In case you missed Dr. Carl Herbert on the Fertility Forum radio show, you can download the Podcast on iTunes or the MP3 version from the Fertility Forum website.  Hear Dr. Herbert talk about the History of ART, Genetics, Fertility Preservation, Egg Banking, and other topics in the field of Assisted Reproductive Technologies. 

We hope you enjoy!

Meet with a Registered Dietitian and:

Nutrition consultations consist of:

Not sure if you are a candidate for nutritional counseling?

Set up a time for a free 20 minute phone chat with the dietitian to find out!

Ask a member of the front desk or call 415-834-3000 for more information or to set up an appointment.

Alison Boden, MPH, Registered Dietitian

Alison received her undergraduate degree from UC Davis, followed by graduate training in nutrition and public health from the University of North Carolina at Chapel Hill. As a practitioner of integrative nutrition she takes a holistic approach to wellness, recognizing that the foundation for optimal health and healing begins with a health promoting diet. Her emphasis is on using medical nutrition interventions to create a basis for health promotion and healing.

A lover of good food, Alison believes that a healthful diet should be thoughtful, enjoyable and satisfying. Each meal does not only provide calories, but is an opportunity to supply our organs with the nutrients and building blocks needed for health. When the body is out of balance, as in the case of infertility, proper food choices can correct deficiencies and bring balance back to the system. What you eliminate from your diet is often as important as what you include. Consultations with Alison will help you address the key components of your diet that may be affecting your fertility and wellbeing, as well as help prepare your body for pregnancy.

Alison has experience assessing and counseling clients related to pregnancy and fertility, weight management, lipid control, food allergies, digestive health, sports nutrition, and chronic diseases such as cardiovascular, kidney disease and cancer. She views each person as a unique individual, and is dedicated to educating patients on natural ways to achieve optimal health and allowing them to take an active role in their health care decisions.

Alison is a member of the American Dietetic Association and the Women’s Health and Integrative and Functional Medicine practice groups.

Tune in and listen to PFC’s Dr. Carl Herbert talk about the History of ART, Genetics and ART, Fertility Preservation and Egg Banking on The Fertility Forum radio show Monday, October 17^th from 6-7 pm PST.

To listen, you can call in live to 877-864-4869 or go to The Fertility Forum webpage and listen there.  You can also click the LIVE CHAT button on the website to IM live during the show!

If you can’t tune in on Monday, you can download the audio AFTER the show from either the site above OR iTunes.

Don’t miss it!

Embryo freezing is a routine part of the IVF process.  Approximately 60% of patients have embryos in frozen storage after their cycle is complete.  These embryos can be used at any time; but it is common that some embryos remain after couples have completed their families.  This situation leaves patients facing a very difficult decision regarding the final disposition of any embryos still frozen.  Quite often patients are not prepared to make such a decision, nor are they aware of their disposition options. Patients were so focused on simply getting pregnant, they had not considered what to do with any remaining embryos after the cycle was complete. This article provides a brief explanation about the three disposition options available at PFC for surplus frozen embryos: disposal, research (and then disposal), or donation to another couple for use in achieving pregnancy.

Disposal of your embryos means they are removed from the storage tank and placed in a biohazard waste disposal container. Once the embryos are removed from the liquid nitrogen storage tank, they lose all viability in a matter of seconds. The embryos are not used for research purposes, not donated to any individual or company, and are not cultured beyond the stage of development at which they were frozen.  They are disposed of as medical waste.

Donating your embryos for use in research requires that the embryos be shipped to a company called Reprogenetics, LLC, based in New Jersey (www.reprogenetics.com). At Reprogenetics, the embryos are studied to understand normal and abnormal development.  Donating embryos specifically for stem cell research is also possible.  Reprogenetics offers a stem cell research option, however,  some additional paperwork must be completed directly with Reprogenetics  Whether donating to Reprogenetics for stem cell research or basic research, a PFC Research Disposition form must be competed.

Donating your embryos for use by another couple can be broken down into three sub-categories: known donation, open donation and anonymous donation. Known donation, also called directed donation, is the donation of your embryos to a person or couple that you know personally, perhaps a good friend or family member.

