Baby-Making

Depressed Men Damned If They Do or Don't

Oh, great. Adding more fodder to the eternal question "Should I focus on getting pregnant or would I be better off just trying to avoid a big depressive slump?" is the recently published study by
New York-Presbyterian Hospital/Weill Cornell Medical Center in Fertility & Sterility.

That's a very real question for a lot of anxious people. I mean, having a tough time getting pregnant produces its own brand of misery. Just think of the double-whammy for folks who are already trying to treat depression, TTC aside.

A few years back, the FDA told women about the increased birth defects risk from taking the SSRI paroxetine (that's Paxil, to you and me) during pregnancy. There've been other worrisome reports that cause women with depression to slide off their meds for the sake of conception. The new report is a first to link paroxetine to male infertility at a genetic level.

We already knew that guys on Paxil have a hard time -- well, staying that way, anyway -- which can make baby-making a truly aggravating experience. But now we're learning that even when you work around that detail (and this study did indeed have confirming evidence of the Paxil-ED connection,) paroxetine makes something else happen: it slows sperm down to the point that they sort of corrode, DNA-wise.

The relatively small study (35 subjects) had otherwise big numbers: DNA fragmentation went from less than 10 percent to 50 percent while taking the drug. More than a third experienced significant erectile function changes and almost half had ejaculatory difficulty.

The good news: both sexual function and DNA fragmentation return after one month of laying off the paroxetine.

How to Have Baby-Making Sex

If getting pregnant hasn't been so easy for you, maybe you're not doing "it" right. Maximize your chances. Straight-forward stuff, no quips. Some of these tips are under the category of "It Can't Hurt to Try"...

Here's how:

1. Stop using hormonal contraception or have IUD removed at least 3 months prior to conception attempts.
2. Make sure you have intercourse during the woman's most fertile time.
3. Men should refrain from unproductive ejaculation for 48 hours prior to the woman's fertile time.
4. If possible, schedule your conception attempts for the morning, as sperm concentration may be higher then.
5. It is best to avoid artificial lubrication, but if it's necessary, use only water-based ones. Water-based are the same lubricants that are marketed as condom-safe.
6. Avoid douching at any time.
7. Use sexual positions that encourage the natural tilt of the vagina toward the uterine opening (cervix) and that assist gravity, for example, missionary or doggy style positions, or lying on one's side.
8. Avoid cunnilingus (oral sex given to the female) during conception attempts.
9. Avoid anal sex during conception attempts.
10. Avoid underwater sex and hot tubs in general during conception attempts.
11. Avoid sex toys during conception attempts.
12. After ejaculation, the man should remain inside the woman for several minutes and withdraw carefully.
13. After ejaculation, the woman should remain lying down for twenty minutes or more, and may also elevate hips and legs with a wall or pillows.

Tips:

1. Include satisfying foreplay to keep things interesting and assist with lubrication.
2. Allow time in your lives for spontaneous, non-productive sexual relations during less fertile times.
3. Seek relationship counseling through your doctor's office if sexual dysfunction of any kind becomes a factor.

In the Middle of My Story: Infertility & Miscarriage Journal

In what seems like another life, I had my own baby-making struggles, and sometime in the mid to late 90's (BB - before blogs), I published my journal online. Written in hindsight up to a point, I paused in the middle to birth a boy who is now 10 years old. Then, at the request of my readers, I put up my epilogue. This is the introduction to that epilogue.

From there, you can also access the trials & tribs prior, as well as my pregnancy journal. Be forewarned: these are relatively roughly written (as in, hardly a smidge of editorial polish) and not exactly what I consider my better work. But if you're inclined toward others' stories, here is mine.

I gratefully forget about my infertility/miscarriage story often, but it's also intrinsic to me now. I can't think of a single facet of my happily complicated life that isn't touched by the experiences I lived from 1994 through 1999. Every now and then, I am reminded by others that my story is still there and welcome.

The present location of these journal pieces is FertilityCommunity, a place assembled by some nice folks several years ago. It was originally written for About.com when I worked as their infertility guide.