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7. LIFESTYLE AND ENVIRONMENT

7.1 Did either take any particular vitamins or minerals (e.g., extra zinc; extra vitamin C; l_arginine)? In what dosages? [certain vitamins and minerals apparently can help enhance fertility in both men and women]

7.2 Did either avoid, or cut down on, alcohol? tobacco? other drugs? [recommended to enhance fertility]

7.3 Did either avoid, or cut down on, caffeine? [recommended by some sources to enhance fertility]

7.4 Did either follow any particular fertility-related dietary guidelines? If so, what? [too many to summarize here!]

7.5 Did either make use of any fertility-related herbs or herbal treatments, internally or externally? What were they? [too many to summarize here!]

7.6 Did either exercise moderately? Strenuously? What exercise? [moderate exercise is good; strenuous exercise may cause decreased fertility in women; little data on fertility in men, except for heat-effect on testicles as noted below]

7.7 Did either or both have a normal body-fat ratio (around 20-28 percent?) [too-low or too-high body fat may cause decreased fertility in women; unknown effects on men]

7.8 Has either ever had any STDs (sexually-transmitted diseases)? How long ago, and what STD? Are you aware of any lingering effects (e.g., scar tissue)? [certain STDs are known to decrease or even eliminate fertility]

7.9 Did she have an abortion(s) prior to attempting to conceive? [there is little evidence to suggest this reduces fertility, under ordinary circumstances]

7.10 Was undue stress an element in her life? [some evidence exists that unusually-high stress may interfere with or delay ovulation; effects less clear for male fertility; NEVER say "just relax" to anyone trying to conceive!]

7.11 Did she try taking Robitussin (guaifenesin) cough syrup? [believed to help by thinning the cervical fluid]

7.12 Did she use any douches at or near the times of (attempted) conception? What was used as a douche? [can alter pH or other chemical environment in the vagina and/or uterus; generally not recommended]

7.13 Does she have a retrodisplaced or "tipped" uterus? [may possibly make conception more difficult; intercourse in rear-entry position may help]

7.14 What kind of underwear did he usually wear? (boxers / briefs / bikinis / none) Did he switch to a different type before conception? How long before? [sperm count and quality is known to be inhibited by high temperatures in testicles, associated with wearing tight underwear; the single most-common fertility recommendation for men is "wear boxers, not briefs"]

7.15 Did he often wear other tight clothing around the genitals (e.g., Levis, compression shorts for exercise)? [as with tight underwear, this is known to inhibit sperm count and quality]

7.16 Did he often take hot baths / hot tubs / saunas? [advice for men is to avoid, or limit duration to a few minutes, in order to maintain sperm count and quality; effects on women's fertility are uncertain, but probably less than effects on men]

7.17 Does his occupation require him to sit in one position for long periods? [can also cause higher-than-normal testicle heat]

7.18 Did he avoid excessive heat at night (e.g., sleep naked, avoid electric blankets)? [can also cause higher-than-normal testicle heat]

7.19 Did he often take lengthy bicycle rides? [thought to decrease fertility, by heat on testicles and pressure in genital area from bike seat]

7.20 Did he try "artificially" cooling his testicles? How long? [might help to counteract effects of heat on sperm count and quality, but only over a 70-80 day period; cooling the testicles with an icepack is probably a little extreme]

7.21 Did he often eat non-organically-grown bananas? [suspected by some of bearing pesticides that could reduce male fertility]

7.1 Did either take any particular vitamins or minerals (e.g., extra zinc; extra vitamin C; l_arginine)? In what dosages?

RAH - The role of vitamins and vitamin-supplements is "a book in itself", as Toni Weschler comments. In this section, I'm not going to attempt to summarize either the published literature or the Internet material included below. Instead, I would call your attention to the following two items: (1) For a brief summary of vitamins' effects on fertility, see Toni Weschler, pp. 156-160, and p. 182; (2) for an excellent book-length treatment of the subject, see Marilyn Shannon's book _Fertility, Cycles, and Nutrition_. The subsections below are meant to suggest possibilities, and to illustrate what worked for particular individuals. (I have arranged them more or less with couple recommendations first, female-only recommendations second, and male-only recommendations third.)

Above all, I would recommend consulting a nutritionist before getting into some of the more "exotic" vitamin regimens. - RAH

Her = A good multivitamin and mineral, but with beta carotene replacing the retinol (vitamin A oil). Him = no supplements.

I was having luteal phase problems and I took vitamin B complex, 100 mg. every day. I also took folic acid.

I [female] just took a one-a-day multi-vitamin which included folic acid. I didn't feel comfortable taking more than 100% of the required vitamins.

I [female] have been on folic acid for 8 weeks now. My doctor told me that it is good for the mother to be on it before she gets pregnant. Is it okay that I have been on it for such a long time? Should I go off of it for a while, or just stay on it?

It is recommended that all women of childbearing age take folic acid for the duration of their childbearing years, just in case they get pregnant. In any case, once you get pregnant, your prenatal vitamins will probably contain folic acid, so you will take that for months. You should stay on it.

I hear it's really important to have a diet high in folic acid, and it helps to start this before getting pregnant. I started prenatal vitamins in June for this baby- didn't start on first one until about 6 weeks pregnant.

I have a sister in law that has been trying to concieve for over 3 years. Just recently she has been looking in to natural supplements and vitamins instead of such medicated methods. I tend to believe that the body only does the best it can with what it has to work with. If your needing something that it's not getting that could be the answer. Often it's much less expensive too. Some suggested reading on infertility and natural supplements can be found in a book called "The prescription for nutritional healing" by James F. Balch, MD.

Some Food for thought! Good Luck, Keep trying!

Can any one tell me how long this should be done - I mean taking folic =acid 4mg a day ? Thanx.

Every day from 4 weeks *before* conception till 8 weeks after.

If you are interested, the following is a list of herbs and vitamins thought to help the sperm count.

My husband had a bilateral varicocelectomy last June. A couple of months later, I started him on a regimen of vitamins and herbs. His pre-surgery count was 1 mil per cc, 2 ccs, 30% motility, and 30% morphology. In December his count was 1.4 mil per cc, 2 ccs, 60% motility, and 97% morphology. We did our first IUI last month. At that point, his count was 6.4 mil per cc, 4 ccs, 60% motility (they didn't mention the morphology). I am not sure whether the surgery or the vitamins or both helped, but something did.

The vitamins and herbs he takes are: multi (without iron but with zinc), 1 mg C, 1000 mg l_arginine, 200 IU E, Bee Pollen and Siberian Ginseng in 500 mg pills, 100 mcg selenium, high potency B-complex, and 250 mg l_carnitine. His multi vitamins have: 10000IU beta carotene, 400 IU D, 150 mg C, 100 IU E, 25 mg B1, 25 mg B2, 25 mg B6, 100 mcg B12, 100 mcg niacinamide, 50 mg pantothenic acid, 300 mcg biotin, 400 mcg folic acid, 25 mg PABA, 25 mg choline bitartate, 25 mg inositol, 25 mg calcium, 7.2 mg magnesium, 5 mg potassium, and 15 mg zinc.

So now the question I have is, do boxers in some magic way promote motility as well as count? Any clues on how, if possible, to improve motility.

Our doctor has recommended the following recipe for improved motility (taken daily):

500 mg Vitamin C 400 IU Vitamin E 200 micrograms Organic Selenium

Can't say if it works yet. We're going for our first GIFT/IVF cycle in June. Been doing the boxer thing and the above mix for 2 months now, hoping it'll help out. Problem is with my count [between 1.0 and 1.8 million]... just barely enough to work with after sperm wash.

Anyone know of any vitamin or nutritional supplements to improve the quality of sperm? I understand that unless they are perfectly round shaped, they cannot penetrate the egg to fertilize. Hopefully, there are guys out there who have been to a urologist for this problem. Please offer whatever information you can on the subject. Thanks!

My urologist indicated that there is some evidence building that the ingestion of supplemental anti-oxidants help in the production of healthy sperm cells. The dosage that I've been told are as follows: 1000 mg of Vit C, 800-1000 IUs of Vit E with some trace amounts of selenium, and 25,000 IU of Vit A. I substituted beta carotine for the Vit A, since the beta carotine is converted by the body into the the Vit A it needs and cannot store it as it can with Vit A. Not that 25,000 IU of Vit A is a tremendous dosage but why ask for trouble.

Try to take the amounts spread through out the day, like breakfast, lunch, and your final meal of the day. Always take them with food since the food is the carrier for for the absorbtion of the vitamins.

