There are approximately 4 million live births in the U.S. each year, but getting there isn’t easy. Each year there are 600,000 miscarriages and 26,000 stillbirths. Additionally, 875,000 Americans experience one or more pregnancy complications. Of the babies born, 467,000 are born prematurely. Sadly, 27,864 infants die before their first birthday. So what can you do to improve your chances of making a healthy baby?

First off, there are certain health behaviors that effect fertility. Women who drink two alcoholic beverages a day decrease their fertility by 60%. Drinking some alcohol in moderation while you are trying to get pregnant is okay, but once you become pregnant it should be avoided to prevent problems like fetal alcohol syndrome. Drinking also decreases men’s fertility by decreasing sperms motility, the ability for them to move. Drinking too much coffee, over five cups or 500 milligrams of caffeine, can also impair a woman’s fertility. Doctors recommend staying under 200 to 250 milligrams of caffeine per day.

Both obesity and malnutrition can also impair fertility. In one study, women who had BMIs between 25 and 39 had a twofold increase in the time it took to get pregnant. Women with a BMI under 19 had a fourfold increase in time. Exercise can help maintain a healthy body weight, but excessive exercising can negatively affect ovulation and menstrual cycles.

Women aren’t the only ones with biological clocks. After 40, men gradually become less fertile. A diet rich in antioxidants can help counteract this. Getting full daily doses of vitamins C and E, folate and zinc can boost male fertility. Tight underwear, heated car seats, laptop computers, cell phones, hot baths and hot tubs can also reduce male fertility. However, “saving up” does not increase male fertility. In this case, practice does make perfect.

A woman is most fertile in the six days before ovulation. The most likely time for a woman to get pregnant is three days before ovulation, but it is better to err on the early side. Techniques such as Natural Family Planning monitor a woman’s cycles and hormonal changes to find the times when a woman has the best chance of conceiving.

By age 40, 85% of women had a birth and 76% of men had fathered a child in the U.S. Overall, after 12 months of unprotected intercourse, approximately 90% of couples will become pregnant. However, 10-15% of couples in the U.S. are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year or at least six months if the woman is age 35 or older. Impaired fecundity, a problem with the potential ability to conceive, affects 6.7 million (10.9%) of women ages 15-44 in the U.S. As a result, 6% of U.S. infants are exposed to ovulation stimulation treatments.

When fertility drugs aren’t enough, potential parents often turn to Assisted Reproductive Technology (ART). Approximately 1% of births are conceived with ART, and there are several methods:

• In vitro fertilization (IVF): involves retrieving mature eggs from a woman, fertilizing them with a man’s sperm in a dish in a laboratory, and implanting the embryos in the uterus three to five days after fertilization.
• Electric or vibratory stimulation to achieve ejaculation: can be used in men with a spinal cord injury.
• Surgical Sperm Aspiration: removing sperm from part of the male reproductive tract, when blockage is the problem.
• Intracytoplasmic sperm aspiration: a single sperm is injected directly into an egg in conjunction with standard IVF.
• Assisted hatching: assists the implantation of the embryo into the lining of the uterus by opening the outer covering of the embryo.

There are two types of surrogacy: traditional surrogacy where the surrogate’s own egg is artificially inseminated and gestational surrogacy where the embryo, already partially developed, is inserted into the surrogate’s uterus. There is also a new three parent child technique used when the parents may want to avoid passing a genetic disorder down to their child. It is called mitochondrial replacement by a donor, and the rest of the DNA comes from the mother and father in IVF. The genes are manipulated to remove the unwanted trait and the donor egg provides the desired genes.

A new study also suggests that recurrent miscarriages may be a result of super-fertility as opposed to infertility. Some women’s uteruses are more conductive for implanting embryos, both healthy and unhealthy. Therefore, unhealthy embryos are not naturally weeded out and progress farther along into pregnancy.

The future of fertility treatment, whether it is gene manipulation, gender selection, or new types of IVF, is uncertain. In Sweden, a successful uterus transplant was performed from a mother to a daughter, opening the door for the possibility of infertile women being able to carry their own child. No matter where technology takes us, the birth of a child will still be a blessing.

Additional Resources

Web MD 8 Ways to Boost Your Fertility: http://www.webmd.com/baby/guide/8-ways-to-boost-your-fertility

The American Fertility Association: http://www.theafa.org/

Safer Chemicals Healthy Families: http://www.saferchemicals.org/

CDC Infertility: http://www.cdc.gov/nchs/fastats/fertile.htm

CDC Fertility Drugs: http://www.cdc.gov/Features/dsFertilityDrugs/index.html

American Pregnancy Association Statistics: http://www.americanpregnancy.org/main/statistics.html

The World Bank Fertility Rate: http://data.worldbank.org/indicator/SP.DYN.TFRT.IN

The Mayo Clinic Infertility: http://www.mayoclinic.com/health/infertility/DS00310/DSECTION=causes

CDC Fertility of Men and Women Aged 15-44 in the United States: http://www.cdc.gov/nchs/data/nhsr/nhsr051.pdf

Medical News Today “Three-Parent IVF”: http://www.medicalnewstoday.com/articles/250343.php

ABC News Uterus Transplant: http://abcnews.go.com/Health/Wellness/uterus-transplant-latest-fertility-feat/story?id=17261824

Medical Daily Everything You Need to Know About Surrogacy and Fertility: http://www.medicaldaily.com/articles/12183/20120918/everything-need-know-surrogacy-fertility.htm

The Huffington Post Gender Selection Has Become A Multimillion-Dollar Industry: http://www.huffingtonpost.com/2012/09/17/gender-selection-_n_1889991.html

Bioscience Technology New Egg Freezing Method Expands Reproductive Options: http://www.biosciencetechnology.com/News/2012/09/New-Egg-Freezing-Method-Expands-Reproductive-Options/

Brainerd Dispatch Taking Control of Your Reproductive Health: http://brainerddispatch.com/news/2012-09-18/taking-control-your-reproductive-health

Live Science Super-Fertile Women May Have More Miscarriages: http://www.livescience.com/22706-super-fertility-recurrent-miscarriages.html

Chicago Tribune Antioxidants Tied to Older Men’s Sperm Quality: http://articles.chicagotribune.com/2012-09-14/lifestyle/sns-rt-us-antioxidants-spermbre88d13w-20120914_1_sperm-quality-sperm-dna-damage-sperm-samples