How to Get Pregnant – Coaching Topic #1

Hurrah! We have power at last…a week after hurricane Irene romped through, we have juice! Thanks for bearing with us while we camped out.

So let’s get on with the topic of How to Get Pregnant, starting with why do we need to know this?

In the past few decades, the average age for a first pregnancy in the U.S. has moved from the mid twenties into the mid thirties. In the same time period, the facts of conception – sperm enters egg released in mid cycle, then zygote implants in the uterus, along with how sex allows this to happen and how to prevent it – seems to have disappeared from middle and high school health classes. If that weren’t enough, as women have become more and more essential in the work force, the cost of having children as well as starting later, have driven down the birth rate. Similar conditions exist in most developed nations, although teen pregnancy rates are lower everywhere else.

The birthing population has bifurcated – we see older women (over 35) and teens as the major groups having children. On the one hand we have been working to reduce teen pregnancy while helping older and older women become first time moms. To a certain extent, they need the same information; its just that with teens we use this information to prevent pregnancy and with older women we use information to help them increase their odds of getting pregnant.

Understanding the menstrual cycle, ovulation, charting temperature – all the basic techniques of using the “natural” method of birth control – have become the first steps of the how-to-get-pregnant coaches. Beyond this, a number of sites have their own essential lists to help women be healthy and ready. Sites such as,, and provide additional information. Many suggestions – things to avoid eating, what proteins are needed for ovulation, how to reduce stress, what to do if there are sperm problems, how to find IVF clinics, donors and surrogates – are addressed.

How effective are these suggestions? Well, research tells us they are somewhat effective. None of the sites I contacted answered my query about how they measure or assess consumer outcomes when following their suggestions.

An interesting article in the NY Times 9/1/2011, entitled Are You as Fertile as You Look? openened with this sentence: “FORTY may be the new 30, but try telling that to your ovaries.” The reality is that being under 35 is still the best predictor of how difficult it may be for you to become pregnant. As the article makes clear, looking 30 and being 30 are not the same thing. Even healthy living does not prevent the loss of good eggs.

So, what conclusions can we draw? First, even if you come from a “fertile family,” it may behoove you to have your children in your late 20s or early 30s. Second, if you are putting off having children beyond that time, ask yourself what extremes you are willing to go to to have your own biological offspring. And, third, consider adoption. Frankly, it would be wonderful if adoption were easier, but in the drive to conceive at later and later ages we see the hand of biology and understand why adoption is not easy:  Our own offspring – our own DNA out there in the world – is a heady motivation.

If you are on the pathway of becoming pregnant, being under 35 is the best ally you have. If not, maybe some of the suggestions on the web will work for you. Whatever you decide, all the best.

One parting comment:  Regular moderate exercise – while it helps you stay young and healthy – will not prevent your eggs from being popped out every month. It will help you have a healthy pregnancy if you conceive, so stay with it!

Pregnancy Pathway…Important Notes from Wonderrobyn

The following are notes from co-author Robyn Brancato, CNM (certified nurse midwife) who practices in New York City, or, as she is know here: Wonderrobyn! You can read about both authors in the About tab above. Here they are on the beach in San Diego, when they gave a talk at conference there a couple years ago. Robyn on the left, Ann on the right.

Robyn and Ann, Pathway authors

Robyn and Ann, Pathway authors

1. Addition to Small Rant: “Resist the temptation to watch A Baby Story on TLC! It does not portray birth accurately, as they condense 15 hours of labor into 30 minutes and play up the drama so that you will be on the edge of your seat! In the majority of women, birth is not that dangerous.”

2. Regarding: When does conception occur? “This is a really interesting post… I love the discussion about at what point conception occurs! Personally, I like the Biblical notion of quickening. Even though this varies from woman to woman and can range anywhere from 16 to 22 weeks gestation, it seems like the most natural theory.”

Dear Reader:  What do YOU think? Did you read the conception post on March 23, ’09?

3. About sperm & preeclampsia. “Is the connection between barrier methods and preeclampsia actually established? I have read studies stating the contrary – that barrier methods have no effect on preeclampsia rates.”


More information: The immune maladaptation theory suggests that tolerance to paternal antigens, resulting from prolonged exposure to sperm, protects against the development of preeclampsia. Thus, barrier methods and being young may predispose women to this major disorder of pregnancy.

Evidence exists on both sides of this theory. Here are two recent studies (one of each) that readers may find helpful in understanding this idea. Keep in mind that other factors than just sperm exposure may be affecting research findings. But, it does seem that under some conditions, barrier methods and amount of exposure to sperm can affect the pregnancy itself.