Something else I came across is an amino acid L_arginine. The literature stated that when severeal grams per day were taken by a male group with "low" fertility they recorded a 80% improvement in the sperm. What this means I don't exactely know. However, since it's an amino acid, a basic building block for protein, you cannot injure yourself by taking it. I take about 3000 mg a day and the last analysis my urologist conducted showed a tremendous improvement in count and morphology. Not conclusive proof, since I also had a varicocelectomy in June of 95 but the Dr. says that I should keep on doing what I'm doing.

I also started working out in Sept of 95, if that has anything to do with it and do not wear underwear when at home (I wear a robe) or in bed.

Some additional facts about L_arginine: the body usually synthesizes L_arginine, ~80% of semen is composed of L_argine, 1500 mg a day of L_arginine is considered safe, body builders take L_arginine as a detoxifying and muscle building agent.

L_arginine also is working for us - counts up from 20 - 60 million to 113 million!! My husband takes about 2,000 a day now (he started in June) and took 4,000 the first two months. There was not any other changes to his diet and in fact we had been warned by a number of people that his vasectomy reversal would stop "working" at about 1 1/2 yrs. That was in May and that's when he had the 113 million count.

I, needless, to say thing the stuff is grand!

You can get L_arginine and other free-form amino acids in any health food store, pharmacy, or nutrition store. Weight lifters ingest it for muscle tone and repair. The literature I've read says that 1500 mg a day is safe however the best results have been recorded with 4000 mg or so a day. I take 2000 to 3000 mg a day and it seems to have been working great. In matter of fact I'm stepping up to about 4000 mg a day as we speak. Remember to take it several times a day and always on an empty stomach, e.g. approximately two hours after meals and an hour or so before meals. It's like eating protein so I should not make you feel any discomfort and unless you start taking an outrageous number of milligrams a day ( say greather than 10 grams a day!) you should be safe. You can take it the moment you wake up, in between breakfast and lunch, after lunch, after dinner, and before you retire for the evening. Remember to take in plenty of water every day and make sure you take the other supplements such as vitamins and anti-oxidents WITH meals.

L_arginine can be found in most health food/ nutrition stores. Ask where the amino-acids are displayed. As for the the dose, I'm still working on that.

My husband is now using L_arginine. He started on doses of 1000 mg 4 times a day for 3 months and now takes about 2000 mg. per day. His count went from 20 -65 million to 113 and his motility increased as well. (I don't have the figures in front of me, but it was about 15% increase). He also has always taken multi-mineral pills daily and Vit. C.

P.S. No we haven't gotten pregnant yet.

My husband is currently taking L_arginine 1500 mg day and antioxidants(C,E, beta carotene and selenium) 2x/day. He has low motility, poor morphology, etc, etc. We are doing this while we wait for my new insurance to kick in and move on to pergonal/IUI. Hopefully we won't have to use donor this time!!

My question to the group is, and I've asked before...has anyone heard anything about Co-Enzyme Q-10? Supposedly it is supposed to be effective in male infertility...altho I've only read a small blurb on the subject.

I just read last night that a study done on men who had a [problem with sperm agglutination, or] clumping problem and were given Vitamin C 1000 mg with two other vitamins. Samples were dramatically improved. This is from the oft touted Taking Charge of Your Fertility, my oft chosen browsing matter of choice :-)

I've heard that there are vitamin regimens that help men. My husband takes 1000 mg C, 50 mg zinc, a multi and 1 ginseng pill. It certainly couldn't hurt.

can anyone tell me a common sense way for me to improve my sperm count? Although I'm 32 y.o., I really don't know what to do, stop drinking coffee, wear boxers, more or less sex, etc.

My DH (dear husband's) count, motility and morphology increased when he started on a vitamin regimin that included a Centrum, 1000 mg vitamin C, 1000 mcg vitamin b12 and 5000 IU vitamin A. We have no proof that's what increased his count (from 20 mill to 68 mill) but it's the only change my DH had made.

I'm interested in the "vitamin therapy" that you tried. My husband is taking a multivitamin daily plus another 500 mg vit c and we've even tried bee pollen -- all with some success-- but no pregnancy. My husband had a varicocele repaired last year with some improvement in his numbers. We're unsure how much can be attributed to the vit. or the surgery.

Here are the exact vitamins, mineral, etc. and dosages that I've taken. Keep in mind that the fact my wife became pregnant may have been a fluke. Also, I have made special efforts for ...arrr ah... temperature control. Including using boxer shorts and not taking hot showers, baths. Also, I did just about everthing else I could think of to keep cool. This was on the advice of another man who described great success with simular techniques.

a. Vitamin C 1000 mg time release

b. Anti-oxidant multi:
Beta Carotene 10000 IU
Vitamin C 250 mg
Vitamin E 200 IU

c. Zinc 50 mg d. Selenium 50 mg

e. Ginseng & Pollen
Siberian Ginseng 250 mg
Bee Pollen 250 mg

f. B50-Complex 50 mg time release

g. L_arginine 2000 mg

h. L_carnitine 1000 mg

Note that I phased in the supplements over about two months in the order that they are listed. This was simply because it took me about two months to find out about all of them.

For me the biggest gains have come from L_arginine (2000-3000 mg per day). I recently started taking zinc (50-100 mg per day) copper (2-4 mg per day) and selenium (50-100mcg per day). The L_arginine increases [sperm] count tremendously in some people but not all. The zinc/copper and selenium work together to help the prostate. The theory here is that if the semen volume quantity and quality goes up so does the count, a compounded count effect.

Of course the men should be on anti-oxidents, (vitimins A,C, and E). My next quest is taking me into the world of herbs. Bee pollen has come up but I cannot find the direct connection to fertility. However bee pollen is a rich source of protien (pound per pound it's richer in protien than beef!) and it is very rich in the B-complex group. Consequently it cannot hurt.

My husband is currently taking L_arginine 1500 mg day and antioxidants(C,E, beta carotene and selenium) 2x/day. He has low motility, poor morphology, etc, etc. We are doing this while we wait for my new insurance to kick in and move on to pergonal/IUI. Hopefully we won't have to use donor this time!!

My husbands low sperm count was one of the things we had to deal with when trying to get pregnant. My husband was told to take Baking Soda to decrease the acidity. He took the amount recommended on the box for indigestion twice a day. It worked. We were finally able to get pregnant. We actually used this with our first also 3 years ago, but his sperm count was a little higher to start with then than it was this time.

7.2 Did either avoid, or cut down on, alcohol? tobacco? other drugs?

RAH - Tobacco: I hope it goes without saying that tobacco is not good for anyone's health in general, specifically including one's reproductive health. If you use tobacco, and you're having trouble conceiving, quit the habit!

Alcohol: Like tobacco, alcohol is known to lower sperm count and/or quality in men; the effects of moderate alcohol consumption on women's fertility is less certain, but certainly drinking to excess is not going to help. The dangers of drinking on fetal health are considerable and well-documented; therefore, any woman contemplating pregnancy ought to limit alcohol intake, if not abstain altogether.

Medically-Indicated Drugs: There are too many to list here! Your best move, if you're unsure about whether a particular medication will affect fertility, is to consult the printed material accompanying the drug; many drugs' effects on fertility are also listed in standard reference works such as the _Physicians' Desk Reference_. Two in particular deserve comment: Antihistamines in women, which can dry up cervical [fluid]; and some ulcer medications in men, which can lower sperm counts.

Recreational Drugs: As with tobacco, I hope it goes without saying that most of these substances should be avoided altogether by both partners when trying to conceive. Even marijuana, which has the reputation of being a "softer" drug, has a demonstrated negative fertility effects in both men and women. - RAH

A very interesting research article appeared in Human Reproduction 10:3213-3217 Dec. 1995.

A group in Toronto examined the effect of smoking on the maturations of human eggs. They looked at active smokers, passive smokers, light smokers and heavy smokers, as well as nonsmokers. Smokers had fewer numbers of oocytes retrieved during in vitro fertilization (IVF).

In addition, eggs from smokers had more chromosome abnormalities (diploid eggs - they should be haploid). The number of chromosomal abnormal eggs correlated with the number of cigarettes smoked. In addition, smokers produced more embryos that were abnormal (triploid embryos). Interestingly, smokers also had more tubal disease.