Anonymous donation of your embryos means that you donate your embryos to an organization, and the organization places your embryos with a family that you do not know and will not meet. The identity of both the donors and the recipients is not disclosed to either party. Through the PFC Embryo Placement Program, only anonymous embryo donations are accepted. Any stipulations about to whom or to what type of family situation the embryos are donated cannot be accommodated (i.e.: that the embryos be donated to a two-parent household, or a household of a certain income level, or living in a certain geographic area). The placement of anonymously donated embryos operates on a first-come, first-serve basis. At the moment, we have a very long list of patients wishing to receive donor embryos. Currently there is nearly a two year wait).

Open donation is the donation of your embryos to a party that you do NOT know, but wish to meet, and/or possibly remain in contact with, after the embryos are donated. Open donations require further legal expertise and overall guidance and handling beyond PFC’s current abilities. For these reasons, PFC is unable to offer open donations to our patients. For those interested in an open donation, or for those requesting certain criteria be met by the recipients, patients are encouraged to research third party agencies that facilitate embryo donations, both anonymous and open. One such program is the Snowflakes Frozen Embryo Adoption and Donation Program (www.snowflakes.org), operated by Nightlight Christian Adoptions. Snowflakes facilities both open & anonymous donation of embryos and can accommodate most requests from the donors and the recipients. Another possibility is Miracles Waiting (www.miracleswaiting.com), an online do-it-yourself matching program for donors and recipients. More general information about embryo donation and adoption can be found at the National Embryo Donation Center (NEDC): www.embryodonation.org.

At PFC, all embryo dispositions are handled by our tissue bank manager Alexis VonAustin.  Her contact number is 415-249-3636. She can assist you with information, paperwork, and if necessary, with the shipping of embryos to the agencies listed above.

- Alexis VonAustin and Joe Conaghan, Pd.D., HCLD.

I liken our fertility journey to the story of the woman who thought she was traveling to Oakland, California but got off the plane in Auckland, New Zealand.  We, too, thought we were in for a much shorter trip! We had achieved a pregnancy naturally the very first time we tried, a pregnancy that ended in a painful miscarriage five weeks later. Despite the emotional setback, I followed the lead of my gynecologist and other friends and family members who said that the fact of conception was a very good sign. My husband and I overcame our grief and assumed the stance that having a baby would come rather easy for us. At the time of our pregnancy, I was 33 years old and he was 37.

We tried to conceive again on our own for a year following the miscarriage. Then we sought external help. We underwent fertility analyses to determine what might be getting in the way of another pregnancy and discovered a problem with sperm motility and morphology. We engaged in Eastern medicinal treatments, using herbs and acupuncture to augment fertility as we geared up for an IUI (Intra-Uterine Insemination). When this was unsuccessful, we decided to switch gears. I was quickly edging towards 35 and my gynecologist agreed that it was better we move quickly. I also felt strongly that I wanted help from a specialist that would take my husband and my situation in a more holistic way.  That is when we found Dr. Herbert at the Pacific Fertility Center.

In November 2009, Dr. Herbert informed us of his analysis that, due to the condition of my husband’s sperm, we would have to resort to IVF to conceive a child. In addition, I would have to undergo a procedure to remove a large uterine polyp that might get in the way of a developing embryo and hence create another miscarriage. My biggest fear- that we would have to undergo invasive and painful procedures to have a baby- had come true. I felt robbed of my dream of a natural conception. My husband felt only lucky that there was a solution to our fertility problems. Our differences in the way we regarded this situation created tension in our relationship. But at each step, he gave me courage and showed me that we would get through this together.

In early January 2010, I checked into the surgery department at the hospital. My husband held my hand tightly and wiped away my tears as we waited for my turn in the operating room. I looked around the surgery prep room and reminded myself that a polyp removal was minor compared to what other people were going through. However, it was the very first time I had an IV in my arm, much less been in the hospital. I was terrified.

