Whether or not you and your partner are having trouble conceiving, it's wise to attempt to sort out any problems six months to a year prior to
Seek out a doctor with a good deal of experience with preconception nutrition, who can take a detailed history of both of you and take a number of blood, urine and sweat tests to access your nutritional status. Low magnesium is often associated with repeated miscarriage in women, and low zinc with low sperm counts in men.Tests should examine levels of all vitamins and minerals, particularly zinc, red cell magnesium, copper,essential fatty acids and toxic metals like lead. You should also check pancreatic enzyme functioning, thyroid function and rubella immunity and red and white blood cells. (These sorts of laboratory tests can be performed by Biolab in the UK (0171-636-5959) or in the US, Jonathan Wright in Seattle, Washington (206-631-8920.)
Sort out any allergies, malabsorption problems, hypoglycemia or possible candida albicans overgrowth (particularly common if you've been on the Pill).
Have the man undergo a genito-urinary examination.
Have both of you screened for genital infections, such as bacterial infections, chlamydia trachomatis, candida albicans, haemolytic streptococci and, E coli, many of which cause no symptoms. Chlamydia is directly implicated as one of the most common causes of infertility (Journal of Nutritional Medicine 1994; 4:351-61) and also the most common sexually transmitted infection. In the US, some 4 million men and women are infected. Chlamydia has been linked with ectopic pregnancy, prematurity, perinatal mortality, spontaneous abortions and serious illness in newborn babies born to an infected mother.
Follow a low-allergy, varied wholefood diet with quality proteins and plenty of fresh vegetables and fruits. Drink filtered or bottled water.
Cut out smoking, alcohol and drugs, which affect sperm count.
Follow the supplement programme recommended by your doctor or nutritionist; repeat any tests with abnormal results after three to six months to see if your nutritional levels have normalized and infections have cleared.
Make love frequently, particularly at the time of ovulation (which can be determined by ovulator predictors or, less accurately, by taking your basal temperature). The idea of "saving" up sperm is misguided; intercourse at least several times a week improves sperm quality.
If you still can't conceive after using this programme, acupuncture, homeopathy and herbalism by experienced, qualified practitioners all have a good track record for improving what conventional medicine can't.
If the above fails and you decide to try assisted conception, have a fertility specialist attempt to isolate the problem before treatment. Taking clomiphene will be useless if your problem is blocked tubes.
Have your doctor use the minimum amount of ovarian stimulation drugs for fewer than 12 cycles, and freeze any extra embryos or eggs to minimize future exposure.
Consider adoption as a safer alternative. There is no shortage of foreign babies and domestic children who need loving homes.
Foresight: 28 The Paddock, Godalming, Surrey GU7 1XD. Send SAE.