During the maturation of the egg, the egg must divide in order to reduce the amount of DNA by one half (the sperm will contribute DNA that will bring it to the normal level.) It appears that some factor in smoking inhibits this division of the egg (polar body extrusion) and so the egg has two copies of each chromosome. When it gets fertilized, it will have three copies of each chromosome (triploidy) and it will fail to produce a viable pregnancy. The authors mention that smoking may also be responsible for increases in ectopic pregnancy.

If you wish to further investigate this topic, check out:

Stillman, 1986: epidemilogical study that shows a strong association between smoking and decreased fertility.

Zenzes 1995: Smoking effects time to conception.

Walsh, 1994: Smoking effects on pregnancy loss.

Midgette and Baron, 1990: Smoking effects on reducing age of menopause. In addition, there is good evidence for smoking affecting male fertility.

Hard to say how relevant this is, but neither of us smoke or drink alcohol at all, and we've conceived within 3 months each [of three] times we tried.

Both - no tobacco ever Her - no more than two beers a day, once a week; Him - two homemade beers every day

Neither of us use tobacco, and she uses alchohol rarely, and he not at all.

P.S. I would be interested to hear about any scientific study linking alcohol and infertility. I always thought people abstained out of fear of being pregnant and hurting the fetus. (Which ain't quite true. A glass of wine or a single beer once in a while in the first weeks of pregnancy can't hurt - nor can it hurt at the very end.) Someone fill me in?

Our RE said that there was no real evidence or studies that demonstrated that moderate use of alcohol was bad, but he recommended that we drink no more than 4 drinks a week (beer or wine) and no more than 2 drinks on any given day. As for caffeine, he said what you've all said--under 3 cups a day is probably ok. We drink our coffee half-decaf and no more than 2 cups a day.

By the way, the alcohol recommendations were for both my husband and me, not just me.

what affect does marijuana have on a man's fertility? Is it primarily on sperm count, motility, or morphology. Until last week I was a heavy user (5x/week). Since these results, I've completely stopped.

I'd say there's a good bet that this where your problem lies. I book I recently read would advise you to quit (which you have) and use birth control for 3 to 4 months to produce healthy sperm and not risk impregnating your wife with a stoned sperm (sorry, couldn't stop myself :) ) risking miscarriage or birth defects. I wouldn't even bother with the urologist until you find out if this fix will do the trick. Retest in 3-4 months. A very honorable decision you made to quit for this important reason!! Uh, if you wife smokes, it would have consequences for her as well (I'm sure you knew that!).

My understanding of marijuana use on sperm quality is that it can affect it, but that in approx. 3 months the effects are worn off, and they should be back to normal. It takes about 3 months for the sperm to recycle themselves.

I think it is probably good advice to abstain for 3-4 months and retest.

I hope this helps. I have been told that marijuana affects a man's fertility too and I married a man who spent the years between 18 and 30 stoned. He's 41 now and when we could not get pg, I suspected he might have a problem due to his use of marijuana. He had himself tested and turns out that he's fine, good counts, volume, morphology and motility. I assume whatever effects the drug had have worn off, but we still haven't gotten pg yet....

7.3 Did either avoid, or cut down on, caffeine?

RAH - The effects of caffeine on fertility are less clear than those for other pharmacologically-active substances (as the first item below demonstrates). On the whole, it seems wise to rcomend cutting down on, if not avoiding altogether, caffeine. - RAH

Does anyone know of a relationship between excessive caffeine intake and sperm parameters - motility, morphology, etc?

I asked this a few months ago and there were two basic answers. Yes and no. Some people said that caffeine is supposed to help the sperm motility (i.e., it gives them a zing in their step!). Others said that caffeine had negative effects on sperm. I think the jury (medical-wise) is still out on this one.

On the other hand, I have had my hubby cut down on the caffeine. He has not given it up yet, but he's dropped down about two Pepsis a day.

If male then our andrologist has advised that caffeine intake should be restricted as it *may* effect sperm production. It probably has an impact on quantity and quality of sperm produced though he says that what effects sperm production in the male is a grey area, what may effect production in one male may not have any effect in another and there is no hard and fast rule - but more likely than not that coffee intake not good news.

As to the female :- ... a study/research [shows] caffeine has a detrimental effect on the quality of developing eggs.... For the female I am thinking the time-period after ovulation cannot effect egg quality (as eggs released) but then IF chance of pregnancy exists, i.e. embryo transfer or insemination - whichever your chosen method :) - has taken place, caffeine should be avoided for the possible effect on embryo/fetus development (am not sure how that jives with the early early days of pregnancy - that is before it has attached to female body and would be effected by females caffeine intake).

Half the time with these things I just give up the activity - I find it simpler to avoid coffee then to add it to my (long) list of things to worry about (but then I'm no coffee drinker, depends on your feelings - stressful denial cant be good for either you or a baby !).

Recently read that more than two cups of coffee per day can impact on male infertility. Who really knows, but why take the chance. In regard to female fertility, I read that more than one cup of java a day can reduce your chances of conception by 27%. Can't remember where I read that though. Needless to say, I've given up my morning cup of coffee and I'm drinking herbal tea.

I just pulled a study off a lit search that says the following: They studied 2,500 pregnancies.

Women who drank 3 or more cups of coffee a day (300 mg of caffeine) had a 17% decrease in their chance each month of becoming pregnant. 2 cups a day -- an 8% decrease and 1 cup -- a 2% decrease. The findings held true whether or not the caffeine was consumed as coffee or another source. The authors of the study postulate that caffeine can damage DNA and chromosomes and act as a heart and cirulatory system stimulant. They think it is particularly damaging during the luteal phase because women are less able to clear it from their bodies then.

Also, they think it affects male infertility possibly by interfering with sperm development.

Comments by any doctor regarding caffeine consumption (either pro or con) should be followed with research data. I believe there is some evidence that caffeine may cause problems in female infertility. This may apply to even one cup of coffee. This is based on a study done in vitro with human eggs. Eggs exposed to caffeine did not mature correctly and they also tended to degenerate. The study was done by Cathlene Racowsky at the University of Arizona and was presented as an oral presentation at the annual metting of the American Society for Reproductive Medicine. I have since then found at least one other research paper on the role of caffeine in oocyte maturation. We now need to find out whether this applies to oocytes matured "in vivo", but until then, I'd advise no caffeine.

An article in our national newspaper published details of a Professor's study of the effects of caffeine on sperm. Basically she indicated that caffeine by itself wasn't a problem.

The motility, morphology, counts, normalcy, etc., problems occurred when caffeine was combined with other factors such as stress and alcohol. I don't have the figures and there may be more factors involved which I haven't remembered.

The info I could find indicated that [caffeine] consumption over 300 mg per day [by women] could interfere with fertility and also contribute to low birth weight. I also read a study that suggested fertility could be helped by consuming less than 150 mg per day.

A recent talk given by C. Racowsky at the annual meeting of the American Society for Reproductive Medicine discussed the role of caffeine in the maturation of human eggs. Eggs were matured in a test tube (yes, not in the women) with different levels of caffeine. Even 1/10th the dose of caffeine found in the serum after drinking one cup of coffee impaired the ability of human eggs to mature properly. This may mean that caffeine may disturb the part of the egg involved in the separation of chromosomes. My recommendations would be that until further studies show otherwise, it's best to stay away from caffeine if you are trying to reproduce. Especially if you are subfertile.

l have just started drinking caffine free coffee, well it says 97% caffine free !!!?? Will the other 3% Caffine make much of a difference?

The other 3% won't make any difference at all. From what I've read about caffeine consumption and pregnancy achievement, it's a matter of how much caffeine you take in. I'm assuming you're trying to get pregnant, there are different thoughts on caffeine intake while pregnant.

The JAMA stated that ingesting the equivalent of 3 cups of regular, caffeine-full :) coffee decreases a woman's chances of conceiving by 25%. I asked my doctor, and she said that's about 450 mg of caffeine. Considering how many other things we eat and drink have caffeine, it would be easy to amass that. I used to drink 3 cups of coffee a day, and at least one diet coke. That would put me over the limit. I've since given up the regular coffee (I have one cup of 97% caffeine free, and one diet coke. On a day when I have chocolate (PMS), I skip the diet coke).

Her - no caffeine, ever; Him0 - 2-3 cups of coffee a day

There isn't very much caffeine in chocolate. You'd need to eat a LOT of chocolate to equal the caffeine in one cup of coffee.

