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More important questions
5. Have you ever had a sexually transmitted disease (STD)?
If it was caught early and treated, an STD will probably not affect your ability to get pregnant. But one that was untreated for a long period of time may cause problems; untreated chlamydia, for instance, can lead to pelvic inflammatory disease, which may make you infertile. Chlamydia and gonorrhea can also cause scarring of the fallopian tubes or low-grade infections that can change how receptive your uterine lining is, says Carolyn Salafia, M.D., director of EarlyPath Diagnostics, a research facility in Larchmont, NY.
That's why it's important to be checked for STDs by your doctor before you try to get pregnant. Your partner should get checked too: STDS can also block production of sperm.
6. Was your last delivery difficult?
Even if you've had a c-section, you won't necessarily find it harder to conceive your next child, unless there was tissue scarring, which can potentially impair fertility. (Nor do the vast majority of abortions affect conception.)
On the other hand, even a problem-free pregnancy doesn't mean it'll be easy to get pregnant the next time. "If your first pregnancy was uneventful, it excludes certain problems in the future, such as specific congenital abnormalities, but it's not a guarantee - other factors, like age, can affect your chances," says Dr. Davis.
7. Is your period regular?
If you have an irregular cycle that is very long (more than 36 days) or short (less than 22 days), it's possible that your ovaries aren't functioning normally, and that could have an impact on the viability of your eggs when you try to get pregnant. Every woman's cycle is different, but see your doctor to rule out possible medical causes, such as thyroid disease or polycystic ovarian syndrome; both can be detected by blood tests and treated. Fibroids, which can cause heavy periods, may also interfere with fertility and are also easily treated. Fortunately, if you are not ovulating normally when you want to conceive, there are a number of medications that can correct the problem.
8. Are you under a lot of stress?
It isn't clear whether daily stress has an effect on one's chances of getting pregnant. Some experts think it may decrease the production of estrogen, but others find no link. It's a bit of a chicken-and-egg issue: Infertility itself is stressful, so it's not surprising that women who seek help may report feeling tense.
Depression is another matter: "A number of studies link depression and trouble conceiving," says Alice Domar, Ph.D., director of the Mind/Body Center for Women's Health at Boston IVF, Harvard Medical School, and coauthor of Conquering Infertility. "If you want to conceive in the future and you're having emotional problems, try to see a mental health professional," says Dr. Domar. But if you're sure that your emotional stress is related to pregnancy worries, you may want to join a fertility support group. It will not only give you a place to talk about your experiences but also teach you coping techniques for stress management and relaxation. To find a group in your area, visit , the website of the National Infertility Association, and click on Local Chapters.
9. Are you a healthy eater?
A well-balanced diet with plenty of fruits and vegetables is always a good idea, but the average American diet provides the necessary vitamins and minerals for fertility, says Dr. Cowan. Of course, every woman of childbearing age should take a multivitamin with at least 400 micrograms of folic acid - it helps prevent neural tube defects only if you take it before you get pregnant.
Caffeine remains controversial. Some studies indicate that it can delay conception, but others show - you guessed it - no effect. Once you do become pregnant, though, caffeine matters: As little as two cups a day can double your risk of miscarriage. Says Dr. Milad, "I give my patients who are trying to get pregnant the same advice I give those who are pregnant - keep caffeine intake in check and take your vitamins."
So, will you be fertile in five years? There's no way to be absolutely sure, of course. The more you know, the easier it is to plan your future. And the healthier your lifestyle, the better your chances will be.
Kristyn Kusek writes about women's health issues for a number of magazines. This is her first feature for PARENTING.
The Dad Factor
The male contribution to infertility has only recently received the scientific attention it deserves. Here are some questions worth asking about the aspiring father:
Does he smoke? Infertility rates are three times higher in men who smoke compared with those who don't. Just as tobacco use affects a woman's eggs, it can also cause a reduction in the number of sperm as well as damage those being formed. After a man quits, it takes about three months for his sperm to return to normal, says Dr. Davis. If he was a heavy smoker, it can take longer.
What's his health history? Mumps can cause sterility, according to Dr. Davis. Also, about 1 in 500 men have Klinefelter's syndrome, a genetic disorder that causes them to be born sterile.
How old is he? Although a man can impregnate a woman into his 70s and older, new studies make it clear that a man's fertility declines with age, beginning around 35. Both the quality and the quantity of sperm are affected.
Is he okay "down there"? One of the biggest causes of male infertility is varicoceles varicose veins in the scrotum. These affect one in ten men. Some get them around their testicles, which can reduce sperm production. Have him see a urologist for treatment options.
How's his diet? Men who get enough folic acid, vitamin C, and zinc produce more sperm, studies show. The amounts for each in a healthy diet or a standard multivitamin are fine.
Is he regularly exposed to heat? For men who use hot tubs often or truck drivers who spend a lot of time sitting above a vehicle's engine there may be a reduction in the number of sperm produced.
Does he drink a lot or smoke pot? In some men, even moderate drinking affects fertility; some researchers believe men should limit themselves to one drink a day for optimal fertility. Marijuana use can reduce the production of sperm, and heavy use is associated with infertility, says Dr. Davis.
Timing the Test for Pregnancy
If you're using a home pregnancy test, wait at least ten days after your period is due to try it. If you test too soon, the result may signal that you're not pregnant when you really are, says epidemiologist Donna Day Baird, Ph.D. "The fertilized egg may not yet be implanted in the uterus by the time a woman expects her period," she says, "so the test can't detect the pregnancy." Rachelle Vander Schaaf
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