Conventional Medicine

As an integrative physician, I regularly use the many advances available in conventional medicine. I am deeply appreciative of all that it has to offer to promote good health before conception, to assess fertility problems, and to treat  infertility when necessary.  Conventional medicine can be simply miraculous, allowing women and men who previously wouldn’t have been able to conceive to bear children.

Your overall well-being is of vital importance, and addressing health issues before pregnancy is the ideal. If you are overweight, I would advise you to lose weight in order to conceive more easily, reduce the risk of gestational diabetes, and improve the health of your baby. I would discuss lifestyle issues such as smoking, exercise, alcohol consumption, and other topics. Even your dental health matters: gum disease due to bacteria can be transmitted to your baby, increasing the risk of preterm labor as well as childhood cavities and poor dental health. Getting your blood pressure or diabetes under excellent control (or even better, reversing them with lifestyle changes) is a worthwhile endeavor before conceiving a new life.

Vitamins and Medications

While it is recommended that all women of childbearing age take a multivitamin with folic acid to help prevent neural tube defects in their babies, 67 percent of young women are not taking such a vitamin. Certain medications like Accutane, prescribed for acne, are contra-indicated during pregnancy, and should be stopped. To find out if a medication is safe during pregnancy talk to your physician or pharmacist or look it up on this NIH website here. Other medicines must be at exactly the right dose to assure fertility, thyroid replacement medicine being one example.

Men may be taking medicines that affect sperm; for example, calcium channel blockers, a class of blood pressure medication, interfere with the sperm’s ability to penetrate the egg. Spironolactone, another antihypertensive, can impair production of testosterone and sperm. Medicines used to treat colitis, such as sulfasalazine, affect normal sperm development, as can the antibiotics tetracycline, gentamicin, and erythromycin. In most cases, an alternative medication can be prescribed when a couple is thinking about getting pregnant.

Lab Work

Basic lab work that I advise for all women include blood tests to check for immunity to German measles (rubella) and chicken pox. If you are not immune, there is time to get vaccinated before pregnancy. Other labs assess for anemia, suboptimal thyroid function, and vitamin D levels.

Your doctor may also discuss what to expect in terms of the likelihood of conception. Although 85 percent of couples do get pregnant within six to eight months of unprotected midcycle intercourse, some couples believe that they will conceive right away and are surprised when it takes longer than they had anticipated. In these discussions, your doctor may pick up on potential warning signs that could signal future difficulty conceiving.

Difficulty Conceiving

Although most couples will become pregnant within a year, some will struggle; difficulty conceiving affects approximately one in seven couples. It is usually suggested that further evaluation occur after one year of trying in women under the age of thirty-five; six months in women aged thirty-five to forty; and three months in women over the age of forty. You will notice the paradox here, since the older a woman is, the longer it will take for her to conceive; yet the older she is, the more urgency exists.

If you belong to the 15 percent or so of couples who struggle to conceive, your physicians will want to examine both of you for a variety of conditions. While the percentages vary a bit according to the study reviewed, it is thought that infertility is due to a male factor in one-third of all cases, a female factor in one-third, and combined male-female factors in the last third.

There are many solutions that conventional medicine offers to couples who are having problems with conception. These include intrauterine insemination, in vetro fertilization, and a variety of ovulation inducing medications as well as surgical procedures.

American Society for Reproductive Medicine:

ASRM resource about ovulation inducing medications

The Fertility Advocate contains useful medical diagnoses, explanations, and information.