7.4 Did either follow any particular fertility-related dietary guidelines? If so, what?

RAH - As with many other aspects of fertility, the books and other publications on proper diet to aid conception would fill an entire bookshelf, if not bookcase! As with the vitamins section above, I wil avoid trying to summarize this material (which can be contradictory), and will instead recommend the same two resources: (1) For a brief overview of diet's effects on fertility, see Toni Weschler, p. 154, and pp. 181-182; (2) for an excellent book-length treatment of the subject, see Marilyn Shannon's book _Fertility, Cycles, and Nutrition_.

The items below are meant to suggest possibilities, and to illustrate what worked for particular individuals. Above all, I would recommend consulting a nutritionist before embarking on any major changes in diet. - RAH

-My husband and I are trying to have a baby and we are curious as to what foods -we should really be eating more of. I know for myself there should be a lot of -folic acid foods (but what exactly are they and how much). Also, what type of -foods should I avoid. - -Should I cut out all alcoholic beverages too?

I recommend the book _Before You Conceive_, by John R. Sussman. M.D., and B. Blake Levitt, ISBN: 0-553-34718-7 (Bantam Books, 1989). It has an entire chapter on "Nutrition: Feeding Your Baby Before You Conceive" as well as lots of other good information on what to do while you're trying to conceive.

I read "What to Eat When You're Expecting" best odds diet, but found it too unworkable.

I've been reading _Women's Bodies, Women's Wisdom_ by Christiane Northrup, MD, which deals with gynecologic and reproductive health. She is completely anti-dairy, and associates the following problems with dairy foods: benign breast conditions, chronic vaginal discharge, acne, menstrual cramps, fibroids, chronic intestinal upset, and increased pain from endometriosis. She also says that consumption of high-fat dairy products has been linked to breast and ovarian cancers. (She advocates something along the lines of a macrobiotic diet, although she's not a hard-liner. She has advice for those who aren't ready to go all the way with that kind of diet.)

: cannot be met better in some other fashion. If you eat meat, then : lose the dairy and carry on. If you don't eat meat, then make sure : you eat lots of green leafy veggies (lettuce, cabbage, broccoli) and : legumes. In fact, lists like these are misleading -- just make sure

Even if you do eat meat, you should still be eating those dark green veggies (broccoli, romaine lettuce rather than iceberg, spinach, kale)---not only good sources of calcium, but also of folic acid, which all of us females in this group should be getting plenty of (although I take a multivitamin, I still try to get as many vitamins, etc., from my food as possible). Also legumes have some folic acid and lots of other good stuff. And you might want to watch the fat content and keep in mind that most commercially produced meat is full of hormones and other nasty stuff.

_Laurel's Kitchen Cookbook_ is a good source of nutritional info for those who want to get away from meat and use less dairy, although it may be getting out of date. Anyone have other suggestions?

I have taken wheat germ oil after reading in some health oriented books that it is good for fertility and it seemed to help me. I was nursing my son and wanted to start ovulation again. After taking wheat germ oil capsules, my period promptly returned although I was nursing the same amount. I also took it before conceiving the baby I am pregnant with now.

I've been taking flax seed oil on the recommendation of my lactation consultant for the same reason. There are other oils out there that would work just as well. The idea is to get more fat in your diet. This is mostly an issue for women that don't have a lot of fat on their bones in the first place.

Hi. I believe that it is essential fatty acids (EFA's) that you should be using, so milkshakes, although high in fat, would not necessarily help. flax seed, oil and wheat germ oil are both high in EFA's, as are raw nuts (almonds are great) and seeds -- sunflower, pumpkin and sesame being the most common.

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Does cholesterol make any difference? We both have unusually low counts for "bad" cholesterol. (I don't know about the "good" kind.) And we're obviously pretty fertile! [conceived in the first month both time]

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I just read in Toni's Weschler's book a sentence that said large consumptions of milk [may possibly] decrease fertility. Has anyone seen or heard of any studies that back this up? I drink about a gallon of milk a week!

Yes. I posted the following last year on "Milk and Metrodin don't mix":

My RE recently recommended avoiding dairy products (because of the galactose) during ovarian stimulation (that is, while on clomid, pergonal, or metrodin). I'm staying off dairy products (taking calcium supplements) during my current IUI cycle. Has anyone else tried this and noticed a difference?

I found a reference:

"Milk may impair fertility in women ...", Science News, 12 March 1994. Abstract: " Researchers have found a correlation between high rates of milk consumption and infertility in women. Dairy goods contain galactose, a sugar apparently toxic to human eggs."

From SCIENCE NEWS 3/12/94 Women who would like but have failed to conceive a child may want to review how big a role dairy products play in their diet, a new study suggest. A team of researchers in the United States and Finland now reports that where per capita milk consumption is highest, women tend to experience the sharpest age-related falloff in fertility. -With the exception of certain northern Europeon populations and their descendants, most adults lose the ability to easily digest lactose, a sugar in milk. Because lactose intolerance discourages high consumption of milk and other dairy goods rich in galactose -a sugar apparently toxic to human eggs- this trait may be beneficial, observe gynecologist Danial W. Cramer of Harvard Medical School and his coworkers. -Five years ago, Cramer linked galactose consumption with increased risk of ovarian cancer. To look for hints that this sugar might also affect fecundity, his team compared published data from 36 countries on on rates of fertility, per capita milk consumption, and hypolactasia -that adult inability to digest lactose. In the Feb. 1 `American Journal of Epidemiology', they now report a correlation between high rates of milk consumption and waning fertility, beginning in women just 20 to 24 years old. -The strength of that association -and the rate of fertiliy decline- grew with each successively older age group studied. In Thailand, for instance -where 98 percent of adults are hypolactasic- average fertility in women 35 to 39 is only 26% lower than peak rates [at age 25 to 29]. By contrast, in Australia and the United Kingdom, where hypolactasia affects only about 5% of adults, average fertility by 35 to 39 is fully 82% below peak rates. -Many factors -including marriage customs, divorce rates, contraception use, and individual wealth- affect fertility, the authors concede. However, notes Cramer, the new analysis does offer "demographic confirmation of what we have observed both experimentally, when you feed a mouse high galactose, and clinically, in women with galactosemia [an inability to metabolize galactose]." Women with this disorder who have high concentrations of the sugar in tissue are infertile, he observes.

This was mentioned in another thread (Milk & Metrodin don't mix). I recently cam across this in a misc-kids FAQ and I am including the article here. I thought it might be of interest to others using fertility drugs. When I saw this I was surprised because I had not read it anywhere else.

MILK and FERTILITY

Cycle irregularities or infertility, early menopause, PMS and recurrent vaginal yeast infections may involve milk consumption, according to recent medical research. Studies have shown that a sugar unique to milk, galactose, is harmful to ovarian function. When lactose, the ordinary milk sugar, is sigested, galactose is one of the products absorbed into the blood. This galactose is harmful to the developing, unfertilized egg. The liver converts this galactose into glucose (blood sugar), but some women do not convert it well. Such women develop early menopause.

One study showed a link between PMS and women who consumed an average of 3.5 "dairy servings" a day, vs. 2 servings a day in women without PMS. The milk's high calcium to magnesium ratio was faulted; magnesium is important in preventing PMS.

In another study, limiting sugar and milk resulted in great improvement in the frequency of vaginal yeast infections.

Marilyn Shannon, author of "Fertility, Cycles and Nutrition" (a book every fertile person should have, IMHO), reports on the above (incl. medical references) and makes specific recommendations for nutritional adjustment in the Nov-Dec issue of CCL Family Foundations. I am not going to type the whole article here...but if you are experiencing the above problems you can cut down (not out) on milk (not yogurt) for a few months to see what happens.

Subscriptions to Family Foundations (which is 75% fertility-infertility articles) are $15 a year. It's a non-profit org for natural family planning. Address: Couple to Couple League PO Box 111184 Cincinnati OH 45211

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I also read the Science News article, however I got the impression that the damage to human eggs from galactose was cumulative - if you had been drinking milk all your life it wasn't going to do much good to stop for little while. On the other hand I don't see how it could hurt. I tried reducing dairy products for a couple of cycles - it didn't do any good, but that doesn't mean anything. Did your doctor know of any other studies other than the one mentioned in the Science News article? Is the damage to fertility in women with galactosemia (excess galactose due to inability to process it) reversible with treatment, or permanent?

An anti-cheese posting: I have a simple question that I don't seem to get an answer to anywhere: Is there anyone out there who has heard about blue cheese or Gorgonzola cheese or the kind interferring with the fertility? Such as misscarriages or problems with getting pregnant? Thanks in advance for any answers, references or bibliographics.