The polyp removal, which went well, was a test of my strength. I felt proud of myself for getting through it and began to see it as preparation for the procedures that lay ahead. A few weeks after the removal, we returned to see Dr. Herbert. My uterus had been cleaned out and prepared, and had time to recover. Or so I thought. I was ready to move forward with IVF but the results of the ultrasound showed that my uterus was still not ready.

The months to follow were ones of great introspection for me. For the first time in my life, I was at the mercy of a situation that was completely out of my control. I was humbled. I come from a family of doers who put a great emphasis on perfectionism and achievement. Because of my background, I had always pushed myself hard and been very self-critical, never knowing when I had given enough.

The process of conceiving a child is so different. You don’t get to choose when or how quickly things happen, as the body has a rhythm of its own. The more you push the worse you make the situation. After waiting for a child for almost two years, the final months leading up to IVF felt impossibly long. I was terrified that I was never going to have a baby, and felt unspeakably frustrated and anxious. I had no choice but to master these feelings and allow my body the time to prepare and heal. I also had to trust that this was all part of a process. We would have our baby, but it was going to take time.

In April we were finally cleared to begin using the fertility drugs. The results of our egg retrieval were very fruitful: 30 eggs and 9 embryos. Unfortunately, the results of our embryo transfer were less so. I remember getting the call from the nurses at PFC. “We are so sorry. We know how much this means to you.” To make matters worse, another polyp had formed in my uterus that needed to be removed before we could try again.

I took a huge step back from the fertility process at this disappointing news. I let go entirely and shifted gears, getting back into hobbies and activities that I enjoy but had been pushed to the side in my pursuit of a pregnancy. I hiked, I read, I cooked, I traveled, and I reveled in my relationships with my husband, friends and family. Sometime in late summer, when I felt whole again, I went back to the hospital and had the second polyp removed.  A few months later, my husband and I decided it was time to try another embryo transfer. This time, I was greeted with a “Congratulations” by the nurses at PFC. After two and a half years, we had achieved another pregnancy!

Our baby girl is now 6 weeks old. Difficult as it was, I feel blessed to have gone through what we went through to have her.  It taught me the value of patience, and the hard lesson that we don’t always get to have what we want when we want it. It has also allowed me to be more kind to myself, which helps me be more in the moment with my baby. Most importantly, I learned that sometimes you need to take steps back to move forward, and that all steps, no matter how small, are still steps in the right direction. Now that’s something even our baby girl will appreciate!

-RLS

I was born and raised in Shanghai.  My father, a university mathematics professor, was one of the first generation of college graduates in China after the Cultural Revolution.  My mother, though intelligent and bold, never had the opportunity to pursue higher education.  They were “tiger parents” long before that term even existed.   This was the era before China had opened its door to the West, and disposable income was limited.  Nonetheless, they spent every penny towards my education and broadening my horizon.  I was the only child in my neighborhood to take private lessons in Chinese calligraphy and classical Chinese painting.  We spent weekends touring art exhibits and museums.  To ensure that I would succeed in school, my father taught me English and algebra during my summer breaks.

My childhood years spent holding the calligraphy brush played a critical role in helping me stay connected with my cultural roots after my family’s immigration to Canada when I was twelve.  Through the mastery of this traditional art form, I gained a deeper understanding of Chinese history and culture.  It has given me a platform with which I was able to continue my study of the Chinese language and literature long after English had become my primary language of learning.

My family’s immigration to Canada was serendipitous.  My father initially took us abroad for a one-year visiting fellowship at the University of Manitoba in Winnipeg.   It was the summer of 1989, when the communist regimes throughout Europe fell like dominos and in Beijing the bloody suppression of student demonstrators for democracy occurred in Tiananmen Square.  Although we were not politically involved, my family was given the opportunity to seek asylum in Canada. My parents decided to stay.

What followed was the classic immigrant story, filled with the hardships of survival in a foreign country away from loved ones, and, at the same time, the never diminishing hope and optimism for the attainment of the “American dream”. 

