My husband and I have been trying unsuccessfully to get pregnant. I've seen many ads for fertility herbs and supplements. Do they work?

Infertility can be a difficult problem to treat, and modern interventions — while sometimes effective — can be expensive. So it's not surprising that some people look to herbs and supplements as a possible alternative treatment.

However, there's no evidence in the medical literature that supports herbs or supplements as a treatment for infertility. The research on so-called fertility herbs and supplements is inconclusive and based on a few small studies. Some of the fertility herbs and supplements studied include:

• L-carnitine.
  For male infertility, studies didn't show increased sperm production and motility in men who took a combination of acetyl-L-carnitine and L-carnitine.
• Vitamin E.
  One study found an association between taking vitamin E and improved sperm motility in men who had low sperm counts or poor sperm motility. Other studies found no improvement in male fertility when vitamin E is combined with vitamin C or selenium.
• Coenzyme Q10.
  A few studies have suggested that coenzyme Q10 may improve sperm counts or motility, but this was not shown to improve the chances of getting pregnant. Another study suggests that coenzyme Q10 may improve egg quality in mice, but study results haven't been confirmed in humans. More research is needed to determine whether such findings lead to improved fertility.
• Folic acid.
  Although some research suggests that folic acid taken with zinc may improve sperm counts, more research is needed to determine if this will have an impact on conception.
• Vitamin C.
  Some preliminary research indicates that vitamin C might help with certain types of female infertility. More research is needed to clarify whether vitamin C can improve fertility in men and women.

While herbal supplements are often marketed as "natural," this doesn't mean these products are safe. Consider these important issues about herbal supplements:

• They have limited Food and Drug Administration regulation.
  Herbs and supplements supplements are subjected to limited regulation by the Food and Drug Administration. The regulations are less strict than are those for prescription and over-the-counter drugs.
• They have a potential for drug interaction.
  Conventional hormone and drug treatments for infertility are complex. It's not known how herbs or supplements might interact with them.
• They can have potentially serious side effects.
  This is true especially when taken in larger doses. If you have side effects from a supplement you take, stop taking it and contact your health care provider.

Talk to your health care provider about herbs or dietary supplements you take or plan to take. Until researchers more clearly define the risks and benefits of fertility herbs and supplements, conventional treatment for infertility appears to be the best option.

The post Home Remedies: Can herbs and supplements enhance fertility? appeared first on Mayo Clinic News Network.

Doctors have known for a long time that smoking is associated with infertility and early menopause. But the impact of secondhand smoke has been unclear. A new study published in the journal Tobacco Control shows that even passive exposure to smoke seems to have detrimental effects on a woman's ability to conceive. The study also reports that secondhand smoke may lead to early menopause, before the age of 50.

Mayo Clinic reproductive and infertility expert Dr. Jani Jensen says, "Although quitting smoking can be very difficult, the motivation to become pregnant and have a healthy pregnancy may help some women attempt to quit using tobacco. Similarly, this new study may be motivating even to partners to quit tobacco use to reduce the risks of secondhand smoke on pregnancy."  

Although the researchers did not explore how secondhand smoke impacts fertility and menopause, Dr. Jensen says one theory behind the menopause issue is that early onset is the result of accelerated loss of healthy eggs.  

The researchers of the study say their findings underscore the importance of shielding women from active and passive tobacco smoke.

Centers for Disease Control and Prevention statistics:

• 40 million American adults smoke
• Close to 15 out of 100 (15 percent) of American women smoke
• Cigarette smoking is the leading cause of preventable disease and death in the United States
• More than 16 million Americans live with a smoking-related disease

If you want to quit smoking, call 1-800-QUIT-NOW for help.

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DEAR MAYO CLINIC:

ANSWER: For couples who would like to become pregnant, ovulation predictor kits can be very useful. And although there’s no specific tests recommended for everyone before getting pregnant, it is a good idea for both you and your husband to meet with a doctor before you try to conceive to review your medical and family history.

As you’re trying to gauge how long it might take you to conceive, you may find it helpful to know that of couples who have regular, unprotected intercourse, about 85 percent become pregnant within one year. More than 50 percent of those are pregnant within the first three months. By four months, it’s 60 percent, and by six months, it’s up to 75 percent. Between the 6-month mark and the 12-month mark, an additional 10 percent of couples become pregnant.

The 15 percent, or 1 out of 6 couples who have difficulty getting pregnant, include those who are trying to have their first child, as well as those who already have a child and want to add to their family.

Being older can make it more difficult to become pregnant. Because of that, women older than 35 who have been trying to get pregnant for 6 months are often advised to see a fertility specialist. Women 35 and younger typically can wait until they have been trying to conceive for 12 months.

