Six Steps to Increased Fertility
An Integrated Medical and Mind/Body Program to Promote Conception

Robert L. Barbieri, M.D., Alice D. Domar, Ph.D., and Kevin R. Loughlin, M.D.

A HARVARD MEDICAL SCHOOL BOOK

Simon & Schuster

Introduction

As doctors dealing with fertility problems, we see, listen to, and ultimately help hundreds of people to get pregnant each year. We know how concerned you become when another month passes and conception has not occurred. We know a great deal about your dreams and aspirations — and your frustrations and sense of failure. And we wanted to write this book to answer many of the questions and concerns we hear daily from you in our offices. Most of all, though, we wanted to write this book to reassure you that most of you will be able to conceive. Research has shown that although 20 percent of couples will be unable to achieve a pregnancy after a year of unprotected intercourse — the current definition of infertility — most of them will eventually achieve a successful pregnancy. Very few people have physical conditions that make it impossible to have a child, and in many cases, simple lifestyle changes and low-tech strategies can make a decisive difference. Besides, one year is far from a magic number — age and health differences and many other factors will influence your own chances of becoming pregnant.

If you do have difficulty getting pregnant, there is a great deal more you can do about it today than ever before. While assisted reproductive technology can help a large number of couples previously infertile, many couples can be helped by our greater knowledge of how lifestyle factors like stress, exercise, and nutrition affect conception, of better ways to regulate and target ovulation cycles, and of common medicines to avoid that can inhibit sperm and egg production. So much attention in the media is focused on the latest high-tech intervention that many people forget to give nature enough of a chance.

Each of us is an expert in a particular area affecting fertility. Dr. Barbieri, chairman of obstetrics and gynecology at Brigham and Women’s Hospital, specializes in physical problems women have in getting pregnant. Dr. Loughlin, professor of surgery at Brigham and Women’s Hospital, specializes in physical problems men have in conception. And Dr. Domar, the director of The Mind/Body Center for Women’s Health at The Mind/Body Medical Institute, specializes in how the mind and emotions affect conception. We are delighted to be able to bring our separate viewpoints and expertise to this book. Like three pieces of a puzzle, we provide information that separately shows only part of the picture, but taken together creates a clear blueprint for success.

In this book we take a step approach to dealing with infertility. Just because we have sophisticated technology doesn’t mean that everyone needs to make use of it. We believe that couples should always try the simplest, safest approach first before advancing to a more complicated and often more stressful and expensive intervention. In fact, for some of the steps in this book, you don’t need a doctor at all.

Along the way you will meet a number of patients who have experiences similar to your own, and a host of tips and suggestions for maximizing your natural fertility.

But we will also tell you when it is time for the next step — the kind of tests and doctors that would be most helpful — and give you enough information to be sure you are getting the best available care. And because many couples are so anxious to get pregnant that they are tempted to skip important steps and jump to procedures that may not be necessary, we remind readers to always get a second opinion after a diagnosis and before starting a course of treatment.

One of the pleasures of this book is that you can start right now — today — without making a doctor’s appointment, to improve your chances of conception. We hope this book can help bring you knowledge, peace of mind, and ultimately, a successful pregnancy.