After attending junior and high school in Canada where I excelled in math and science, I applied to colleges in the U.S. with a vague plan to have a career in the sciences.  With this in mind, I was convinced that MIT offered the strongest programs in virtually every scientific discipline.  My years at MIT were the most formative period in my professional and personal development.  My professors and research mentor opened my eyes to the wonders of biology and inspired me to pursue a career in the study of the human body.  I became fascinated by how the body functions, especially the mysterious process by which a single stem cell develops into a complete organism.  At the same time, I continued to pursue my interest in Chinese by taking graduate level courses at Harvard and obtained a minor in Chinese literature along with my S.B. in Biology from MIT.

My interest in the human body led me to study medicine at Harvard Medical School.  During medical school, I conducted research in developmental neuroscience, which led to my honors thesis.  In addition, I became clinically interested in women’s health, a multifaceted discipline with broad psychosocial, political, as well as ethical implications.  I realized that I wanted to take care of women, promote reproductive health, and be a part of building families.  To that end, I completed a residency in Obstetrics and Gynecology at the University of California, San Francisco (UCSF).  During my residency, I learned to treat women of all ages and with every type of ailment from morning sickness to ovarian cancer.   It soon became clear that while I enjoyed delivering babies, I resonated most with patients who could not conceive.  Furthermore, the combination of advanced technology and cutting edge research in reproductive medicine perfectly matched my long held passions in science and technology.  Having come to that realization, I decided to pursue subspecialty training in Reproductive Endocrinology and Infertility, and was accepted into the fellowship at Columbia University Medical Center in New York. 

At Columbia, I was fortunate to be taught by some of the pioneers of the field, Drs. Roger Lobo and Mark Sauer, who have trained many respected Reproductive Endocrinologists around the country, including PFC’s very own Dr. Chenette.  Under their guidance, I conducted research on how follicular hormones affect human oocyte and embryo quality, which has led to several published manuscripts in peer respected journals, as well as my fellowship thesis.  Clinically, I became interested in treating patients with polycystic ovary syndrome (PCOS) and other endocrine disorders, as well as fertility preservation, for patients who desire to delay childbearing for either medical or social reasons.

While I was a resident at UCSF, I met and fell in love with my husband and we welcomed the birth of our daughter last year.  We both love the Bay Area and decided that San Francisco is the place where we want to raise our family.  I have always had the highest regard for the physicians at PFC, one of the most respected fertility centers in Northern California.  Therefore, it is my pleasure and privilege to be able to join Drs. Herbert, Schriock, Givens, Chenette, and Ryan in their mission to help women and families of the Bay Area and beyond in achieving their reproductive potential.

Throughout all these years of training and research during which I learned many exciting new skills and technologies, I still derive the most profound joy and satisfaction from the very first glimpse of a beating heart on ultrasound and the accompanying excitement in my patient’s eyes.  It was not until I held my own daughter and she flashed me one of her toothless gummy grins that the notion finally hit home: life is precious and the love for one’s child knows no boundaries.  I am truly lucky to be in a profession where I have been granted the privilege to take part in the creation of a family, a privilege that I will honor and treasure throughout my career.

Infertility & Reproductive News featured Pacific Fertility Center and interviewed Dr. Herbert for their August newsletter issue. 

Click here to read the article in Infertility & Reproductive News.

We appreciate your interest in research opportunities at Pacific Fertility Center (PFC). As a private practice we are committed to conducting research that will promote and advance the field of reproductive medicine. We welcome your questions about potential participation in research, also known as a “clinical study”.

Currently, PFC has several research opportunities for which you may be eligible. If you would like further information regarding research opportunities at PFC, please ask your physician. The opportunities for which you may be eligible can be identified and discussed at your physician consult. At that time you may be connected with research personnel who can guide you through the process.

If you are not a current PFC patient, please contact our New Patient Coordinators to make an appointment to speak with one of our physicians. 415-834-3095.

Our Active Studies include the following:

A RANDOMIZED, CONTROLLED CLINICAL TRIAL OF THE EFFECT OF TRADITIONAL CHINESE MEDICINE ON IVF SUCCESS RATES

Who Is Sponsoring This Study?