The advice given by the UK Cheif Medical Officer concerning this is to avoid all soft cheese products as the process by which they are made does not involve pasturising the milk, and therefore carries the bacteria called Lysteria which can cause miscarriage. The general advice is to also avoid eating packaged pre-cooked foods, such as pate, quiches etc. as these are also vulnerable to bacteria.

7.5 Did either make use of any fertility-related herbs or herbal treatments, internally or externally? What were they?

RAH - Once again, we have a bewildering array of options under this category, and no easy way to sum them up. The best piece of advice I can give is: Find a competent herbal practitioner with whom you feel comfortable, and follow her/his recommendations for administering herbal treatments in aiding conception.

The items below are meant to suggest possibilities, and to illustrate what worked for particular individuals. I have also included in this section inforamtion about other alternative or non-Western remdies mentioned on the newsgroups, including acupuncture. - RAH

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Check out Rosemary Gladstar's book "Herbal Healing for Women". I'm glad someone's talking about herbs instead of all those nasty synthetic hormones (of which some can cause ovarian cancer).

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The best herbal book, at least in my humble opinion, is The New Holistic Herbal by David Hoffman. It really is a wonderful book. Of course, then you have the Herbal books by Mrs. Greives(I need to check on the name, but I know that they are sold in volumes I and II. Also, Chinese Medicine has many wonderful remedies for fertility..like cleansing the liver and kidneys. There is just so much to read, that every book has something valuble.

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My mother is a Master Herbologist. According to her, the best things you could be doing to help with "female problems" is to exercise, no caffeine, as much red rasberry leaf tea as you can handle (iced or hot, it matters not) Black Current, Strawberry leaves, Dong Quai, Uva Ursi, Peppermint, Black Cohosh, ginger, ginseng, a very small amount of Goldenseal, and rubbing castor oil on your belly once a night before bedtime to help cirrculation of blood to that area.

She also suggests that you call your RE and ask what viatmins you should be taking. The right amounts of follic acid are most important. Your RE should already have you on vitamins. However, sometimes you're best not to take prenatals unless prescribed. They sometimes lack all the nutrients you should be taking. Fertility patients need more to help the process along.

She also suggested that you contact a local herbologist, or visit your local chinese herb store. Sometimes people respond better to the chinese herbs than ones more commonly used in North America. Most chinese herb stores offer free classes to teach you how to use the herbs and most of the people who work there are very knowledgeable.

She advises to NEVER TAKE HERBS WITHOUT BEING MUSCLE CHECKED ON THEM FIRST. If the herbal approach is what you're going for, your body will tell the practitioner what it needs. This might sound funny and pretty far fetched, but so are the percentages the Dr.'s office gives you for your chances of conception! : )

Other herbs that are recommended to enhance fertility include red clover tops, nettle leaves, red raspberry leaves, dong quai root, false unicorn root and vitamin E, however there are PRECAUTIONS with many herbs, so if you plan to use any, please consult an experienced midwife (empirical midwives usually are more knowledgeable of herbs than cnm's), herbalist, or at the very least buy a good herbal that addresses pregnancy (_Wise Woman Herbal for the Childbearing Year_ by Susun S. Weed is great).

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I've read a lot about red clover tea on this ng. Also, dong quai, a chinese herb that is supposed to regularize a woman's menstrual cycle. There is a book: Overcoming Fertility Naturally by Karen Bradstreet that discusses these and other herbs.

I'm trying herbal remedies for a few months before I spend lots of money on infertility treatments. I already know I dont ovulate, so I'm hoping some of this will cause me to start.

Based on what I've read in books and on the newsgroups, I found two pills that I think should probably have the best chance of helping. they are:

FEM - a Woman's Herbal Formula (by Natures Way). Ingredients: Golden Seal root, Blessed Thistle herb, Cayenne, Uva Ursi leaves, Cramp bark, red rasberry leaves, Squaw vine, Ginger root and False Unicorn Root in preservative-free capsles. (cost: $11.50/100 capsules, 6 per day)

Ovary/Uterus-plus (STF Labs, Inc). Ingredients: American Ginseng (SW red), Valerian root, hops, ginger root, juniper berry, slippery elm, rue, kelp, black haw, wild yam, gentian root, calcium AAC, Magnesium AAC, Red raspberry leaves, marshmallow root, calcium ascorbate, whole desiccated bovine ovary, whole desiccated bovine uterus (gee, dont those two sound lovely!), Siberian ginseng, sarsaparilla, queen of the meadow, d-alpha tocopheryl succinate with mixed tocopherols, Iron ACC, Zinc ACC, Thiamine Hydrochloride, Riboflavin, Niacinamide, Pyridoxine Hydrochloride, d-calcium pahtothenate, PABA, Soya Lecithin, palmiate, fish liver oil, yellow jasmine, black haw, high bush cranberry, cyanocobalamin, folic acid, Aloe vera extract, lactose, calcium phosphate, rerric phosphate, potassium chloride, and magnesium phosphate. *ACC = Amino Acid Chelate

Some of the ingredients in the second sound more like a science experiment than herbs and I'm not quite sure why they're in there, but it claims to give you 210% RDA B-1, 190% RDA B-2, 160% RDA B-6 and 80% RDA B-12 for each 2 capsules, it suggests 6 capsules per day (100 capsules for $13.25).

I also drink dong quai/fo-ti tea (marketed as women's liberty tea, I forget the company).

Just started this last weekend, and just bought a BBT, so I'll start charting things, we'll see what happens :)

=I was wondering if anyone has been using chinese herbs to help with infertility. My naturopath prescribed a just about drinkeable tea made from angerlica root and red dates, some fertility pills called Quarto-bi-Quinto and some others called Placenta Compound Restorative Pills. She says they're all to help balance the reproductive hormones and the yin/yang energy in my reproductive organs. I find the tea quite powerful--hard to describe but I feel like my ovaries are alive and energetic--very weird. Any info or experiences with chinese medicine would be gratefully received. Thanks to all for being out there. Maybe we'll all start sprouting babies along with the daffodils.

Check the web page at www.primenet.com/~bci/herb.html. Melissa talks about the herbal treatment she undertook -- she's now pregnant. Also, there's a book by Anne McIntyre called something like The Complete Women's Herbal which has an excellent discussion of herbs and infertility.

I know nothing about "Placenta Compound Restorative Pills" -- Pills are such a Western Medicine "thing". I also know nothing about naturopaths prescribing Traditional Chinese Medicine (TCM). I do know that many TCM prescriptions are REALLY POWERFUL STUFF! I would seriously be afraid to take it from anyone other than someone who had studied it for years.

In our one successful cycle, my wife drank a soup prescribed by an MD (Western Medicine) in Hong Kong who has also extensively studied TCM. The soup contained placenta, red dates, that funny wood like root, Dong Quai, squab, and several other things. We were warned to watch for symptoms like ovarian hyperstimulation and excessively heavy period. If we had those we needed to get to a hospital. Were you warned?

We weren't told that it balanced ying & yang, we were told that it helped hemoglobin levels, increased levels of "pregnancy hormones" (placenta?), and helped the blood flow "better". Yes, my wife's organs felt different -- dramatically -- almost frighteningly.

So, I guess I'm saying yes, TCM works (for some people), but TCM medicine is just as dangerous as Western Medicine. Be careful.

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I am trying to respond to your questions about herbs for fertility. I can only tell you of the herbs I am familiar with for women. I would have to dig out my books to find things for men. However, I do know that some herbs are interchangeable.

CHASTE-TREE BERRY

LICORICE ROOT

RED CLOVER

FALSE UNICORN ROOT

WILD YAM

ANGELICA

DONG QUAI

There are many others. As I look at this list, I am noticing that most of these actually serve as a uterine strengthener. Perhaps the best out of all of these would be the Chaste-tree berry, as it is a known hormone(progestrone specificaly) regulator. It has a nasty smell, and bitter taste, and I have ended up making capsules out of it. Also, another herb that is suggested is Bladderwrack(sp). It is a specific form of Kelp. It is loaded with iodine, and stimulates the thyroid and metabolism. But, as with all things..they need to be used with caution and moderation, unless you are being treated by an herbalist, certified in instruction. ALthough people are quick to jump at using herbs as opposed to other "traditional" forms of therapy, they can be just as dangerous. Somepeople are known to have had alergic reactions to some herbs, but no one that I know personally.

