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Mayo Clinic Guide to Fertility and Conception
Contributors
By Elizabeth A. Stewart, MD
By Mayo Clinic
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Excerpt
MAYO CLINIC
Guide to
Fertility and
Conception
A Member of the Perseus Books Group
MAYO CLINIC
Medical Editors
Jani R. Jensen, M.D.
Elizabeth (Ebbie) A. Stewart, M.D.
Senior Editor
Karen R. Wallevand
Editorial Director
Paula Marlow Limbeck
Product Manager
Christopher C. Frye
Contributing Editors
Charles C. Coddington III, M.D.
Gaurang S. Daftary, M.D.
Shawna L. Ehlers, Ph.D., L.P.
Dean E. Morbeck, Ph.D.
Landon W. Trost, M.D.
Myra J. Wick, M.D., Ph.D.
Contributing Writers
Rachel A. H. Bartony
Alicia C. Bartz
Kelly M. Kershner
Jennifer Koski
Laura Hamilton Waxman
Art Director
Richard A. Resnick
Creative Director
Daniel W. Brevick
Illustration and Photography
Michael A. King
Jodi O’Shaughnessy Olson
Malgorzata (Gosha) B. Weivoda
Research Librarians
Amanda K. Golden
Deirdre A. Herman
Proofreading
Miranda M. Attlesey
Donna L. Hanson
Julie M. Maas
Indexing
Steve Rath
Administrative Assistant
Beverly J. Steele
© 2015 Mayo Foundation for Medical Education and Research (MFMER)
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. For information, address Da Capo Press, 44 Farnsworth Street, 3rd Floor, Boston, MA 02210.
Cataloging-in-Publication data for this book is available from the Library of Congress.
ISBN 978-1-56148-787-5
ISBN EPUB edition: 9780795346019
Published by Da Capo Press
A member of the Perseus Books Group dacapopress.com
Note: The information in this book is true and complete to the best of our knowledge. This book is intended only as an informative guide for those wishing to know more about health issues. In no way is the book intended to replace, countermand, or conflict with the advice given to you by your own physician. The ultimate decision concerning care should be made between you and your doctor. Information in this book is offered with no guarantees on the part of the authors or Da Capo Press. The authors and publisher disclaim all liability in connection with the use of this book. The names and identifying details of people associated with events described in the book have been changed. Any similarity to the actual person is coincidential.
For bulk sales to employers, member groups and health-related companies, contact Mayo Clinic, 200 First St. SW, Rochester, MN 55905, or SpecialSalesMayoBooks@Mayo.edu.
MAYO, MAYO CLINIC and the Mayo triple-shield logo are marks of Mayo Foundation for Medical Education and Research.
Introduction
Deciding to start or build your family is a life-changing decision. Maybe you recently decided to try to become pregnant or perhaps it’s something you’ve been contemplating for a while. But once the decision is made, there’s a whole new set of unknowns, including whether the journey will be easy or difficult.
You may already have a lot of questions: How can you increase your chances of becoming pregnant? What health and lifestyle changes should you make to have a healthy pregnancy? And if you’re struggling to become pregnant, what medical treatments are available? Where can you get emotional support if you can’t get pregnant or have had a miscarriage? And when is enough?
The fertility experts at Mayo Clinic are here to guide you through the process of trying for — and achieving — a successful pregnancy. Mayo Clinic Guide to Fertility and Conception is an easy-to-use yet comprehensive resource that provides answers and explanations to many common questions of couples hoping to have a baby. From lifestyle and dietary recommendations to understanding your ovulatory cycle to medications and procedures that can improve fertility, this book covers it all.
In the pages that follow, you will also hear from couples and individuals who have struggled to have a family. For a variety of reasons — health conditions, unexplained infertility or life circumstances — getting pregnant or deciding to have a family was difficult for them. These personal stories are to let you know that you’re not alone in your journey, and to give you hope that with time and patience pregnancy is often possible.
A project of this scope requires the teamwork of many individuals. A special thanks to all of the people who helped make this book possible.
The Editors
Meet the Editors
Jani R. Jensen, M.D., (left) is a specialist in the division of Reproductive Endocrinology and Infertility and the co-director of the In Vitro Fertilization Program at Mayo Clinic, Rochester, Minn. She is an assistant professor at Mayo Clinic College of Medicine and directs the Obstetrics and Gynecology Clerkship for medical students.
Elizabeth (Ebbie) A. Stewart, M.D., (right) is the chair of the division of Reproductive Endocrinology and Infertilty at Mayo Clinic, Rochester, Minn., and a professor of obstetrics and gynecology at Mayo Clinic College of Medicine. A noted researcher, author and clinician, Dr. Stewart’s research interests focus on the epidemiology, diagnosis and treatment of uterine fibroids.
