Take note if you are trying to have a baby

As one of the human body's most basic and most powerful processes, pregnancy - and the ability to conceive a child - is often thought of as a "natural" occurrence. Yet there are numerous factors involved in achieving and maintaining a healthy pregnancy, and even a minor flaw in just one area can wreak havoc on couples attempting to conceive.

Dr. Mark Leondires, one of the Northeast's leading reproductive endocrinologists, shares his "top five" list of requirements for pregnancy, and points out simple ways that women can self-assess their level of function in those areas.

"Dealing with infertility is draining, from a mental, physical and emotional standpoint," Dr. Leondires notes. He believes that much of the difficulty lies in the powerlessness people feel when a medical situation is "out of their hands." "By providing five simple ways that men and women can determine - and enhance - their own fertility levels, I hope to give them back a sense of power over the process," Dr. Leondires explains. The five factors he discusses are:

1. That "tick-tock-tick-tock" you've been hearing isn't just your imagination. "The biological clock is real," Dr. Leondires stresses. Women are born with all the eggs they'll ever have, and the vast majority of these eggs never mature. What's more is that quality, as well as the quantity of viable eggs, diminish with age. "If you are over 35, and you haven't been able to achieve or sustain a pregnancy over the course of six months' unprotected sex, see your OB/Gyn or a reproductive endocrinologist," Dr. Leondires advises.

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2. What's your cycle? A normal cycle that produces ovulation lasts between 23 and 36 days. If yours is shorter or longer, it is possible that you are not ovulating. To check, take your temperature every day before you rise from bed, and chart it on a graph for two to three months. "The basal body temperature will typically dip a bit mid-cycle, then spike and remain higher until menstruation," Dr. Leondires says. "The dip and spike usually indicate ovulation." A more reliable tool to check for ovulation would be an Ovulation Predictor Kit. This kit can be purchased from any local pharmacy. By checking the hormone levels in the woman's urine, the kit can help most women accurately time intercourse during their ovulatory phase.

3. Check your tubes. The fallopian tubes are the only route between the ovaries and the uterus, and they're usually the spot where sperm fertilize the egg. If one or both tubes are blocked, conception will be difficult. "A history of a pelvic infection, tubal pregnancy, abdominal surgery, or ruptured appendix can damage your fragile fallopian tubes," Dr. Leondires says. Yet, forty percent of women with damaged fallopian tubes do not report any history of infection. A simple X-ray called a hysterosalpingogram can determine the condition of the fallopian tubes.

4. Timing is (almost) everything. Up to 20% of couples miscalculate the optimal time for conception. Dr. Leondires suggests subtracting 17 days from the average number of days in your cycle, and having unprotected sex on that day, and two days later. "It's best to have sperm waiting for the egg in the fallopian tubes prior to ovulation," he notes. "And since sperm can live for two days or longer, intercourse prior to ovulation is often the key to success."

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5. Sometimes, it's a male thing. Up to 40% of fertility-challenged couples encounter a male factor, Dr. Leondires points out. Perfectly healthy men can have a low sperm count of less than 20 million per ejaculate. But the good news is that the majority of couples with male-factor infertility can conceive with intervention. Wearing loose fitting clothing, avoiding nicotine and excessive caffeine or alcohol, and having a simple sperm test can help diagnose and allow treatment for male-factor infertility, Dr. Leondires says.

Dr. Mark P. Leondires, M.D., FACOG, is a leading authority on reproductive medicine. Dr. Leondires is board certified in Reproductive Endocrinology and Infertility. He is a member of the Society of Reproductive Endocrinologists, the American College of Obstetrics and Gynecology, and the American Society for Reproductive Medicine.