There is a list of herbs that are suggested for women, but are not stated for any one purpose other than there being a general weakness of the sexual organs, which has an obvious effect on the whole body. They are: BLACK COHOSH (not to be used at all during pregnancy, unless at normal onset of labor), BLUE COHOSH (likewise), CHASTETREE BERRY, FALSE UNICORN ROOT, LIFE ROOT, MOTHERWORT, RASPBERRY LEAF, SQUAWVINE.

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Thanks to all who responded to my questions about yams helping with Luteal Phase Defect (LPD). Here are the answers that have been sent to me.

1) Wild yams are indeed high high in progesterone, but usually what are sold in supermarkets as yams are sweet potatoes ... you must go out of your way to find "wild yams". No one said taking yams in the first part of the cycle is harmful, but rather people said it's more helpful to take them in the latter part of your cycle, when your body naturally needs the progesterone.

2) The yams you need are an African vegetable calle "name". They are not at all like our regular store-variety. You can get yam extracts much easier and dosages are on the bottle. Try herbal stores, health food stores, etc. If you really want the veggie, try stores that sell African or Caribbean foods. One person wrote that she ate one cup of the steamed vegetable/day. I tried it and felt really sick the next day so I didn't finish the yam. The active ingredient is called "saponin", which is somewhat toxic so overdosing would not be good. Try a herbal +

vitamin supplement with dehydrated yam extract.

3) A Master Herbologist says "DON'T TAKE THE YAMS!" She says that they produce estrogen. That is exactly what we don't need for LPD. For LPD she says to take Black Cohosh, Uva Ursi, Dong Quai, Ginger, Mint, Sarsparilla, and raspberry herbal tea. Also two litres of water a day. Seems to help build an incredible endometrial lining.

As you can see, conflicting views. Looks like I'm going to have to experiment on my own body.

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I remember seeing on this NG about 6 months ago some information about yams/sweet potatoes. But I can't remember any of the information - can you?

I know they are most helpful in the leutal phase of your cycle to keep progesterone levels up, but which ones are best?

Actually, the yams we buy in the grocery store aren't yams at all -- they're sweet potatoes. The yams that help progesterone levels are actually wild yams. You can get an extract in the health food store, either in cream form that you rub on your skin or in pill form. Ask for wild yam root (well, I guess yam and root are redundant...). It should come with instructions. I know that it's worked for a lot of women. I'm taking wild yam as part of my overall herbal course of treatment, so I can't say how well it would work for me by itself. I do have a friend with PCO who's not trying to get pregnant, and she says her PMS is MUCH better, so it clearly has some benefits.

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Be careful not to overdo it on the wild yam root......

Wild yam contains the main ingredient that is used in some types of birth control pills (disogenin). Some wild yam is good for you, but too much may be bad. I take some myself, but not the high level they recommend for post-menopausal women.

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Be careful when using Wild Yam root. It is a great supplement for any problems relating to you estrogen levels. If you have problems with progesterone levels, STAY AWAY FROM THE WILD YAM! I can't stress this enough. It would be counter productive.

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It is my understanding that the wild yams that contain progesterone are not related to the yams or sweet potatoes that are grown in North America. The ones that have progesterone are from Africa and are only available in extract or capsule form (in the US at least.) The real thing supposedly tastes terrible. The only benefit you'll get from American yams is lots of beta carotene (vit. A.)

Herbal remedies: I was working with an acupuncturist who urged me to take vitamin E supplements. She also had me on some Chinese "women's formula" but I have no idea what was in it.

By the way, to anyone who is looking for non-western medicine solutions to fertility problems, I highly recommend talking to some qualified acupuncturists. I felt that the acupuncturist I worked with helped me tremendously. Although I was also using "western" solutions (Humegon/IUI), I am convinced that they would not have been successful without the acupuncture.

Has anyone tried acupuncture or herbal/chinese tea to help with ovulatory problems? I do not ovulate and have tried several dosages of clomid, with no luck. I talked to a chinese certified accupuncturist. She though herbal tea might help. I'm not pregnant, but it seems to be working. I had my first period (without provera) in two years after taking the tea for a few weeks. I don't know that I ovulated, but something is happening. I'm planning to continue with the tea for now, and postpone my decision on whether or not to try pergonal until I've tried this tea a little longer. I may try the accupuncture, too. It's worth a try, and a lot cheaper than pergonal.

Hi! You bet--acupuncture does work for some of us. I also do not ovulate (often) and had tried three cycles of Clomid. The Clomid didn't cause me to ovulate, in fact, I didn't even get a period. I went two years without getting a period on my own (did Provera from time-to-time, like you).

Then I turned more earnestly to chiropractic and started acupuncture. I am now having cycles on my own--they're irregular, but hey! at least I'm having them without drug assistance! Just last week, my RE was getting impatient for me to get a period, so she gave me a prescription for Provera. I said, no, wait, I just got an acupuncture treatment, and I wanted to give that a few days to work. Well, it did!!

My acupuncturist does not do Chinese herbs himself, but referred me to someone else. I have called her, but have not yet gone. When I asked this herbalist on the phone about infertility, she said in her broken English: "Many babies! Many babies!" :-)

Good luck. Be brave and try the acupuncture. :-)

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i was diagnosed with a normal count and motility, but a very low morphology (which refers to the shape of the sperm). i underwent acupuncture and herbal treatments and the numbers increased incredibly. there was one other factor, i had been on a 6 month regimen of antibiotics for testing positive on a tb test. i'm not sure if this drug had an impact on the sperm or not. either way, the acupuncture appears to have had some impact.

I've been meaning to respond to this thread. I hope I'm not too late! I think the first poster asked about whether herbs have actually been known to work. My acupuncturist/herbal doctor has been treating people in the States for less than a year, and she's helped four women get pregnant. One of them had been doing IUI for a year and was about to go on to IVF but got pregnant within two months of doing the acupucture and herbs. I don't know what her success rate is, because I don't know how many fertility patients she's had, but it sounds like it's very high, at least with women who are under 40. She says it gets harder after that... What I especially like is that she's a trained gynecologist, so she looks at my BBT every week and we discuss how I'm doing.

I understand that acupuncture and herbs work together to make the treatment twice as effective. Also, my acupuncturist changes the herbs I take on a weekly basis, depending what part of the cycle I'm in. I take one tea (a combination of herbs) during my period, then an herbal pill for my follicular (pre-ovulation) phase, then another tea during ovulation, then nothing until I get my period. In three months, I've gone from having an abnormally long pre-ovulation phase and midcycle bleeding and a short luteal phase to having none of the above. In my last cycle, I ovulated on day 15 (a first for me!) and my luteal phase was 12 days. Still a little short, but not as bad as it's been.

I guess what I'm suggesting is that it's a good idea to find someone in your area who is really knowledgeable about Chinese medicine, and have them oversee your treatment. It's especially important to change the combination of herbs you're taking at different points in your cycle. The developing egg needs a different kind of stimulation from an egg that's ready to pop out.

If you do the herbs with no supervision, or with someone who doesn't know much, you're not getting the full benefit. I know, because I tried herbs on my own and they did very little for me.

Also, this is a gradual healing/balancing process, unlike drugs like Clomid and Pergonal. You can't expect to get pregnant immediately. My acupuncturist said it would take two to three months to balance my hormones and then possibly another few months to correct other fertility problems. I started seeing her [three months ago] and only now does she say we're ready to start trying to get pregnant!

As for the taste of the tea -- the first time I took the period tea, I thought it tasted awful! I got through it by holding my breath and glugging it down in one go. But the ovulation tea was better, either because of different ingredients or because I'd gotten used to it. At this point, I kind of even like the taste of the ovulation tea and the period tea isn't bad at all. When I first went to fill the "prescription", I asked the guy at the store about the taste -- he said that a lot of times, your body gets to crave what's in the tea, and that's why it tastes better to you. I don't know if that's the reason or not, but it does get more bearable.

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Does anyone know of any fertility-enhancing herbs or herbal treatments, internally or externally, for men or women? What are they? Men: 1000 mg C, 50 mg Zinc, I ginseng pill, 500-1500 mg L_arginine plus a multi; Women: Vitex Agnus Castus (aka Chasteberry), Dong Quai, False Unicorn Root, B-6, Folic Acid (400 mcg/day to prevent spina bifida). This hasn't worked for us yet, but it doesn't seem to have hurt either.

[These are] daily doses. I use extracts of the Chasteberry and False Unic. Root - @ 10 drops in a little water twice a day. I use more Chasteberry during the luteal phase.