Age certainly isn’t the only factor that plays a role in fertility, though. (And many women older than 35 conceive without any problems.) Your own medical history, as well as that of your family, your current physical condition, the amount of stress you have in your life and many other considerations all can have an effect.

Meeting with a physician as a couple before you try to conceive can help pinpoint potential areas of concern. These appointments usually include an assessment of both sides of the family to see if any genetic risk factors could affect a pregnancy. A review of your current medications is also important to make sure that all the medicines you’re taking are safe during pregnancy.

Your doctor may offer suggestions on ways to enhance your physical health to increase your chances of timely conception. For example, maintaining a healthy weight can make it easier to conceive and decrease the risk of complications during pregnancy. Sometimes losing even a small amount of weight can have an impact on fertility. Not smoking, lowering stress and eating a healthy diet can make a difference, too.

Timing is also key to conception. The window of time for an egg to be fertilized after it’s released from an ovary — the process called ovulation — is less than 24 hours. This is where the ovulation predictor kits can be helpful. You can buy one of these kits without a prescription at most drug stores or pharmacies. The test uses a sample of your urine to detect a surge in a specific hormone, called luteinizing hormone, that typically happens about one day before ovulation.

I recommend my patients test their urine with the ovulation predictor kit each day beginning about ten days after the first day of their periods. The day the kit reads “positive” is the best time to try to become pregnant. — Jani Jensen, M.D., Reproductive Endocrinology and Infertility, Mayo Clinic, Rochester, Minn.

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Here's the podcast: MayoClinicRadioPODCAST 06-20-15

The post Fertility and Conception/Osteomyelitis/Melanoma: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

Fertility ... the ability to make a baby ... is affected by a host of factors. From diet and stress ... to age and genetics ... they all play a role in success or failure when trying to conceive. On this week's program, Dr. Jani Jensen, a specialist in reproductive endocrinology and infertility, discusses her new book, Mayo Clinic Guide to Fertility and Conception. Also on the program, cases of osteomyelitis ... an infection of the bone ... are on the rise, especially among older adults. We find out what's behind this increase from orthopedic surgeon Dr. Paul Huddleston. And dermatologist Dr. Jerry Brewer has insights into the disturbing upward trend in cases of melanoma.

Myth or Matter-of-Fact: Half of all pregnancies in the U.S. are unintended.

Mayo Clinic Radio is available on iHeart Radio.

Click here to listen to the program on Saturday, June 20, at 9:05 a.m., and follow #MayoClinicRadio.

To find and listen to archived shows, click here.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

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Myth or Matter-of-Fact: Half of all pregnancies in the U.S. are unintended.

Miss the program?  Here's the podcast:MayoClinicRadioPODCAST 06-20-15

Follow #MayoClinicRadio and tweet your questions.

Mayo Clinic Radio is available on iHeartRadio.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

To find and listen to archived shows, click here.

The post Mayo Clinic Radio: Fertility and Conception/Osteomyelitis/Melanoma appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. -- With Mother’s Day being May 10 and May being Women’s Health Month, Mayo Clinic offers expert guidance on fertility and conception.

Mayo Clinic expert Jani Jensen, M.D. is available to talk about the latest research and provide expert guidance for reporters writing articles on women’s health and fertility and conception.

Dr. Jensen is a Mayo specialist in the division of Reproductive Endocrinology and Infertility and co-director of the In Vitro Fertilization Program at Mayo Clinic.

She is co-author of the recently released Mayo Clinic Guide to Fertility and Conception. The comprehensive book provides answers and explanations for nearly every aspect of achieving a successful pregnancy. It covers lifestyle and nutrition, the intricacies of natural conception, common fertility problems, the latest medical treatments to help (including intrauterine insemination, in-vitro fertilization and donors), and information on special situations (fertility preservation, choosing single parenthood, same-sex couples and more).

Some common questions addressed in the book:

• How long after you stop using regular birth control, like a birth control pill, is a reasonable time to expect for a woman to conceive?
• Why should you find an obstetrician before you start trying for a preconception visit?
• Can you influence the sex of your baby?
• How exactly do age, stress, caffeine and alcohol affect fertility?
• What tools can determine when you’re most fertile?
• When is trying naturally not enough? When is it time to see a fertility specialist?
• And then what? What are the latest treatments to help you get pregnant?
• What if you’re not ready? What are the options for fertility preservation?

JOURNALISTS: To interview Dr. Jensen, contact Brian Kilen at 507-284-5005 or e-mail newsbureau@mayo.edu

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ANSWER: Age can have an effect on a man’s fertility. But the influence of aging on fertility in men is not as significant as it is in women. Research has shown that there may be an increase in the risk for certain health problems in the children of older fathers. The risk, however, appears to be small.