 The study is Sponsored by Pacific Fertility Center and is overseen by Eldon Schriock, M.D. Grant support providing medications and funding for study development has been provided by EMD Serono, a biopharmaceutical company.

What is the Purpose of This Study?

The purpose of this study is to determine the value of combining Traditional Chinese Medicine (TCM) Protocols including acupuncture with In Vitro Fertilization (IVF).

The Auxogyn Eeva Study

Who Is Doing The Study?

Auxogyn, Inc. has selected Pacific Fertility Center as one of several centers to participate in The Auxogyn Eeva Study

Why Are We Doing This Study

Auxogyn is initiating a clinical study in an effort to submit data to the FDA to support the claim that the Eeva System may be used to identify embryos at day 2 that are most likely to form blastocysts. As a result, the Eeva System Study is an investigational study and is a non-significant risk device.

How Data Will Be Used

The data collected in this study are intended to demonstrate the effectiveness of the Eeva System to successfully capture and record images of embryo development within a standard incubator and accurately identify those embryos on day 2 that are most likely to form blastocysts. The results may lead to effective methods for embryologists to identify the most viable embryos so that embryo implantation and pregnancy outcome may be significantly improved for future IVF patients. A higher success rate such as that seen with blastocyst transfer may be achieved for day 2 embryo transfer by using the Eeva System to select embryos; therefore, the adverse events associated with extended culture may be avoided. It may also facilitate implementation of single embryo transfer on cleavage stage (day 2 or day 3) and reduce multiple pregnancies. In summary, this new technology may increase IVF success rates within a given cycle and improve pregnancy and birth outcomes.

Impact of Parental Support on Pregnancy Outcomes (IPSO) Trial- Day 3 Preimplantation Genetic Screening (PGS) With Day 5 Fresh Transfer

Who Is Doing The Study?

Gene Security Network (GSN) has selected Pacific Fertility Center as one of several centers to participate in The IPSO Trial

Why Are We Doing This Study?

The purpose of the study is to determine whether PGS – testing of embryos created during IVF for chromosome abnormalities prior to transfer to the uterus – improves pregnancy and implantation rates in patients when compared to patients whose embryos are not tested. PGS will be conducted using 24 Chromosome Aneuploidy Screening with Parental Support from Gene Security Network

Article originally written by Erica Reder and was published in The New Fillmore.  Article was slightly shortened for length.  To read the complete article and to see pictures, click here.

It’s 7:30 on a Tuesday evening, and nearly every seat in Dino’s Pizza at the corner of Fillmore and California is taken. Couples and families crowd the tables, sharing pizzas, draft beers and sodas. Three television screens broadcast the Tennessee-Vanderbilt basketball game, while mob movie stills and portraits of famous athletes stare out from the walls.

But the newest decoration hangs from the balcony. It’s a blue blanket that proclaims: “BABY BOY.”

Owner Dino Stavrikikis struts among the diners, his photo-loaded iPhone at the ready. Customers gush over pictures of the month-old baby named Santino, while the proud father regales them with tales from the crib. “I really love talking about this story,” says Dino, who’s on a first name basis with nearly everyone in the neighborhood. “I talk about it 10 times a day.”

Santino Vasili Stavrikikis was born on January 22. But the story began a year and a half ago, when the 50-year-old bachelor set his sights on becoming a father.

“There wasn’t one specific day that it hit me and I said, ‘Okay, this is what I need to do,’ ” says Dino. “It was just at this point in my life — you know, you get a little older.”

When the idea of having a son took root, he turned to his customers for advice. “I don’t know what anyone does for a living, but everyone does something,” he says. “So I was kind of throwing out words here and there, and hoping someone would hear me and say, ‘This is where you need to go.’ ”

That moment occurred in August 2009 when friends of Dr. Carl Herbert, a fertility specialist and president of the Pacific Fertility Center, came to Dino’s for dinner. “I started talking about it,” Dino recalls. “They all just stopped eating and said, ‘We have the guy for you.’ ”

Still, Dino admits he had a steep learning curve. “I didn’t know what a surrogate was, I didn’t know what an egg donor was,” he says. “I just kind of knew something about the process.”

