her schedule to allow her to pursue treatment protocols, and fortunately, after considerable work and persistence, she had her first child. Child number two came as a complete surprise since not everything was perfect yet for that second child. The point: Many active people need to maintain a certain level of activity to control their stress. Don’t confuse activity with stress.
Full disclosure: Dr. R is not a firm believer that stress is a significant cause of infertility. He is a strong believer that infertility causes stress. To that end, anything that will reduce your stress and allow you to pursue treatment is desirable.
What can you do to reduce stress? We talk more about stress-reducing techniques in Chapter 9, but in general:
Talk it out. Stress increases when you hold everything in.
Try to focus on the “big picture.” When you’re trying to get pregnant, every failed month seems like a year — or the end of the world. When you finally do get pregnant, it won’t matter whether you got pregnant in November or January. Remember that the odds are on your side, in most cases, and that you will get pregnant.
Don’t lose sight of the rest of your life. While trying to have a baby may be a big part of your life at this moment, it’s not the only thing you have going on in your life. Make time for your family, your partner, your friends, your hobbies — and anything else that helps you remember that you had a life before you started thinking about pregnancy, and you still do!
Getting Checked Out from Top to Bottom
Having a checkup even before you try to get pregnant is always a good idea, and it’s essential if you’ve been trying for a few months and still getting “not pregnant” results on the home pregnancy tests. Sometimes simple imbalances in your thyroid levels, or other levels easily checked by a simple blood test, can be keeping you from getting pregnant.
Having a full physical
You can see either your primary care physician (PCP) or your gynecologist for a checkup — or both! Your PCP looks at the “big picture” while your GYN looks mainly at your reproductive issues. Either one can order blood work and do a physical exam. (See Chapter 8 for more on choosing a doctor to help you get pregnant.)
Do you need to book a full body MRI or CT scan to find out if you’re in shape to get pregnant? No, a half hour with your doctor should do the trick. If you’re putting off a visit because you’re afraid of being “yelled at” because you’re overweight, have bad habits you know you’ll be lectured about, or are terrified of having blood drawn, now is the time to put those fears aside.
A routine checkup by your gynecologist or family doctor may be all you need to help you get pregnant; for example, your doctor can look at the following possible pregnancy stumbling blocks:
Your weight: Are you underweight or overweight? Being either over- or underweight may interfere with pregnancy.
Your sexual practices: Are you missing the big day each month because you’ve been misinformed about when you ovulate?
Your sexual history: Do you have a sexually transmitted infection (STI) that could be preventing pregnancy? (See the section, “Understanding Common Infections That Can Cause Uncommon Results” for more on STIs.)
Your habits: Do you douche right after sex? You may be washing some of the best swimmers away!
Your blood pressure: Women with high blood pressure may be prone to developing serious hypertensive disease during pregnancy.
The physical exam includes examination of the thyroid gland in the neck, breasts, heart, lungs, abdomen, and reflexes (for neurologic response). A pelvic exam includes a vaginal speculum exam to evaluate the cervix (this generally means a PAP smear!), a bimanual exam to assess ovaries and uterus, and a rectal/vaginal exam. A transvaginal ultrasound frequently completes the initial pelvic exam so that your ovaries and uterus can be visualized.
Checking your blood levels
The good thing about having blood drawn is that a single specimen can be used to test for many different health conditions, including some that can interfere with getting pregnant; we look at a few in the next sections.
Looking at your thyroid function
Women who have an underactive or overactive thyroid may have trouble getting pregnant. Thyroid abnormalities can cause anovulation (no egg is released), irregular menstrual cycles, or short menstrual cycles. (See Chapter 2 for more about menstrual dysfunction.)
Hypothyroid, or low thyroid levels, can raise your prolactin level (prolactin is a hormone that helps control milk production in breastfeeding women). High prolactin levels can prevent ovulation; prolactin levels can be diagnosed with a blood test.
Running a chemistry panel
A chemistry panel tests your blood sugar to show if you have diabetes; it also tests your liver and kidney functions. Many health problems that can have impact on pregnancy can be found through a chemistry panel.
Checking your blood count
A complete blood count, or CBC, tests your hemoglobin, which shows if you’re anemic. It also tests your white blood count, which can show chronic infection.
Checking your medications
Have you overlooked something that could be interfering with your getting pregnant? Think back a few months, especially when thinking about sperm production; the sperm being ejaculated today have been over two months in the making, so anything your partner was taking a few months ago could be affecting his sperm count today. Ask yourself the questions in the following sections about a few possible deterrents you may not have thought about.
Taking a closer look at prescription medications
What you put in your body may matter when you are trying to get pregnant. Taking a quick inventory of any ongoing or recent prescription drugs can identify if any of these are getting
