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In order to establish the cause for missed periods, a thorough history and physical examination should be performed with additional testing that addresses each level of the reproductive axis (i.e. brain, ovaries, uterus). The evaluation may reveal that more than one system is involved here. I generally recommend that women be evaluated if they have had complete cessation of menses for 3 months or irregular periods for fewer than 9 cycles per year. When in doubt, always contact your physician.View Thread

1. Can I get pregnant with the pull-out method or the initial ejaculate?
Oh, yes, you can. Even if a man pulls out before ejaculation, a small amount of semen can still be expelled into the vagina during intercourse. This is because the initial ejaculate contains the most sperm. If you are not trying to get pregnant, I would not rely on the "pull-out" method to prevent conception.
2. Do men who wear tight underwear have a hard time conceiving?
Unfortunately, the answer isn't clear here. There is no conclusive evidence that wearing tight underwear makes it harder to conceive. However, normal sperm production requires a cool environment. If in doubt, switch to boxers.
3. Does lifting my legs up after intercourse increase my chances of getting pregnant?
No. Lifting your legs in the air after intercourse will not increase your chances of getting pregnant. Once sperm is deposited into the vagina, they find their way to the egg fairly quickly. However, I do recommend that women lay on their backs for 10-15 minutes after intercourse to make sure that the majority of the semen stays in the vaginal vault.
When in doubt, always ask your physician to help you with ways to enhance your fertility.
View Thread

However, when a couple has experienced two or more failed pregnancies, I generally recommend that they undergo an evaluation to see whether they have any predisposing factors for recurrent miscarriages. Certain genetic and hormonal disorders, uterine abnormalities, and immune disorders have been linked to recurrent pregnancy loss. Most of the time, the evaluation does not reveal anything and these couples end up doing just fine with emotional support and reassurance.
In the end, it is important to remember that most couples who have experienced a loss are likely to achieve a successful pregnancy. I always find that support from one's family, friends, and physicians can be very comforting and helpful during this difficult time.View Thread


infertility.View Thread

Both partners should be evaluated at the same time. The easiest and simplest way to determine whether male infertility problems exist is to do a semen analysis. This test will let your doctor know whether your partner is producing sperm, and whether the sperm are misshaped or slow-moving. Fortunately, most causes of male infertility are treatable, and this allows most infertile men a chance to start a family. Treatment for male infertility varies, and can range from artificial inseminations for mild forms of male factor infertility to in vitro fertilization for more severe cases.View Thread

In the past, egg freezing was considered experimental because pregnancy rates using thawed eggs were lower than those using fresh embryos. This difference was due to increased damage to the egg during the freeze and thaw process. However, pregnancy rates are similar to those achieved with fresh eggs during in vitro fertilization in low risk groups.
I generally recommend that egg freezing be offered to women who have a medical reason to postpone pregnancy (such as women undergoing cancer treatment) and for those who are at increased risk for premature ovarian failure, since they have few options to help preserve their fertility. It can also be offered as a last resort to couples who have insufficient sperm at the time of their egg retrievals, and to couples who have do not want to consider freezing embryos.
Many clinics are now also offering elective egg freezing as an option to preserve fertility in women who want their biological children but want to delay childbearing. Despite improvements in pregnancy rates with egg freezing using newer processes, patients should still be advised about the limitations of elective egg freezing since its safety and effectiveness has only been studied in select groups.View Thread

Have you heard anything about orgasm affecting fertility? Are there any other myths that you have questions about?View Thread

Contraceptives like birth control pills won't affect your ability to conceive (unless you're still taking them, of course!), but it could have a slight effect on timing, depending on which contraceptive you were taking. If you've been using the birth control pill or the ring, their effects disappear almost immediately. It's estimated that 50% of fertile women trying to conceive will get pregnant by 3 months after stopping the pill and having sex regularly. Users of mechanical methods (i.e., intrauterine devices or IUDs) also should have no delay in conception. If you use an injectable form of contraception, on the other hand, it can take longer to get back to a normal menstrual cycle and ovulation — in some women, up to 9 months after the last injection. I usually suggest that women who want to conceive immediately after discontinuing their contraceptive use other kinds besides depo-medroxyprogesterone acetate (Depo-Provera, an injectable contraceptive).
Besides the potential delay in timing with the injectable forms of contraception, there is no increased risk of infertility from the use of hormonal forms of contraception.View Thread

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