Vaccines for Population Control

A vaccine against HCG (Human Chorionic Gonadotrophin) for stopping pregnancy is under development. 

I'm assuming this would be a permanent sterilization? 

How would you "unvaccinate"? 

HCG is a hormone for fat regulation too (Homeopathic HCG is used in a currently popular weight loss program). 

"Human chorionic gonadotropin (hCG) is synthesized soon after fertilization and is essential for embryonic implantation. A an anti-hCG vaccine would be ideal for immuno-contraception."

Learn More -  

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TD4-521MCG3-1&_user=10&_coverDate=03%2F09%2F2011&_rdoc=20&_fmt=high&_orig=browse&_origin=browse&_zone=rslt_list_item&_srch=doc-info%28%23toc%235188%232011%23999709987%232921799%23FLA%23display%23Volume%29&_cdi=5188&_sort=d&_docanchor&_ct=20&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=574fa3f90e112db16b4a18b05e51943a&searchtype=a



Source

This information is provided by Creating Health Institute
through our Health Matters(c) project.

Pregnant women often deny smoking

Overall, about one in four women who smoke while pregnant deny it, a new study hints. The numbers could be even higher in certain groups of women, like those in their early 20s.

In the United States, smoking by moms-to-be is one of the most common preventable causes of illness and death among infants, Dr. Patricia Dietz from the division of reproductive health at the Centers for Disease Control and Prevention in Atlanta, and colleagues note in their report.

In their study, they estimated how many pregnant and nonpregnant smokers aged 20 to 44 years did not disclose their habit on a health questionnaire.

How did they catch the deception? They took blood samples from the women to measure levels of cotinine -- a byproduct of nicotine that serves as a marker of exposure to tobacco smoke. Their analysis included 994 pregnant women and 3,203 nonpregnant women.

Overall, 13 percent of pregnant women and 30 percent of nonpregnant women were active cigarette smokers. The pregnant smokers smoked an average of 11 cigarettes a day, while the nonpregnant smokers averaged close to 14 cigarettes a day.

According to the investigators, far more pregnant than nonpregnant smokers failed to disclose their habit - 23 percent versus nine percent - and were identified by their cotinine concentrations.

For a variety of reasons, such as the fact that pregnant women's bodies break down cotinine faster, the researchers think the results "likely underestimate" the true number of pregnant women who smoke and don't say so.

Among both pregnant and nonpregnant smokers, those most likely to keep this information to themselves were women aged 20 to 24, as well as those with Medicaid or other source of government-funded health insurance and those with less than a high school education.

Race also factored in. Pregnant smokers who failed to report their habit were most likely to be non-Hispanic black. In women who weren't pregnant, nondisclosure was most common among Mexican-American women and non-Hispanic blacks.

Writing in the American Journal of Epidemiology, Dietz and her colleagues say their findings may have important implications for researchers studying how smoking during pregnancy affects the developing baby, as roughly one in four pregnant smokers, and one in 10 nonpregnant smokers, deny smoking.

Studies and surveillance systems that rely on people to accurately state their smoking status may get inaccurate information, "especially among pregnant women," they warn.

SOURCE: http://link.reuters.com/tux34r American Journal of Epidemiology

Fish oil during pregnancy

The Facts:

* Approximately 70 pregnant women were asked to take either fish oil (omega-3 polyunsatuated fatty acid) or olive oil for the second half of their pregnancy.

* The children were studied when they reached 2 ½ years of age to see how they were developing.

* The children whose mothers had taken fish oil were further developed and had better language, behaviour and hand-eye coordination skills than children in the olive oil group.

Shaun’s comment: We seem to have some research about a new benefit of fish oil every month! This was a good study from an Australian School of Paediatrics and Child Health. The dose used was 2.7g of omega-3 fatty acids, which is equivalent to one meal of fish per day. As well as the benefits, no adverse effects were seen. A larger study of 400 children is planned which will give even more information, including whether the fish oil supplement can prevent the onset of allergic disorders such as asthma and hay fever.

Study Reference:

http://www.theaustralian.news.com.au/story/0,20867,19851298-23289,00.html

Drinking milk during pregnancy

The Facts:

* Not enough milk consumption during pregnancy can lead to smaller babies.

* Women who generally drank less than 250ml milk per day gave birth to babies who weighed less than those born to mothers who drank more milk.

* Vitamin D (present in milk) was directly linked to the babies’ birth weight.

Shaun’s comment: Pregnancy is a unique time in every mother’s life when health worries are at their peak. Mums-to-be are barraged with information about what they should and shouldn’t do during pregnancy, and some of the information can be confusing and conflicting.

It is generally accepted that low birth weight babies are at a higher risk of becoming ill and frequently don’t thrive as well as babies of normal birth weight. The study indicates drinking milk every day during pregnancy may help improve birth weight.

