How to get pregnant when all else fails - includes list of resources - Natural Remedies - Special Women's Health Issue

Vegetarian Times, July, 1997 by Luise Light

My families who want children face the problem of infertility, notes Sharon A. Winer, M.D., clinical professor of obstetrics and gynecology at the University of Southern California in Los Angeles and a reproductive endocrinologist affiliated with Cedars-Sinai Hospital in Beverly Hills. Nationally, one out of six couples (15 percent) are infertile, using the official definition of not being able to conceive after 12 months of regular intimate relations without any form of birth control. "But frankly, if you're over 34 and have never been pregnant and haven't gotten pregnant after six months of trying, you should probably seek help right away because your biological clock is ticking down," says Winer.

As many as 10 million Americans are affected by infertility. In about 20 percent of the cases, both partners have problems that cause the infertility. The rest are evenly divided between men with problems such as low sperm count and women with problems such as pelvic inflammatory disease. Winer adds that the number of infertile couples appears to be increasing, possibly because many women delay starting a family until their careers are established.

"I call it Murphy's Law," says Nancy Lee Teaff, M.D., a reproductive endocrinologist who is Medical Director of the Institute for Assisted Reproduction in Charlotte, N. C., and is the co-author of Perimenopause (Prima, 1995). "The women who want to get pregnant can't, and those who don't want to do." Teaff adds, "Believe it or not, the number of 40-something women crowding the infertility clinics is only exceeded by the throngs of 40-something women turning up at abortion clinics." Taeff says many women 40 and older have unplanned pregnancies because they don't realize they're still fertile. (To be perfectly safe, doctors recommend waiting a full year after your periods stop before having unprotected sex.)

However, the risk of infertility in women 40-plus is greater than the risk of pregnancy. It rises from 20 percent of women in their 20s to 30 percent of women in their 30s and over 60 percent of women over 40. There are many reasons, only some of them biological. "First, you've got to play to win," says Teaff, noting that couples in their 40s have sex less frequently than couples in their 20s. Second, although women are born with 700,000 eggs (ova), most never get released and therefore are not available for fertilization, and the eggs released when women are in their 20s are the most likely to produce healthy babies.

Conditions such as endometriosis, hormonal imbalances and polycystic ovaries can make it more difficult to conceive. The only way to know what's causing the problem, says Taeff, is to undergo an infertility workup, consisting of complete physical and sexual histories, semen analysis for the man, hormone evaluation for the woman as well as tests of how the man's sperm and the woman's vaginal secretions get along together.

Once the fertility problem is diagnosed, conventional medicine has a truck load of low and high-tech methods available to help you, including some with strange-sounding names straight out of Star Wars: IVF (in vitro fertilization -- the so-called test tube baby procedure); GIET (the woman's egg is mixed with her partner's or a donor's sperm and transferred to the woman's fallopian tubes where fertilization occurs); and ZIFT (an embryo in its earliest stages, after fertilization in the laboratory, is transferred to the fallopian tube by laparoscopy).

The choice of procedure depends on the clinic you select, but all of the methods are time-consuming (don't start if you've just taken on a big new assignment at work); invasive (get used to sharing your anatomy with strangers); and costly (on the average, $10,000 per high-tech procedure). Perhaps even more discouraging, successful conception is a fifty-fifty proposition with the odds better for younger women and worse for older ones.

According to Alice D. Domar, Ph.D., director of Harvard Medical School's Mind-Body Program for Infertility at Boston's Deaconess Hospital, and author of Healing Mind, Healthy Woman (Henry Holt, 1996), infertility is a stressful condition, causing measurable levels of depression, anxiety and fatigue similar to that seen in women with cancer, heart and autoimmune diseases. "The relentless focus on menstrual cycles, hormone levels, tests and treatment schedules takes over women's lives. To top it off, women going through fertility treatments really feel lousy. They have poor self-esteem, and the fertility drugs they take make them feel premenstrual all the time. Many women complain that they can't stop crying, and it's likely that their depression contributes to their inability to conceive. It's a vicious cycle."

A valuable coping tool is the relaxation response, made famous by Herbert Benson, M.D., a Harvard cardiologist. It tranquilizes racing minds and bodies constantly on alert and in crisis mode. Borne out by two decades of scientific studies, Domar says the relaxation response enables us to turn off the physiological and psychological alarm bells.