And the options seemed overwhelming. He had to choose both an egg donor and a surrogate mother.

But other variables would prove beyond his control. “In January of 2010, within three days my egg donor and carrier fell apart,” says Dino. “I had to start the process all over, start the finances all over. But not once did I think it wasn’t going to happen.”

After losing two egg donors to failed tests, Dino met his best match yet. “Once I met her, I knew she was the right one,” he says of his third, and actual, egg donor.

Searching for a surrogate mother, Dino found the winning combination in a Southern California woman named Dusty Kenney. “We clicked right away,” he says.

Kenney agrees. “I feel really blessed that we found each other because we have such a good connection,” she says. Kenney has a daughter of her own, but she too was new to the world of surrogate pregnancies.

She and Dino kept in close contact throughout her pregnancy, which resulted from the implantation of the donor’s egg fertilized by his sperm. “He would call and check on me probably every other day,” she says. “He would fly down all the time and hang out and he would cook me dinner. He was supportive through the whole process.”

Dino had planned to visit more often as Santino’s February 23 due date approached. “I was going to fly down there on the 15th of February and check into a hotel and just wait it out,” he says. But as it happened, everyone was caught off guard when Santino arrived a month early.

“I got the phone call on the 22nd at 5 in the morning,” Dino recalls. He was there when Santino made his appearance that afternoon at 5:18 at Cedars-Sinai Medical Center in Beverly Hills.

It completely changed Dino’s life. A man who says he had “never lived with anybody” acquired not one but two new roommates: his baby son and a live-in nanny. “She’s phenomenal,” he says of the nanny. “We’ve really gotten along, and we’re making it work.”

They weren’t so sure a month ago when Dino and the nanny brought Santino up from Los Angeles. “We got home at 6 o’clock on Thursday night,” he recalls, “and we just looked at each other like, ‘Now what?’ It forced us to get into fifth gear right away.”

Santino’s temperament makes things easier. “He’s really patient,” says Dino. “He’s a good sport.”

His surrogate mother agrees. “He just has such a calm, sweet personality,” says Kenney. “He doesn’t cry unless he’s hungry.” She has visited Dino and Santino since the birth, and expects to continue to make regular visits. “I imagine I’ll see them once a month,” she says.

Kenney also has thought ahead. “I would imagine it would be like the role of an aunt,” she says. “I just want to be there for him. I think the more fans a child has when growing up the better.”

The egg donor has yet to meet Santino, but Dino expects that she will. “She lives in Florida, but she wanted to be involved as much as she could,” he says.

In the meantime, Santino gets plenty of attention. “Every day he gets two or three presents from around the world,” says Dino. “Everybody comes in and asks for him. It’s turned out, he’s not my son; I’m his father.”

Those who have yet to meet Santino will have ample opportunity when they stop by for pizza. “I want to bring him more and more and more,” Dino says. “But he’s got to get a little bigger.”

Until then, a message painted on the restaurant windows announces to customers and passersby alike: “Santino has arrived.”

Dino says he plans to take down the signs after Santino’s 40-day blessing, a Greek Orthodox rite that will take place in early March. And he’s already dreaming of Santino’s future. “He’ll definitely be working at Dino’s when he’s really young,” says Dino, “just kind of walking around and helping me out.”

For now, father and son see each other mainly outside of the restaurant. “I have to work,” says Dino, “but my schedule’s really flexible.”

The two have already created some memorable moments. “On Saturday, we hung out and watched The Godfather,” Dino says. In the film, Santino is the first-born son of New York Mafia boss Vito Corleone — and the name, which means “little saint” in Italian, stuck with Dino when he first saw The Godfather 35 years ago.

“Dino means ‘the sword,’ ” says Dino. “So it’s the sword and the little saint, which to me means we’re basically watching each other’s back.”

Successful conception does not just involve eggs and sperm and the reproductive tract. The reproductive system, just as all other areas of human physiology, works best when the entire organism is healthy and balanced. This includes not just physical health, but mental health and sexual health.