The study does not, however, pinpoint how much milk would be most helpful and like most supplements, it is possible to have too much of a good thing. It is worth discussing this with your healthcare professional as part of a wider conversation about maintaining a healthy diet during pregnancy.

Study Reference:

http://dx.doi.org/10.1503/cmaj.1041388

Asparagus Souffléed Omelet

Although Spring is officially here in North eastern Ohio, the trees are still shy of green leaves and vibrant blossoms.But the signs of budding in the trees and singsong birdies positively assure me,spring will be in full bloom soon.Speaking of which, the succulent asparagus blooming in the stores are also a sure sign of coming of spring.
These tender spears are rich in folate,essential for heart health and to prevent birth defects during pregnancy.Its also rich in potassium ,vitamins and is considered a natural diuretic[a diuretic increases the production and flow of urine from the body, used to remove excess fluid from the body].

Asparagus come in varying thickness,from pencil-thin to nearly an inch.Can be purple ,white or green.For freshest asparagus pick the ones with tight and closed stalk with completely smooth and firm stalk.The bottom woody inch or two of any asparagus should be trimmed and discarded.To keep asparagus for longer,cut off the woody base and let the bunch stand in an inch of water in a container in the refrigerator.Tastes best when steamed or lightly sautéed.


The low-carb Asparagus Souffléed Omelet recipe comes from Sara's Moulton Quick and Easy weeknight meals.Souffléed Omelet is a cross between an omelet and a Soufflé.Make sure you beat the egg whites just to soft peaks;otherwise they won't fold properly in to the egg yolk base.Any left over vegetable such as broccoli or spinach will make a fine filling for this Souffléed Omelet,so consider this a clean-out-the-fridge dish.Serve for any meal of the day with salad greens or toast with fruit spread.

Ingredients
6-8 asparagus,washed and trimmed
1/2 a medium onion,sliced
1 clove garlic,chopped
1/2 teaspoon each of black pepper and salt
1 tablespoon Extra virgin Olive oil
4 large Organic eggs,White and yolk separated
1 tablespoon fresh herbs(parsley,cilantro ,tarragon or dill)
1 tablespoon all-purpose flour
Method
Preheat oven to 375F.
Cut the asparagus cross wise in to 1/4-inch pieces.
Heat a pan with teaspoon of olive oil,add the onions,saute until lightly caramalized about 3-4 minutes,then add the garlic and asparagus.Cover and cook on low flame until asparagus is crisp-tender.Season with salt and pepper.
In another non-stick pan with heat proof handle or cast-iron pan ,heat the oil just until warm and remove from heat.Whisk egg yolks with flour,1/2 teaspoon salt,and 1/4 teaspoon black pepper until mixture is fluffy,about 3 minutes.Beat the egg whites using an electric mixer or a whisk until they hold soft peaks;fold them in to the yolk mixture gently but thoroughly ,and pour the egg mixture in to the skillet,spreading it evenly.
Bake the Omelet in the center of the oven for 10 minutes,or until it is puffed and cooked through.Remove from oven,place the filling in the center and fold using a spatula or for an attractive presentation,cut rounds using cookie cutter and place the filling between them.Sprinkle the herbs.I served it with drizzle of hot and sweet maggi tomato sauce alongside toast and home made mango jam.

Asparagus Souffléed Omelet is my entry for Weekend Herb Blogging,hosting this week is Prof. Kitty from The Cabinet of Prof. Kitty.

9 Natural Fertility Boosters

Limit caffeine consumption

Several studies have shown reduced fertility for women who consume more than 300 mg of caffeine each day. Fortunately, the threshold is high enough that you can still indulge in that morning cup o' joe, since the average 8-ounce cup of coffee only has 100 to 130 mg of caffeine. Don't forget, though, that black tea, green tea, chocolate, and some sodas also contain caffeine.

For women undergoing in vitro fertilization, however, the threshold is much lower: A mere 50 mg of caffeine—the equivalent of one cup of tea—can negatively impact success rates.

Alice Domar, an assistant professor at the Harvard Medical School who also counsels women dealing with infertility, suggests that you may want to further restrict your caffeine intake if you've been trying unsuccessfully to get pregnant, even if you're not doing IVF. Since only limited research has been done on the topic, Domar worries that further research may show that lower amounts of caffeine still impact fertility.

"Fertility is a very time-limited period in a woman's life, so try everything you can now," Domar recommends. "There's no downside to further limiting your caffeine intake, and if further research shows that lower caffeine intakes negatively impact even non-IVF women, you'll know you’ve done everything you could."

If you're overweight, lose weight

Being extremely overweight can make a woman less likely to get pregnant. Obesity can inhibit ovulation and wreak havoc with hormones. It also puts women at risk for a variety of health problems (such as diabetes, heart disease and high blood pressure) that negatively impact fertility and can create complications during pregnancy. Women who are morbidly obese are also less likely to be successful with fertility treatments.