Ness RB,  Markovic N, Harger G, Day R. Barrier methods, length of preconception intercourse and preeclampsia, Journal: Hypertension in Pregnancy 23(3):227-235. 2005.  Results did not support the immune maladaption theory.

Yousefi Z, Jafarnezhad F, Nasrollai S, Esmaeeli H. Assessment of correlation between unprotected coitus and preeclampsia, Journal of Research in Medical Sciences 11(6):370-374. 2006. In a matched controls study, women with <4 months cohabitation or who used barrier methods had higher risks of developing preeclampsia than those with >4 months cohabitation. Oral contraception users had a lower preeclampsia rate than those who used no oral contraception.

In a commentary article in OB/GYN News ,  July 1, 2002, the following note was made by Dr. Jon Einarsson: With insufficient exposure, pregnancy may induce an immune response and preeclampsia in some women with predisposing factors such as an endothelium that already is sensitive to injury due to age, insulin resistance, or preexisting hypertension.

Is there a plain and simple truth about sperm exposure and pregnancy risks? Alas, no. But, know your circumstances. If you are young, protect yourself. Wear a condom. When you are ready to be a mom, you will be ready to figure out your risks. So, this, too follows the axiom:

Events in life are rarely plain and never simple.

Pregnancy Pathway, Conception – Review & Small Rant!

REVIEW: Evidence is clear – pre-pregnancy maternal health status, including physical fitness, healthy nutrition and an uncompromised immune system affect the health and well-being of both mother and offspring, in both short and long term.

This is the message summary from our first two areas of discussion:  Preconditions and Conception – the green and sand colored sections on the chart below.


COMING ATTRACTIONS: We are about to move on to the blue section – Pregnancy!!  So, bookmark this Blog for future reference!

Also, you can subscribe to this Blog by clicking on Blog Info in the upper right corner and then clicking on Subscribe in the drop down menu.

But, yes, you guessed it, first we have a small rant!

SMALL RANT: When we note that fitness, nutrition and a healthy immune system play significant roles in the outcome of pregnancy and the future health of mother and child, we are appealing to young people of childbearing age to be careful about your bodies. The alliance of egg and sperm shapes the world. With 6.5 Billion egg/sperm combinations (yes, people) presently living on earth, our resources are stretched. With time, either we get more picky about doing this, or the 3rd rock from the sun (remember that show?) is cooked.

Humorous incursion: In case you need further enlightenment on this whole area, there is a great website that will help you out. Be prepared to be amused and amazed!

The Truth about Eggs and Sperm

Hopefully, this gets you in the right mood and keeps you smiling. After all, once you actually are pregnant, we have more serious matters to discuss.

Pregnancy Pathway, Conception – Prior Sperm Exposure

Today:  Sperm!!!

For complete graphic, see Feb. 5 or 23 post.

The mother's prior sperm exposure can affect her pregnancy.

The mother's prior sperm exposure can affect her pregnancy.

Not every sperm is your friend! Sperm exposure – like so many exposures – affects our immune system. Women who have babies with more than one father may be at risk for disorders of pregnancy because the challenges to their immune system have been extensive. And, very young women who become pregnant are at increased risk of some disorders because they have had very little exposure to sperm.

In addition, women who have primarily and extensively used barrier methods of contraception may be at risk for disorders for reasons similar to young women with little exposure. Unlike women whose immune system has had too much challenge due to pregnancies by several men, women with little exposure may not have a strong defense against foreign DNA. Please do not take this as a reason to not use a condom – one of the barrier methods along with a diaphragm and cervical cap. Rather, if you use a barrier method of contraception, keep in mind that your body’s adjustment to pregnancy may take time.

For more information on barrier methods, to go the American College of Obstetricians and Gynecologists’ online pamphlet: ACOG Pamphlet on Barrier Contracetption.

Another way sperm can affect the pregnancy is that the combination of the mother’s and father’s natural immune responses may be strong against the trophoblast implantation. This is not something  you can know ahead of time. Also, women are eight times more likely than men to develop autoimmune disorders. One reason may be the prenatal exposure to foreign DNA encountered in pregnancy.

Keep in mind that by getting good prenatal care, exercise, sufficient rest, stress managment and healthy nutrition, you do all within your power to have a healthy pregnancy. Your health care provider will determine your risk factors that may affect pregnancy outcome and treat you in an appropriate manner.

Moms and babies enjoy exercise together!

Moms and babies enjoy exercise together!

Once your baby comes, there will be time to maximize health for both of you. Exercising together is great fun!

Getting there may require some patience, but the reward is well worth it.

When you are looking around for sperm, use your head. The same behavior that protects you from infections you never want to get, protects you from sperm you don’t really want to meet. When the time comes to adopt some sperm, find out about it’s credentials!