The incidence of infertility is much more than most people realize. An estimated 10 percent to 15 percent of couples trying to conceive will have difficulty doing so.

What is infertility and when to see your doctor?

Infertility is the inability to conceive after:

• 1 year of unprotected intercourse when the woman is 35 years old or younger.


• For women over 35, this timeframe is 6 months


• For women close to 40, the timeframe is 3 months.

Once you have crossed this timeframe, it is better seek to advise from an infertility specialist.

The exception to this is if a woman has any of the following:

• Irregular periods (or none at all), or extremely painful periods.


• Two or more miscarriages.


• Previous ectopic pregnancy.


• A history of pelvic surgery.


• A diagnosis of endometriosis or other another complex ovarian cyst/ tumor.


• A history of systemic illness or previous history of tuberculosis (PID)

In any of these conditions, you should seek a consultation from a fertility specialist right away.

Once a couple decides to seek professional advice or help, it is prudent to see a gynecologists who specializes in fertility management and hormone disorders. Also, it is a wise idea to see a fertility specialist before actually planning a pregnancy for what is called as ‘PRECONCEPTIONAL COUNSELLING AND MANAGEMENT’ Pre-conception advice/ management

History: Pre-existing medical problems:

• Stabilize medical conditions, if any, like thyroid disorders, hypertension, diabetes or prediabetes, epilepsy, etc. and ensure that medical control is optimal.


• Check that drugs needed are safe for use in pregnancy and do not affect sperm function.

Weight

• Check BMI The formula is BMI = kg/m2 where kg is a person’s weight in kilograms and m2 is their height in meters squared.


• Advise on weight gain or loss where BMI is <18.9 or >24.9 respectively.

Folic Acid

• Women who are trying to conceive should take folic acid supplements (400 mcg) daily to reduce the risk of neural tube defects. Women with a history of neural tube defect or epilepsy should take 5 mg daily.

Diet

• Dietary modification is good for weight management as well as detoxification.

Recreational Drugs

• Advise both partners to stop using recreational drugs.

Caffeinated Drinks

• Caffeine intake more than two cups of coffee daily should be avoided.

Smoking

• Advise both partners to stop smoking

Virology Screening

• Screen for rubella immunity and offer immunization to those not immune. to those not immune.

Prenatal Diagnosis

• Tell older women about options for prenatal diagnosis and the need for early referral for IVF in Jaipur

Blood Tests

• Before trying to get pregnant, your fertility doctor may ask you to get few blood tests done like thyroid and diabetes screening, tests for ovarian reserve(capacity of woman’s body to produce eggs) and manage accordingly.

Timing of Intercourse

• Check couple's understanding of ovulatory cycle and relate most fertile days to the length of woman's cycle


• Advise that intercourse occurs regularly. Two to three times a week should cover the most fertile time.

Blood Tests

• Few blood tests including thyroid screening, diabetes/ prediabetes


• screening, checking ovarian reserve(the ability of the body to produce eggs) are also required in some cases.

A couple trying or planning for a pregnancy should consider seeing a doctor for a “preconception management” to review what you can do to optimize your chances of a successful pregnancy. For example, certain medications and habits like alcohol, smoking, tobacco intake are harmful to the developing fetus and should be stopped well before planning a pregnancy. Certain conditions like Thyroid problems, Diabetes, Hypertension should be well controlled before attempting to conceive. Also, few supplements like folic acid and antioxidants, if started for both the partners, can help achieve the goal of a faster conception and healthy pregnancy.

The recommendations mentioned below are aimed at preventing and reversing ovulatory infertility, which accounts for one-third of all cases of female infertility. These hold equally good for the male partner. These are meant for improving natural fertility in the form of better ovulation and correction of mild sperm abnormalities. However detailed evaluation and targeted steps are always advisable as problems like tubal factor infertility, uterine factors, severe ovulatory and sperm dysfunctions would need medical assistance. But one thing is for sure that a healthy lifestyle will never go wasted. It can not ensure a pregnancy but can definitely help improving results in most of the cases. Also, it's virtually free, available to everyone, can be done at home, has no side effects, sets the stage for a healthy pregnancy and a healthy baby, and forms the foundation of a healthy lifestyle not just for motherhood but for. That's just like a win-win situation either ways

DO’S AND DON’TS

Avoid trans fats. These fats commonly found in junk foods like chips, cookies decrease chances of conceiving as well as have a negative impact on the heart and blood vessels. Say NO to TRANS FATS.

More fiber, fewer carbohydrates: Choosing foods that are rich in fiber, like whole grains, raw salads, leafy vegetables, whole fruits, and beans, instead of rapidly digested simple sugars can improve fertility by controlling blood sugar and insulin levels.

Drink lots of water: Drink plenty of water, that is the mantra.

Start pre-conceptional vitamins/ folic acid (with doctor’s prescription). Taking extra folic acid (recommended 400 micrograms a day but available as 5 gms) before you get pregnant could actually help reduce the chances of early pregnancy losses.

Drinks to avoid: Caffeinated drinks like Coffee, tea, and alcohol are okay in moderation but excess consumption at any one point or for a long duration is not as good as these have a cumulative effect. Avoid sugared sodas, packaged juices, canned drinks with artificial flavors and concentrated sugars.

Use proteins from a vegetable source: A serving of vegetable proteins each day with beans, peas, soybeans, kidney beans, chana/ roasted chickpeas, tofu, nuts can improve fertility.

Make it whole milk: If you drink milk, choose whole milk while trying to get pregnant, or full-fat yogurt every day.

Regular exercise to stay active and fertile. Daily exercise can help improve fertility, not just for overweight and obese but also for lean thin men and women.

Iron-rich diet. Extra iron from plant sources, like whole-grain cereals, spinach, beans, tomatoes, and beetroot, help boost natural fertility.

Weigh healthy. Weighing too much or too less can cause hormonal disturbances and disrupt normal menstrual pattern by impairing ovulation. The best range for fertility is a body-mass index (BMI) of 19 to 24.9. Try to achieve the targeted BMI rather than a target weight. Reducing 5-10 % of body weight over 6 months can actually help almost 50% women regain ovulation regularly. Also, obese women have a higher risk of complications.