Part of the problem is the hormonal imbalance that's created by the fat cells themselves. Fat cells produce extra estrogen, says Gerard Letterie, a reproductive endocrinologist at the Northwest Center for Reproductive Sciences. The more fat cells, the more estrogen, so being overweight is very similar to being on birth control pills.

Domar explains that although female fertility peaks with a body mass index in the low- to mid-20s, weight-related fertility problems are most common in women with a BMI greater than 34, which is considered obese. For instance, a woman who is 5 feet, 4 inches tall and weighs 200 pounds isn't just obese; she’s also jeopardizing her fertility.

If you're having trouble losing weight, Letterie recommends a group weight loss program like Jenny Craig or Weight Watchers. "Studies have shown that women participating in group weight loss programs are the most likely to be successful," says Letterie.

You needn't diet down to a size 8 to get pregnant. "Research shows that when obese women lose an average of 10 to 14 pounds, many will get pregnant the natural way, without medical intervention," Domar says.

If you're underweight, gain weight

A normal, healthy Body Mass Index ranges from 18.5 to 24.9. Anything lower than 18.5 is underweight. For instance, woman who is 5 feet 4 inches tall and weighs 105 pounds has a BMI of 18 and is considered to be underweight.

Being even slightly underweight can dramatically reduce your fertility, as fertility starts to plummet for women with BMIs of 18 or lower.

Women who are underweight are less likely to ovulate. Some will stop menstruating completely. Others will menstruate irregularly. But experiencing a monthly period doesn't necessarily mean you're fertile, since it's possible to menstruate without ovulating.

Sometimes low body weight can be caused by excessive exercise and athletic training, which has also been linked to problems with getting and staying pregnant. For such women, dialing back on the exercise can be enough to gain weight and boost fertility.

For low body weight caused by an eating disorder, it's important to seek professional treatment.

Simply gaining some weight is usually enough for women to begin ovulating again, says Letterie. For those women who don't, Letterie stresses that there are simple treatments to help women ovulate again, but only after they've gained the necessary weight.

Check your BMI

Try acupuncture

In May 2006, the journal Fertility and Sterility published two studies showing significantly increased pregnancy rates for women receiving acupuncture treatments in conjunction with the embryo transfer stage of in vitro fertilization. In one study, women receiving acupuncture were more than twice as likely to become pregnant. In another, acupuncture prior to embryo transfer increased rate of pregnancy by 50 percent.

Researchers aren't sure why acupuncture may be helpful. Some speculate that acupuncture may positively impact hormonal levels or increase blood flow to the ovaries and uterus. Another theory: Since acupuncture can induce a relaxation response, it may be counteracting the stress that often accompanies infertility. Reducing infertility-related stress and anxiety has been shown to increase success for IVF treatments.

Despite the positive findings, scientists agree that more research needs to prove that acupuncture is truly effective.

Although Domar herself has called for more rigorous testing of acupuncture, specifically to sort out the issue of the placebo effect, that hasn’t stopped her from recommending acupuncture to her infertility patients. "There is some very promising data out there," Domar says. "Acupuncture is a safe, cheap, non-invasive and easy way to potentially increase your chances of getting pregnant."

Walk 30 minutes per day

Walking just 30 minutes each day is a simple, inexpensive form of exercise that helps ward off problems like heart disease and diabetes, diseases which may impact fertility and can cause complications during pregnancy. In addition, regular exercise helps maintain a normal body weight, which is an important part of maximizing fertility.

Walking may also help boost fertility by increasing circulation to the pelvis and the reproductive organs, since some research has linked decreased blood-flow to the ovaries with ovarian aging and reduced success with in-vitro fertilization.

"Many couples I see have jobs that require them to sit all day in front of the computer. This doesn't do much for circulation to the pelvis and the reproductive organs," says Dr. Susan Carr, a naturopathic physician at Fertile Path in western Washington state. "Exercise is one way to support circulation to these organs."

Daily physical activity is also a great way to improve your mood and help ward off the stress and depression that are common side effects of infertility.

Thirty minutes a day is easy to fit into even the busiest of schedules and can provide a great opportunity to spend quality time with your partner or a good friend.

Deal with depression

While many experts believe that depression doesn't cause infertility, proper treatment for depression can help increase fertility.

Since it's not uncommon for women struggling with infertility to become depressed, try joining a fertility-focused mind-body group. These groups teach techniques to relax and manage the stress and anxiety associated with infertility. Research conducted at the Harvard Medical School found that women undergoing in vitro fertilization who participated in a 10-week mind-body program were more than twice as likely to get pregnant.