I did not report exactly what Vitex did to the cycle because it is rather complex and easier to see when the subject's endocrine profile is graphed. It is also difficult to explain without resorting to a lot of physiology. Here is my attempt though:

1) LH was elevated in the follicular phase (about 15 mIU/ml). Norm is about 5 mIU/ml.

2) FSH was very high throughout the follicular phase. (These may be a result of the herb's antiestrogenic effect, similar to clomiphene, and may cause the production of more than one follicle. This lady did develop 4 follicles on her natural cycle using this drug.)

3) The patient had a very low LH surge (max only about 20 mIU/ml and you would expect about 100 mIU/ml). THis low surge continued even in the following cycle after she was off of the herb.

This patient acted as though she was on a high dose of clomiphene, except that she had high levels of LH that may increase the risk of miscarriage (reported in Lancet, 1990). The patient also reported symptoms of ovarian hyperstimulation syndrome. This risk should not be undertaken without continuous endocrine evaluations by the physician. At least one death can be attributed to ovarian hyperstimulation syndrome. (And it is *very* uncomfortable!) This does not mean that Vitex caused these symptoms, but until further study, I'd be leary.

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Good luck with trying. I think the only vitamins you should be taking are prenatal, you must be careful of megadoses of vitamins such as A and D, so prenatal gives you everything you need (make sure the brand doesn't contain over 5,000 IU's of A). I don't know about Dong Quai, but thought I had heard or read somewhere that it was not a good thing and may cause problems. Anyone else know? Don't take it 'till you find out!

Dong Quai is supposed to be helpful to regulate your hormones. It is often referred to as "women's ginseng" but is unrelated. It is supposed to tone the uterus and is a highly regarded blood tonic. However it is NOT recommended to take while pregnant. Therefore I take it in the first phase of my cycle and stop once I ovulate.

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I have recently read that Bee Pollen will increase sperm count, but if you have allergies to plants, etc, you could be allergic to the pills. I don't, however, know about any side affects. You might want to do a little more research on the subject. I found a book entitled, "Overcoming Infertility Naturally", by Karen Bradstreet. You might want to check it out. It deals with male and female factors as well as the emotions of infertility.

Bee pollen has been touted as a cure for almost everything. I'd be verrry skeptical about using it as your only form of treatment for any medical problem.

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Bee pollen has come up but I cannot find the direct connection to fertility. However bee pollen is a rich source of protien (pound per pound it's richer in protien than beef!) and it is very rich in the B-complex group. Consequently it cannot hurt.

Except for those who are allergic to it. I don't actually know how much of a pollen allergy my husband might have (he does definitely have other allergies), but, since he's asthmatic, I am inclined to avoid encouraging him to take common allergens. I'd suggest that other people with asthma, like [husband], or hay fever (like me) hold off on the bee pollen.

It probably wouldn't hurt sperm count (whether it helps it or not), but I suspect there are less allergenic ways to get the same nutrients.

Thanks for the interesting post (I hadn't seen all of these before). Is there research on any of these, or is it mostly based on what people report works for them?

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Does anyone know of any fertility-enhancing herbs or herbal treatments, internally or externally, for men or women? What are they?

I don't, really, at least, not where I have heard evidence that they work. The rumor on alt.infertility is that evening primrose oil is supposed to be helpful for women who have a shortage of fertile [cervical fluid]. I don't know that it actually *does* help; on the other hand, I don't know that Robitussin does either. I haven't tried either. What I do know about evening primrose oil (source - _The Honest Herbal_ - which has lots of useful information about the safety and effectiveness of various herbs) is that its active ingredient is cis-gamma-linolenic acid (GLA), a precursor of prostaglandin E1, and that there is some clinical evidence for its effectiveness in treating PMS (among other things).

A review article referenced in the writeup in _The Honest Herbal_ as A. J. Barber: Pharmaceutical Journal 240: 723-725, 1988.

There is a thread going in alt.infertility ... about herbal treatments of male factor, but all I've seen anyone come up with so far is pollen, which has all kinds of health claims made for it, not much evidence for them, and some serious risks for people with allergies. (Since I have a pollen allergy and my husband has asthma, I wouldn't want either of us to touch the stuff, even if it *did* have some sort of use.)

 

7.6 Did either exercise moderately? Strenuously? What exercise?

RAH - For women, the key to exercise is to avoid either extreme: Too much exercise can lead to delay in ovulation in a cycle, or even anovulatory cycles; too little runs all the risks associated with poor physical condition generally. Moderate, regular exercise is best to promote optimum fertility in women.

For men, there is less evidence connecting exercise and fertility; it seems reasonable to conclude that the recommendations for women -- moderate, regular exercise -- would apply to men also. (This, of course, is an important recommendation for overall good health.) The only specific exercise-related caution for men would be to avoid any activity that will cause heat (or any other stress) to the testicles . - RAH

: I cut most if not all exercise out of my program due to : various articles I've read about exercise causing probs. I don't want to : decrease my chance of conceiving by exercising, especially since it's such : a great excuse for being a couch potato!

: I am interested in knowing about exercise decreasing the possibility : of conception. This is the first time that I have ever heard of this. : Can someone give me some good solid information?!

Actually, I've read that it's good for infertile and fertile women alike to undertake *moderate* exercise when planning a pregnancy. Yes, excessive exercise, to the point of cessation of menstruation, will negatively affect fertility. But I think it's misleading to extrapolate from that, to the recommendation to cut out *all* exercise.

I, for one, feel much healthier when I work out three or four or five times a week, and it bothers me to see people (rather blithely, it seems) posting to the effect that we should all stop exercising if we want to get pregnant. First it worries me, then it sends me scurrying to the library to make sure I haven't missed anything, and then it upsets me to have been worried about something I shouldn't have worried about.

It winds up making me feel like when my mother said, just relax and put on some weight. Well, at 5'8" and 150 pounds, I'm not exactly skinny; nevertheless, I worried unnecessarily until I next saw my doctor.

Please, I understand that for some people exercise could be problematic, but it bothers me to see blanket statements against it that--as far as I know--have no basis in medical science.

Both successful pregnancies I had just started going to the gym and working out hard! He was working out at the gym strenuously all three times.

: Anyway, my question does anyone know if doing aerobics : 4 times/week (step and interval training) reduce fertility? :

Both times I got pregnant and carried to term I had been exercising vigorously!! Step aerobics 3-5 times a week plus some of the machines at the gym.

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My RE has banned me from ALL exercise. He said that once you reach your endorphin high, the endorphins can cause you to have an hormonal imbalance, resulting in a luteal phase defect.

However, I have a very close friend who has what I term exercise bulimia- she is 5'1" and weighs 90 pounds (when she is not pg). She conceived without any medical intervention (although it did take her 5-6 months) and she is now 22 weeks pg and still exercising like crazy. (BTW, at 22 weeks, she has only gained about 7 lbs!)

So, in summary, I think it depends on the individual, but I would cut back if I were you.

[RAH - I believe both extremes should be avoided in the above example -- cutting out all exercise, and "exercising like crazy"! - RAH]

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I have been under specialists care for over a year - 1 IVF retrieval and 3 transfers with no success. Prior to starting meds I quit exercising (was doing Step 3-4 times per week). No only have I put on about 10 pounds in the past year, but I haven't gotten pregs. Docs think my uterine lining is too thin due to irregular blood flow.

Starting my second IVF cycle next week. I've started back to the gym. I think exercise would increase the blood blow to the uterus.

Are there any articles, books, of studies on the effect of running on male potency.

The consensus of opinion ... is that "normal" running, i.e., not [50-mile] ultra-marathons, does no harm, and can be beneficial to male fertility. There's some evidence suggesting that exercise can reduce systemic levels of testosterone -- contrary to what one might think, too-high testosterone levels contribute to *decreased* fertility. The benefits [of exercise] are generalized, and essentially are those of being in good healthy condition, including a healthy body-fat ratio.

The only thing about running (or any exercise) that could contribute to lower fertility, is keeping the testicles too warm. Temperatures above 92-93 degrees F. will cause deterioration in sperm count and quality, and above 99-100 degrees F. will kill 'em off. The longer the heat, the lower the sperm count. It takes 70-80 days to manufacture a new sperm cell from scratch, so this isn't trivial.

The best way to keep 'em cool is to run at the coolest time of day if possible, and wear clothes that allow air to circulate. (This is like the boxers-versus-briefs discussion -- yes, switching to boxers does help!) Obviously you don't want to run in your boxers (well, I don't, anyway :-)), but don't go out in a sweatsuit either. FWIW, I run in spandex shorts with no underwear -- this gives enough support where it's needed, but the spandex allows air to circulate better than anything else. (If this is embarrassing, run at night, it's coolest then anyway :-)).