How to use this book
Mayo Clinic Guide to Fertility and Conception is a comprehensive medical reference that provides answers and explanations to questions and concerns related to fertility. To help you find what you’re looking for, the book is divided into five sections.
Part 1: Getting Ready for Pregnancy
From exercise and eating right to medications and chronic illness, this section discusses daily habits and medical conditions that may affect your ability to become pregnant. Find out what steps you can take to prepare for pregnancy.
Part 2: How to Get Pregnant
Part 2 covers the intricacies of getting pregnant. In this section you learn how to determine when you’re ovulating, when is the best time for sexual intercourse, and steps you can take to increase your chances of a successful outcome. You’ll also read about early signs of pregnancy and of warnings of a possible problem.
Part 3: Common Fertility Problems
Sometimes infertility is the result of a specific health disorder. This section addresses both common and unusual problems that can affect female and male fertility. There’s also a discussion of age and pregnancy. With more women waiting longer to have their first child, understanding how age affects female fertility is important.
Part 4: When You Need Some Help
Here you’ll learn about the latest in medical treatments to help you get pregnant. You’ll find information on medications to improve fertility, as well as procedures such as intrauterine insemination. There’s a detailed discussion of in vitro fertilization and other assisted reproductive technologies. You’ll also learn about third-party reproduction, which may involve the use of donor sperm, eggs or embryos, or the assistance of a gestational carrier.
Part 5: Special Considerations
The last section of the book addresses unique situations — the options available and factors to consider. It also tackles the tough issue of moving forward when pregnancy is unobtainable.
Contents
PART 1 Getting Ready for Pregnancy
Chapter 1 Adjusting your lifestyle
Weight
Why it matters • Find your BMI • Managing weight
Exercise
Moderate exercise is best • Athletes and fertility • Exercise and weight • Getting started • A well-rounded fitness program
Stress
Your body and stress • Fertility and stress • Sex and stress • Relaxation techniques
Sleep
Sleep and your overall health • Night shifts and fertility • 8 steps for good sleep
Alcohol, tobacco and other toxins
Alcohol • Tobacco • Other recreational drugs • Other toxic substances
Diet
Dawn’s story
Chapter 2 Eating to conceive
Carbohydrates: Natural, not processed
Carbs explained • Carbs and blood sugar • Carbs and fertility
Dietary fats: Go for good fats
Phasing out trans fat • Look at the label • What should you eat?
Protein: Eat more beans and nuts
A protein plan
Dairy products: Creamier is better
Caffeine and conception
Focus on your health
Chapter 3 Additional preparations
Going off birth control
Medications and supplements
Prenatal vitamins
Vaccinations
Guide to vaccinations and pregnancy • Vaccines during pregnancy
Chronic medical conditions
Genetic tests
Take heart
Chapter 4 Producing healthy sperm
Sperm health and fertility
Quantity • Structure • Movement
How to improve sperm health
Maintain a healthy weight • Eat a healthy diet • Exercise • Manage stress • Prevent and treat infections
What to avoid
PART 2 How to Get Pregnant
Chapter 5 How babies are made
Reproductive organs
Female organs • Male organs
Ovulation
Fertilization
Implantation
Pregnancy
Multiple babies
Chapter 6 Ovulation and fertility signs
Your menstrual cycle
The follicular phase: Prep time • The ovulatory phase: Go time • The luteal phase: Resolution time
Your fertility window
Use a calendar • Monitor your temperature • Watch for cervical changes • Putting it all together
Products that can help
Ovulation predictor kits • Fertility monitor • Other devices
Don’t be afraid to seek help
Amber’s story
Chapter 7 Tips for increased success
Plan ahead
Know your window
Have sex often
Frequent sex and semen quality
Forget about positions and routines
Avoid lubricants
Have fun
Chapter 8 Are you pregnant?
Early signs and symptoms
Home pregnancy tests
Reading the results • Test accuracy • Follow-up blood test
When to see a care provider
Bleeding • Emergency symptoms • Miscarriage and ectopic pregnancy
Chapter 9 Miscarriage and ectopic pregnancy
Miscarriage
Signs and symptoms • Causes • Getting medical attention • Treatment • Recovery
Recurrent pregnancy loss
Causes • Evaluation • Treatment
Ectopic pregnancy
Signs and symptoms • Treatment • Heterotopic pregnancy • Future pregnancies
Trying again
Emotional recovery • Physical recovery
Kristen and Chris’ story
PART 3 Common Fertility Problems
Chapter 10 Effect of age on pregnancy
Female reproductive life span
Female fertility and age
Fertility over the years • What about today?