With respect to physical health, most of what we should be doing is just common sense. For women, mild to moderate regular exercise is best. Although data on the level of exercise that is optimal for conception is scarce, probably no more than 4 hours per week of aerobic exercise may be best¹. Much higher levels can lead to too low a level of body fat for women (optimal body fat for women should be about 20% of total body weight). Excessively lean women (less than 10%) have more problems with proper reproductive hormonal functioning when it comes to ovulation. And while speculative, it is likely humans evolved mechanisms to limit female reproduction in times of starvation (low body fat may mimic a starvation mode) and when we are too much on the run as well. A study published in 2002 looked for associations between exercise levels and pregnancy and birth outcomes in exercising pregnant women². The study reported that women who exercised heavily during pregnancy had smaller babies, more labor inductions and longer labor and well as more colds and flu than more sedentary pregnant women. These are surprising results! Despite these studies it is likely that some moderate amount of exercise helps to promote a sense of well-being and the mental composure to deal with the stresses of every day life and the stress of dealing with fertility issues. Cardiovascular fitness can only be a good thing for pregnancy and beyond.

For men, there really are no restrictions on physical activity. The one exception would be too much bicycling for men hoping to conceive with their partner. The current bicycle saddles do affect testicular function in men who are frequent riders. In general, maintaining good physical shape enhances sexual functioning and of course, sex is important for conception! Speaking of sex, for men to have optimal sexual health, it is important to avoid excessive alcohol. While alcohol does lower mental inhibitions, it also inhibits erectile function, so excess alcohol, contrary to popular belief, does not enhance the sexual experience. Long term excessive alcohol also causes liver damage and raises estrogen levels in men. Higher estrogen levels can lead to smaller testicular volume and lowered sperm production. There is no problem with an occasional drink – just be aware of how much. Avoid intoxication, dehydration, hangovers, and the other consequences of excessive alcohol intake.

As many of our patients are aware, the experience of trying to conceive, especially if it’s taking a long time, can take a toll on sex and intimacy in a relationship. It is so important for partners to be patient with each other and make the effort to maintain the romance and intimacy which keep the relationship healthy. Yes, plan to have sex on the most fertile days of the month, but don’t stop having it before and after the fertile times as well! There is no medical evidence that sex is harmful during the post-ovulation or early pregnancy period. Try to keep the sex-as-fun-and-special attitude alive throughout the month, including baby-making sex days. If there are stresses associated with this issue, we can provide referrals to psychologists that specialize in counseling about sexual health and are professionals in this area. Remember that our sex lives will outlive the infertility, the new baby and the growing children experiences. So it is crucial to nurture this aspect of the relationship.

There is no question that having a good sexual relationship promotes intimacy and better communication. This is so important when it comes to supporting each other. Fertility problems can be a crisis time in the lives of young adults. Sometimes the crisis situation can bring a couple closer together and sometimes it can cause them to feel isolated, even from each other. Communication is essential. For most women, communication is usually inherently verbal; she wants to talk about it and about her feelings. For most men, dealing with painful feelings, such as that recent negative pregnancy test or that recent miscarriage can be difficult for him to verbalize. Add to this frustration, the obvious sorrow of his female partner and men can feel helpless. It doesn’t necessarily help to try to force people to talk about these feelings, at least until they are ready. Letting him go the gym or shoot some hoops with some friends might be a better way for him to initially deal with bad news. But when the time comes, talking and acknowledging each other’s feelings and understanding how each person deals with difficult situations can make a relationship much stronger.

References:

1. Effects of Lifetime Exercise on the Outcome of In Vitro Fertilization  Morris, Stephanie N.; Missmer, Stacey A.; Cramer, Daniel W.; Powers, R Douglas; McShane, Patricia M.; Hornstein, Mark D.Obstetrics & Gynecology. 108(4):938-945, October 2006.

2  Antpartum, Intrapartum, and Neonatal Significance of Exercise on Healthy, Low-Risk Pregnant Working Women. Maqgtann, Everett F., Evans, Sharon F., Weitz, Beth, Newnham, John. Obstetrics & Gynecology. 99(3):466-472. March 2002.