After puberty, most men produce sperm throughout the rest of their lives. That means men can conceive a child well into their later years. That said, studies have shown that men who are older than 40 tend to be less fertile than younger men. But even though older age does reduce fertility, a man’s age alone does not seem to have a substantial effect on a couple’s fertility overall. For example, studies have shown that a man’s age does not decrease the success of fertility treatment in couples who seek those services.

A man’s age at the time a baby is conceived is called his paternal age. A woman’s age at conception is maternal age. A woman’s maternal age is considered to be advanced and health risks for a baby increase after age 35. There is no universally accepted definition of when paternal age is considered to be advanced. Various studies have used cutoffs of 40, 50 and even 60 years for advanced paternal age.

There is no one clear point at which health risks for a baby start to increase with older fathers because the risk grows very slowly over time. The more times a man’s body has created sperm — a process called spermatogenesis — the more of a risk there is for chromosomal abnormalities. This may be part of the reason why there is an increased risk for certain genetic disorders, such as a form of dwarfism known as achondroplasia, in infants of men older than 40.

The potential for other possible health risks have been identified in children of older fathers, too. Research has found that children born to men 40 and older seem to be more likely to develop autism than children of men younger than 30. Children born to men 50 and older appear to be at an increased risk for the brain disorder schizophrenia when compared to children of men younger than 25.

The risk of cognitive impairment also might be higher for children of older fathers. In a 2009 study, children born to older men scored slightly lower on tests measuring concentration, memory, reading and reasoning skills through age 7.

Despite the increase in these risks, however, the overall likelihood for a baby to be born with health problems just because a father is older is still quite low.

If you are older than 40 and you are considering fathering a child, it may be useful for you to have a conversation with your health care provider. He or she can review your medical history and family history to see if there may be any concerns regarding your fertility or health risks for the baby, as well as discuss your reproductive health overall. — Jani Jensen, M.D., Reproductive Endocrinology & Infertility, Mayo Clinic, Rochester, Minn.

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ROCHESTER, Minn. — Dec. 16, 2013 — Enduring the last few weeks of pregnancy can be physically and emotionally challenging for some women. The aches and pains, the swelling of the limbs and the anxiety of when labor may start are part of the natural gestation process, but they also can seem unbearable. It may seem easier to relieve symptoms associated with late pregnancy by electing to deliver early, but Mayo Clinic researchers caution that there can be an increased risk of complications to the mother and the newborn associated with early-term deliveries.

Mayo researchers recently published a review article on this topic in the journal Mayo Clinic Proceedings.

Historically, a full-term pregnancy is calculated as 40 weeks after the last menstrual period. A term pregnancy occurs at 37 weeks or beyond, and an early-term pregnancy is considered to be 37 weeks to 38 weeks and six days. According to the researchers, approximately 10 to 15 percent of all deliveries in the United States are performed before 39 completed weeks of gestation without a true medical indication for early delivery.

“Morbidity and mortality rates have increased in mothers and their babies that are born in the early-term period compared to babies born at 39 weeks or later,” says Jani Jensen, M.D., obstetrician and lead author of the study. “There is a need to improve awareness about the risks associated with this.”

The increased risks for newborns include morbidity, such as respiratory (breathing) difficulties, feeding difficulties and problems such as cerebral palsy although the overall risk is low. These morbidities can also lead to higher rates of admission to the neonatal intensive care unit (NICU).

An elective early-term delivery requires a pregnant woman to be induced, which involves medication or procedures to help start labor. This can lead to a prolonged labor requiring deliveries with instruments such as forceps or a vacuum and may cause infection or hemorrhaging. There is also an increased risk of needing to have a cesarean delivery, and long term there could be more surgical complications for the mother. “It’s not an entirely benign procedure that we are talking about,” says Dr. Jensen.

Dr. Jensen sees a huge need to increase patient awareness and the public’s perception about term pregnancy and when it is safe to deliver a baby. One research study that was reviewed included 650 women who recently delivered a baby. Half of the respondents believed that a full-term pregnancy occurred at 37 to 38 weeks of gestation and 25 percent thought it was safe to deliver a baby at 34 to 36 weeks.

Public awareness campaigns and health care providers can help raise awareness about the complications. Some hospitals have taken steps to decrease the rate of elective early-term deliveries, such as implementing a “hard-stop” policy that prohibits physicians from scheduling an elective induction before 39 weeks. Insurers and quality academies are also taking a close look at this practice. Some companies are refusing to pay for deliveries that are electively induced without a solid medical indication.

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About Mayo Clinic
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MEDIA CONTACT: Kelley Luckstein, 507-284-5005, newsbureau@mayo.edu

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