Stress is the difficult one... I'm in the Armed Forces and my wife is an ITU Nurse! Ha ha...

But we really appreciate the advice. And thank you for helping so many people!

You are very welcome u/Lt_Devil_Melon!

Lifestyle choices when you are trying to get pregnant is very important. High on the list of things to avoid are smoking and alcohol for both men and women. Being an optimum weight is also important as both underweight and overweight have been linked to poorer IVF outcomes. Also, if you have any medication conditions (such as diabetes or high blood pressure) you want to make sure your condition is under control prior to starting the process.

Regarding supplements, some studies have found a benefit for women taking Co-enzyme Q10 and DHEA supplements. For men, zinc and antioxidants have also been found to be important for sperm production.

Stress reduction is also important but hard to study scientifically.

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Hi,

I want to have kids someday but not yet-- I'm 29 and it's still not feasible with my income/ lifestyle. But and am really starting to worry about my "clock ticking".

But I keep finding contradictory information online. At what age does it actually become harder for women to conceive? Does the matter of conception (IVF or not) matter?

Hi u/dangerWW,

I am sorry to hear about your sister's situation. The best advances in fertility treatments have been in the field of pre-implantation genetic testing (PGT). Using IVF, embryos can be tested safely for specific genetic conditions and then the unaffected embryos can be selected to have a baby without the condition. This is something many clinics including my own specialize in. Looking at my own clinic's data, we have a >85% pregnancy rate using PGT, so this is a very successful option to consider.

Thank you for doing this Dr!

Are there any significant lifestyle changes that either significantly increase or decrease chances of success via IVF?

(Couple, M39 and F31, UK)

Hello u/LucilleandCharlie,

Thanks for the question. NOA (non-obstructive azoospermia) is a common cause of sub-fertility. The causes can vary from genetic to hormone issues, chemical exposure and varicocele. This means the treatment options are best tailored to the underlying cause. Some cases can be treated with medication however not all. Even the best treatment may however only lead to a small amount of sperm production, just enough for IVF.

There are some studies looking into stem cell therapy, but this is not commonplace.

An alternative worth considering is donor sperm which may or may not be a direction you are comfortable with.

My sister has a genetic condition and is worried about getting pregnant and passing it to her child. Is there any fertility treatment that can help her?

Hi u/MsGoogle,

Thanks for your questions!

Regarding question 1: There are different professional guidelines on how many times a woman can donate her eggs but the most common one is no more than 5 times.

For question 2: Laws and regulations regarding sterilization vary widely between different jurisdictions around the world. The most important thing to bear in mind is sterilization is not intended to be reversable and as such most doctors avoid offering it to younger women especially if they have not had children. As far as advocating for yourself, I would advise working with a doctot that you feel comfortable with and who is willing to listen to your concerns and weigh the pros and cons.

Regarding NOA, are there any upcoming new treatments we might want to be aware of? TESA, mTESE unsuccessful, no known cause.

For more AMAs on this topic, subscribe to r/IAmA_Medical, and check out our other topic-specific AMA subreddits here.

Hi! Question 1: In regards to a 'normal healthy' woman, how many egg donation procedures can someone have before the risks of the procedure become unacceptable?

Question 2: What can a woman do to advocate for herself when she wishes to become sterilized? I've heard doctors won't provide this medical intervention without a husband's consent if the woman is otherwise healthy and less than 45 years old.

Hi u/leag63,

Great question. For many couples the best way to start trying is to make sure you are timing things with the woman's menstrual cycle. The easiest way is to plan to time sex every 2-3 days from when her period ends until she expects her next period. If her periods are unpredictable, this is reason to see a doctor rather than try for too long on your own. If she is over 35 it is a good idea to do some fertility tests even if you are planning to try naturally just to make sure all is well.

The basic tests are semen analysis, uterus and tube test (like an HSG), and ovarian reserve testing (such as AMH and ultrasound).

The most common thing people may not know is when to time sex especially when a woman's period is irregular.

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Hi, thank you for doing this AMA!

What would be the advice you would give a couple trying to get pregnant, any basic thing to do / not to do that are generally overlooked?

Aww thanks Ruby. You're lovely. Yes I'm definitely more comfortable doing things myself... Lol

Thanks for the awesome response. I agree with not caring for marketing and the like, def not my bag either! The fact that you got the film done and everything else just confirms to me that you are a total badass! I agree that having someone carry my shoes for me would be very odd. I went to a fancy restaurant once and the waiter cracked my pepper for me, I was very uncomfortable.

Ruby <3

I’m not sure I understand why carbon black would be considered inorganic? Tattoo artist here.

Their food is pretty amazing. It's just such a jarring juxtaposition with how beautiful the rest of the building looks.

I heard from someone they had different design plans pre-COVID and then made a change to them and just haven't gotten to it yet it appears. It is definitely odd, but nothing some soup dumplings can't fix, haha

What’s your favorite restaurant in downtown Binghamton?

I love Red Chilis. But I am so confused why they decorated the place beautifully, but then left the center medium bare drywall that's not even sanded.

Spiedie and rib pit on upper front street is the gold standard.

Nobody's watching the office, I guess.

How are you handling the separation of all of the inks? I’m assuming there are many isomers to consider.