Related risks
Pregnancy loss • Chromosomal abnormalities • Other complications
Male fertility and age
Effect on pregnancy rates • Health of aging sperm
Related risks
When to seek help
Jane’s story
Chapter 11 Female problems: Common and unusual
Ovulation and hormone issues
Thyroid problems • Elevated prolactin • Hypothalamic dysfunction • Polycystic ovary syndrome • Primary ovarian insufficiency • Luteal phase defect
Structural and anatomical issues
Fallopian tube damage or blockage • Hydrosalpinx • Endometriosis • Congenital abnormalities • ‘Tipped uterus’ • Uterine growths • Cervical narrowing or blockage
Unexplained infertility
Chapter 12 Male problems: Common and unusual
Sperm matters
What causes a low sperm count? • When there’s no sperm • Leukocytospermia
Structural and anatomical issues
Varicoceles • Undescended testicles • Sperm duct abnormalities • Hypospadias • Tumors
Hormone imbalances
Primary hypogonadism • Secondary hypogonadism
Ejaculation issues
Retrograde ejaculation and anejaculation • Erectile dysfunction
Chromosome defects
What happens next?
Evaluating infertility: A summary
PART 4 When You Need Some Help
Chapter 13 Seeing a doctor
When to see a doctor
Who should you see? • How to choose a fertility doctor or clinic
What to expect
Medical history • Physical exam • Fertility tests
Tests for women
Ovulation tests • Ovarian reserve tests • Uterine and fallopian tube tests • Hormone tests
Tests for men
Semen analysis • Other tests
Keeping a positive outlook
Lisa and Scott’s story
Chapter 14 Medications and surgery
Many options
Fertility medications
Clomiphene • Aromatase inhibitors • Gonadotropins • Human chorionic gonadotropin • Metformin
Medications for specific conditions
Fertility procedures and surgeries
Intrauterine insemination • Surgical procedures for women • Surgical procedures for men
Looking ahead
Chapter 15 Reproductive assistance
What is assisted reproductive technology? • The first test-tube babies • IVF today
How IVF works
Superovulation • Egg retrieval • Sperm collection or retrieval • Fertilization • Embryo transfer • Freezing extra embryos • Risks of IVF
Advanced ART
Zygote intrafallopian transfer (ZIFT) • Gamete intrafallopian transfer (GIFT) • Assisted hatching • Preimplantation genetic testing
The success of ART
Costs • Extra embryos
Treating infertility: A summary
Chapter 16 Third-party reproduction
Donor eggs
Do you need donor eggs? • How egg donation works
Donor sperm
Do you need donor sperm? • How donor sperm works
Donor embryos
Surrogates and gestational carriers
Do you need a gestational carrier? • How gestational carriers work
Selecting a donor
Egg donor • Sperm donor • Gestational carrier • Known donor
Costs and contracts
Donor sperm • Donor eggs • Donor embryos • Gestational carriers • Known donors
Take your time
Ashley and Susie’s story
Chapter 17 Coping and support
Stress and infertility
Causes of stress • Sexual dysfunction • When to seek help
Coping techniques
Support groups and counseling • Other coping techniques
PART 5 Special Considerations
Chapter 18 Fertility preservation
Reasons for fertility preservation
Cancer • Other medical conditions • Personal reasons
Seeing a specialist
Options for women
Embryo cryopreservation • Oocyte cryopreservation • Radiation shielding • Ovarian transposition • Conization and radical trachelectomy
Options for men
Sperm cryopreservation • Radiation shielding
Looking forward
Chapter 19 Unique circumstances
Choosing single parenthood
Issues to consider
Reproduction options
Women without a male partner • Men without a female partner • Same-sex couples
Cultural and religious considerations
Concerns about in vitro fertilization • Intercourse restrictions • Sperm collection
Melissa’s story
Chapter 20 Other options
When to consider alternatives
Deciding as a couple
Adoption
Issues to consider • Selecting an adoption resource • How to begin the process • Forums and support groups
Child-free living
Myths and facts about child-free living • The benefits of child-free living • Other ways to get involved with children
Finding support
Additional resources
PART 1
Getting Ready for Pregnancy
CHAPTER 1
Adjusting your lifestyle
Planning to have a baby is exciting. You may have thought about the possibility before, but now you’re ready — ready to make it happen. Or at least try to. But hold on. Like many other women, until now you may have been more preoccupied with avoiding pregnancy than with getting pregnant. And now that you’d like to become pregnant, you’re not quite sure that it’s really all that easy! Sure, it can be simple — you have sex and you get pregnant. But it can also be more complicated than you might have thought. If that’s the case, or if that’s what you’re worried about, this book is here to help.
Genre:
- On Sale
- Apr 28, 2015
- Page Count
- 288 pages
- Publisher
- Da Capo Lifelong Books
- ISBN-13
- 9781561487875
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