medical Center. Her special interests are in polycystic ovarian syndrome, thyroid disease, therapeutic reproductive surgery, and di-minished ovarian reserve. Dr. Agard is committed to the model of delivering individualized patient-centric care. ??er greatest reward is being able to help create the family and life plan that is unique for each of us.

Let’s Get Started

By: Danielle E. Lane, M.D.

LFM_Lets_Get_StartedMother’s Day is one of the most challenging holidays for our patients. Every brunch, card, or bouquet of flowers is aimed at the idea of motherhood and the joy of being a mother. Instead of focusing on the sadness of not yet being a mother, try to devote some energy to the joy of being you! Take some time to think about your physical, emotional and spiritual health and find ways to support each element.

Fertility treatment can make you forget about your physical self-care. Daily exercise is still an important element of your health. Exercising as little as 15-20 minutes per day can reduce your stress. In addition, a healthy diet is a good balance to your exercise regimen. Consider walking, yoga, swimming and bicycling.

Pamper thyself! Taking care of yourself emotionally is critical as you travel through your fertility journey. Ensure that you are surrounding yourself with positive relationships. Spend time with friends and family who are warm, caring and respectful of your needs around your fertility issues. Devote some special time to your partner! Make sure that you are giving your relationship the attention that it needs away from the fertility treatments.
Partake in activities that make you happy such as a spa day, a bubble bath or a massage.

Everyone’s spiritual beliefs are different. Consider whether you find comfort in your religion or in meditation. Once you find the spiritual resources you find comfort in and set aside 10 to 15 minutes each day to relax, unwind, meditate, and imagine positive things in your life.

Discovering ways to support yourself physically, emotionally and spiritually can be energizing and healing. Take one or two actions in each of these areas and focus on being good to yourself!
ABOUT THE AUTHOR

Danielle E Lane, MD, Reproductive Endocrinology and Infertility specialist. Dr. Lane attended McGill University before completing her medical training at the University of Pittsburgh school of medicine, her residency at Yale-New Haven Hospital and her fellowship at the University of California, San Francisco. She opened the Center for Reproductive Health at Kaiser Permanente in Napa-Sola-no in 2005. In 2009 she founded Lane Fertility Institute. The Institute has grown to a four physician, multi location practice with a state of the art embryology laboratory. She is committed to providing education for women about preservation of their fertility and developing lower cost models to improve access to care.

Let’s Get Started

By: Danielle E. Lane, M.D.

Remembering your relationship as a part of your fertility journey is very important. After all, having a baby is supposed to be an exciting part of your life as a couple, but with fertility challenges, this can be a trying time.

In a recent study conducted by HealthyWomen, nearly 25% of women reported that infertility had a negative impact on their relationships.   The survey also found that, one-third of women felt that their infertility challenges left their relationship stronger. Most women stated that their partners were very supportive during their fertility treatment and the majority of women were still with their partner after completing treatment. In cases where a couple separated after fertility treatment, most women indicated that the reason for separation was unrelated to the fertility treatment.

There are many ways to protect your relationship if you are facing fertility challenges. First, it is critical to avoid blame. Reassure your partner that you are a team in this process. Remember why you love your partner and why you want to have a child together. Discuss your frustration and anger. By approaching your journey as a team, you are able to celebrate and cope together.

Remember to keep your relationship healthy. Focus on yourselves sometimes and not soley the thought of having a baby. Enjoy dates that do not allow conversation about fertility. Separate having sex from getting pregnant. Insemination cycles may be a relief to couples who have struggled to maintain a challenging schedule of intercourse in the name of “optimizing pregnancy”.   This also means having a conversation about how far you will go in the fertility process. It is easy to exhaust your resources – financially and emotionally. Setting/Establishing a limit that feels comfortable for both partners is important in protecting what you have. Turning to friends or fertility groups who can discuss their experience may be helpful in providing some guidelines.

Stay open to seeking outside help. Patients are often times uncomfortable sharing their fertility experience with anyone.   Many patients are offended at the idea of talking with a therapist or fertility group. They work hard to keep information from their friends, families and work colleagues. Certainly this is one approach, but in reality, it is very difficult to maintain this charade. Missed work, family gatherings and social events can become difficult to explain. Privacy is indeed important and it is good to understand your needs as a couple, however, it is often a tremendous advantage to benefit from the experience of others.

In the end, no matter what choices you make, it is important not to lose the wonderful partner that you entered this journey with!
ABOUT THE AUTHOR

Danielle E Lane, MD, Reproductive Endocrinology and Infertility specialist. Dr. Lane attended McGill University before completing her medical training at the University of Pittsburgh school of medicine, her residency at Yale-New Haven Hospital and her fellowship at the University of California, San Francisco. She opened the Center for Reproductive Health at Kaiser Permanente in Napa-Sola-no in 2005. In 2009 she founded Lane Fertility Institute. The Institute has grown to a four physician, multi location practice with a state of the art embryology laboratory. She is committed to providing education for women about preservation of their fertility and developing lower cost models to improve access to care.