My husband goes to Gym four days a week. He does aerobic exercises for around an hour. Does this exercise have any effect on his sperm count? Also, he loves hot baths. Somewhere I read that hot baths have a negative effect on sperm counts. Is this true? Please help. Thanks in advance.

It depends on what type of exercise he's doing. If he's cycling, that can cause some problems. He could switch to a treadmill and avoid the cycles. Another important factor is if he is wearing tight-fitting clothing when he exercises. This can lead to overwarming of his testicles and that will kill off sperm. If he takes hot baths, he should switch to hot showers instead and avoid directing the hot water onto his testicles. Another good suggestion is to have him wear boxer shorts.

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We're both firm believers in the value of exercise in general. [My wife] goes swimming 3x / week at the YMCA, and also works out on the stairmaster, treadmill, NordicTrak, and nautilus and free weights the other 2 weekdays. I do calisthenics and rowing machine 5 mornings /week, plus go running in warm weather and swimming in both warm & cold. I think this has several fertility benefits: it increases overall health; it helps you resist disease and injury; and it makes you feel physically more energetic, which ought to be good for conception and maintaining a healthy pregnancy.

And, never underestimate the aphrodisiac-effect of seeing your SO wearing clingy spandex :-).

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7.7 Did either or both have a normal body-fat ratio (around 20-27 percent?)

RAH - The same rule of thumb, moderation, applies to the proportion of body fat to total body mass. For women, too much fat can lead to irregular monthly cycles (due mainly to the excess production of estrogen associated with being overweight); and too little body fat (under 18 percent, according to Toni Weschler) can cause anovulation through the body's failure to reach the estrogen threshold. The 20-27 percent ratio is a reasonable target. (Although anyone accustomed to the standards of beauty set by today's supermodels will percive it as heavier than ideal, this IS the best percentage for overall health!)

For men, the relationship between weight and fertility is virtually unexplored. In the absence of evidence to the contrary, a body-fat ratio in the low 20s should be assumed reasonable for fertility, as it is for overall health.

A final caution: Women or men trying to conceive should not go on crash diets or otherwise attempt to lose weight too rapidly; aside from being bad for health in general, this can disrupt the hormonal balances needed for optimum fertility. - RAH

First off, women (as opposed to girls) are supposed to store fat on their bodies in the hips, buttocks, thighs, lower abs, upper arms and breasts. It is natural, it is healthy, and it is normal. It just isn't fashionable.

According to the American Heart Association, a healthy amount of bodyfat for women is 27 percent.

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16-20 percent is not "normal" for women! The normal, most-fertile range for women is 20-25 percent, although most agree that 16-19% *looks* great. (Hard to say what we were, but we're both a bit over-fat.)

I just found some interesting data about weight loss and ovulation (source Canadian study of Reproductive Technology)

A study was done on women who were experiencing secondary amenhorrea (sp??) and who weighed at least 30% more than their high-end goal weight. When these women lost 15% of their body weight, 85% of them started ovulating again!

This piece of information is certainly helping me keep my new years resolution!

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:Now for the question, in the _many_ books on infertility that I've read, all : reference the exercise factor ...... : Right now, I'm exercising about 4 days a week, about 30 minutes of treadmill : or stairmaster and abdominal work.... : So, what have you read, or been told about exercise and infertility? What has: your experience been?

Having been an exercise instructor, avid exerciser, and a successful infertility patient, everything I have seen points to body fat rather than exercise as the culprit (marathon runners sometimes have body fat levels below 15% and this affects their cycles). Your level of exercise would certainly not preclude pregnancy or our race would have died out in the hunter/gatherer age. If you have any doubts about your body fat level, it can be measured. The medical establishment recommends a 20% level for women but in this this-is-better era, many try to go lower than that.

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Exercising too hard, or rapid weight loss can easily upset periods. (They become exclaimation marks :)). Usually, once your body gets used to the new weight, it will return to normal, assuming you have not gone below the proper percentage of body fat, for your body. You did not mention how fast you lost the weight. It makes a difference. If it is slow, it usually won't disrupt. If it is more than 3 pounds (little over a kg) per week, it may be too rapid for your body.

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Does anyone know if being overweight can hinder ovulation and conception ?

Fat cells either produce or promote production of estrogens in your body (I can't remember which ones). The more fat cells, the more is produced. This estrogen is not the same as the "good" estrogen that you are supposed to produce to develop mature follicles. But this "bad" type of estrogen inhibits production of that "good" estrogen. When this happens, you don't get the cycle you are supposed to have. Clomid stimulates the hypothalamus, but if it still recognizes all that "bad" estrogen, it won't do the trick.

Cervical [fluid] is hard for me to use as a sign because I'm so overweight that I can barely reach. I use BBT as a tracking mechanism right now. Since I seem to ovulate irregularly (probably as a result of my excessive weight) we're watching the BBT while I lose weight (start Fenfluramine/Phentermine and Weight Watchers and water aerobics tomorrow). Then if I'm not ovulating regularly we'll know and the doctor can prescribe a different regime for determining fertility.

I actually have had two children. My first was adopted when she was 2 days old and she's now 6 1/2 years old. When I accidentally got pregnant with her I weighed 190. I started my period when I was 9 and I was irregular from day 1. In fact, when I was about 20 and had been playing Russian Roulette for about 5 years (and never had gotten pregnant) I was told that in order to get pregnant I'd probably need assistance. [Of course, [first baby] proved otherwise. :)]

When I finally conceived [2nd baby] I weighed 255. I currently weigh (according to Weight Watchers) 257.5, so I'm at about the same weight as when I conceived.

My cycles from the time I went off the pill to conception were 35, 19, 27, 45, 28, 28, conception. When I conceived (~ September 8), my last cycle had been 3 August, so my ovulation was late. Of course, I had just started charting BBT the cycle I wound up pregnant.

Since [2nd baby] was born, other than the 6 weeks of lochia, I have had odd cycles (again!): first period was triggered by taking one month of birth control pills. September 1, October 19, November 17, January 5, and my temps are still down around 97.5/97.7, so I haven't ovulated yet this cycle.

We'll see how the weight loss affects my cycle and if it makes me 1) more regular and 2) ovulate more regularly.

The way the doctor explained it to me was that fat cells convert the "low level" estrogen produced by the pituitary into the same kind of "high level" estrogen just like that produced by the ovaries. Estrogen is the triggering factor for the buildup of the uterine lining. Since I have so much fat in my body (43% bodyfat right now), I have excessive levels of estrogen. My body doesn't ovulate and so it doesn't product progesterone to provide the structural support to the lining (in case of pregnancy) and so my period depends more on when the lining cannot support itself than the cycle of estrogen/progesterone. Of course, this excessive estrogen could lead to uterine cancer if not monitored. [Just one more good reason to lose weight before I get any older!]

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7.8 Has either ever had any STDs (sexually-transmitted diseases)? How long ago, and what STD? Are you aware of any lingering effects (e.g., scar tissue)?

RAH - The near-epidemic spread of STDs in the past 30 years or so has been called the hidden fertility time-bomb. Diseases such as chlamydia (the most common STD today) can cause sub-fertility or infertility in both women and men, through such means as leaving scar tissue in the upper reproductive tract, blocking passage of egg or sperm toward their destinations. Chlamydia, and a number of other STDs, are doubly insidious, because they can infect with no symptoms at all, or extemely mild symptoms, while creating long-term damage.

Unfortunately, a number of social trends in the past 30 years -- becoming sexually active at young ages, multiple sex partners, and delayed childbearing -- can allow these diseases to do their damage before the victims are aware of it; and sadly, there is little outside of surgery that can repair the harm. If the damage is not too severe, some of the other methods in this FAQ can help overcome the problems it poses to fertility.

The purpose of this section is to alert you to consider whether you may have an STD infection history, knowingly or unknowingly, and to urge you to seek medical assistance if you suspect this is causing delayed conception for you and your partner. - RAH

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I tested positive for ureaplasma when I began seeing fertility doctors. My doctor said we'd probably had it for years, that it could have come from either one of my previous partners or one of my husbands. My husband and I took drugs (dioxycyline I believe) for 2-3 weeks and it cleared up the problem. I retested later and the ureaplasma was gone. Unfortunately this didn't seem to clear up my infertility. We went through 2 more years of doctors and treatments for various things before having any success.

 

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