1. 4A | The Art of Living Well NOVEMBER 2015 WWW.ARTOFLIVINGWELLTODAY.COM
C
onsiderations abound for people looking to start a family, from physical and
mental health to the responsibilities of raising a child, and from testing to
infertility treatments.
It is very important for a woman to be healthy before she becomes pregnant
becausephysiologicallyitisprogrammingtheoffspringtosurviveintheenvironment
outside the womb, according to Dr. George S. Taliadouros, the medical director of
Delaware Valley Institute of Fertility & Genetics.
“Because the environment changes, and there are so many extraneous effects,
the baby should not be lacking any of the information needed,” he says. “A woman
should be like a perfect machine before she becomes pregnant.”
It is critical to set this foundation during preconception because so much of the
information is irreversible, Taliadouros says. He recommends people looking to start
a family read the recommendations set forth by the American Medical Association,
Centers for Disease Control and the American College of Obstetricians and
Gynecologists for a solid set of guidelines to follow.
Making an appointment with a general OB/GYN to open a discussion about
anticipating trying to become pregnant soon would be a proper first step, according
to Dr. Louis R. Manara, of the Center for Reproductive Medicine & Fertility. “That will
elicit an opportunity to do some pretesting,” he says.
Couples should be checked to determine whether they have immunity to the viral
illnesses that can cause birth defects if contracted in the first trimester, including
chicken pox, measles, mumps and rubella.
Irregular menses should be addressed early on, as extreme irregularities in the
cycle can lead to delays in conceiving.
“One of the biggest questions people have is, ‘When do you start to get con-
cerned?’” says Dr. Thomas A. Molinaro, of Reproductive Medicine Associates of New
Jersey. Patients under the age of 35 would generally try for 12 months, those between
ages 35 to 40 for six months, and those over the age of 40 for three or four months.
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2. WWW.ARTOFLIVINGWELLTODAY.COM NOVEMBER 2015 The Art of Living Well | 5A
Having a history of chemotherapy, surgery
on ovaries or fallopian tubes, or early
menopause might be cause for a patient to
seek evaluation sooner, Molinaro says.
“People are largely hesitant because they
don’t know what to expect, and think all of it is
overwhelming,” he adds.
Although there is a lot to take into account,
peoplelookingtohavechildrencansimplystart
with the basics. Basic bloodwork can give infor-
mation regarding a woman’s egg supply. An
ultrasound can be performed to look at the
female anatomy, a semen analysis done to look
at a partner’s sperm, and a hysterosalpin-
gogram, or HSG, X-ray conducted to assess
child-bearing potential.
“For most patients, these will give us every-
thing that we need to know,” Molinaro says.
Patients often find some area that can be
addressed, whether it would entail surgery,
medication to improve ovulation, or more
aggressive treatments including intrauterine
inseminations or in vitro fertilization.
A couple that is relatively young, however,
with no past fertility issues or historical gyneco-
logic problems, has a very good chance of
achieving a pregnancy without needing inter-
vention, says Dr. Stuart Shalit, of Virtua Medical
Group, the lead physician at Virtua Phoenix
OB/GYN and department chair of obstetrics
and gynecology at Virtua Memorial.
Optimizing conditions for conceiving is
rather straightforward, he says. “A well-bal-
anced diet and a routine exercise program,
three to four times a week—there’s nothing
anybody has to do more or less than they’re
normally doing to enhance their fertility.”
Shalit says it’s important for couples to
become knowledgeable on the natural
rhythms, and the science behind them, in order
to set realistic expectations and decrease stress
levels. “Young healthy couples have a 25 per-
cent chance of achieving a pregnancy with each
cycle,” Shalit says. “People tend to believe the
more frequent their intercourse is, the more
likelytheyaretobecome pregnant, butthatisin
fact not the case.”
The male reproductive system cannot pro-
duce sperm quickly enough to have an ade-
quate count on a daily basis, and women with a
regular menstrual cycle have their best chance
of becoming pregnant between day 10 and 20;
therefore, an appropriate intercourse rate
would be every two to three days during that
time.
“People tend to get frustrated when they’re
having intercourse every day, or perhaps more
frequently than every day, and not achieving a
pregnancy,” Shalit says. “If they have less sex
they’re more likely to achieve the outcome
they’re seeking.”
In a day-and-age where “the family unit” is
very diverse—from traditional husband and
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3. 6A | The Art of Living Well NOVEMBER 2015 WWW.ARTOFLIVINGWELLTODAY.COM
wife to single fathers or mothers, and from
grandparents or extended families to same sex
partners—people also want to take a good look
at their values, says Dr. Melissa Suarez, of
Kennedy OB/GYN Associates.
“Anyone interested in starting a family
should envision ‘what does having a family
mean to you?’ and look at the big picture and
whatthatentails,”shesays.“Thenyoucanstart
looking at all the different ways to accomplish
that.” This awareness opens the door to fears
and wishes being openly communicated
among those who will be involved in raising the
child, Suarez says.
Suarez also highlights the importance of
finding a trusted provider who can offer unbi-
ased perspective outside the immediate sup-
port system and underscore a plethora of com-
munity resources are available for people
looking to start a family.
“It might be a social worker to help coordi-
nate care, or someone to work with you on
obtaining medications or transportation,”
Suarezsays.“Peopleshouldnotbeafraidtoask
for any help for their wants and needs they have
as they venture into having a family.”
Center for Reproductive
Medicine & Fertility:
Dr. Louis R. Manara
200 Route 73, Suite A
Voorhees | (856) 767-0009
LouisManara.com
Delaware Valley Institute
of Fertility & Genetics
6000 Sagemore Drive | Marlton
(856) 988-0072
StartFertility.com
Kennedy OB/GYN
Associates
Locations across South Jersey
(856) 218-2312
KennedyHealth.org
Reproductive Medicine
Associates of New Jersey
Serving New Jersey
RMANJ.com
Virtua Phoenix OB/GYN
401 Young Ave. | Moorestown
(856) 291-8865
120 Madison Ave. | Mount Holly
(609) 444-5500 | Virtua.org
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