If you were seriously depressed before attempting to get pregnant, it's important to seek prompt treatment from a mental health professional. "Women with severe clinical depression are much less likely to eat well, exercise, and otherwise take care of themselves," says Domar. "And women who are less healthy are less likely to get pregnant."

While anti-depressants can be effective in the short term, Letterie encourages women to work with their doctors to get on the lowest dose possible. Ideally, he'd like to see women weaned off of prescriptions before getting pregnant, since taking medication during pregnancy is not without risks.

To learn to manage depression without drugs, Domar recommends that women work with a cognitive behavioral therapist to learn effective ways of dealing with depression. The Association for Behavioral and Cognitive Therapies maintains a database of therapists trained in cognitive behavioral techniques.

Eat a balanced diet

To maximize your chances of conception and a healthy pregnancy, Carr and Domar both recommend eating a healthy, unprocessed diet rich in whole grains, beans, fresh fruit and vegetables, raw nuts and seeds (skip the ones with added oil and salt), healthy oils (like olive oil), lean meat, and cold-water fish like wild salmon that are high in omega-3 fatty acids.

A balanced, whole-foods diet will help you maintain a normal BMI, a critical component in maximizing fertility. In addition, by eating well and minimizing unhealthy fats, white flour, sugar, and salt, you'll reduce your risk of diabetes, heart disease, and high blood pressure—diseases that can decrease your fertility and also cause complications in pregnancy.

To further boost your chances of conception, Carr recommends emphasizing foods that are rich in omega-3 fatty acids, such as wild, cold-water fish, walnuts, and flax seeds. "Omega-3 fatty acids promote fertility, since essential fats are required for hormone balance and healthy cell function," says Carr. "Unfortunately, most diets are deficient."

With just a little extra planning, it's easy to integrate more whole foods into your diet. For breakfast, try a bowl of oatmeal with fresh fruit. For lunch, have a sandwich on whole-grain bread or a colorful salad with olive oil and vinegar. Fresh fruits, as well as raw nuts and seeds, make excellent mid-afternoon snacks. "Just be intelligent about your health," says Domar. "Given a choice between fried dough and an apple, we all know which one to pick."

Strictly limit alcohol consumption

Most reproductive experts agree that one or two drinks each week shouldn’t impact a woman's chances of getting pregnant, while excessive drinking is clearly problematic. However, the jury is still out on exactly how much a woman can drink before her fertility is affected.

While a couple of studies have found no link between moderate alcohol (one to two drinks each day) intake and fertility, one Danish study from 2003 found that just seven drinks a week could negatively impact the chances of conceiving for women more than 30 years old. Another Danish study from 1998 found that even moderate drinking (6 to 10 drinks each week) reduced a woman's chances of getting pregnant, with more excessive drinking further decreasing the chances of conceiving.

For women who are heavier drinkers, Letterie recommends that they get their drinking problem under control before they try to conceive, especially since it's critically important that women cut out alcohol completely once pregnant.

Although it's still unclear whether or not moderate drinking will negatively impact fertility, limiting alcohol consumption to only one or two drinks each week surely won't hurt, especially if you’ve been trying unsuccessfully to get pregnant for more than a few months.

In addition, you should stop drinking after you ovulate during any cycle in which you try to conceive. Alcohol consumption after conception can increase the risk of miscarriage and can cause fetal alcohol syndrome.

Stop smoking and avoid second-hand smoke

More than 100 research studies have consistently linked smoking to decreased fertility and increased problems in carrying a birth to term, says Dr. David Adamson, a reproductive endocrinologist at Advanced Reproductive Care in Palo Alto, Calif.

Smoking damages eggs, reducing the chances of getting pregnant during any given cycle, and smokers may hit menopause several years earlier than their non-smoking peers. Smoking also negatively impacts hormone levels, further reducing fertility.

The problems don't end when a smoker gets pregnant. Smokers are more likely to suffer from miscarriage and complication during their pregnancies, and babies born to smokers are more likely to be underweight.

Although smoking does damage eggs, quitting now can still help boost fertility. Going smoke-free will prevent further reduction in egg quality, help reverse hormonal changes, and increase the chances of carrying a healthy baby to term.

According to the American Society for Reproductive Medicine, it's not enough for just the woman to stop smoking, since second-hand smoke has been shown to be almost as bad for a woman's fertility as actually smoking. Since smoking also reduces fertility in men, it makes sense to make quitting a family affair.

By Lisa Farino for MSN Health & Fitness

Calcium for pregnant women

The Facts:

* This study was a huge World Health Organisation study of over 8,000 women.

* Women with low calcium diets took either calcium supplements or placebo.

* Calcium reduced several complications of pregnancy, including pre-eclampsia, eclampsia, severe gestational hypertension, severe maternal morbidity, preterm delivery and neonatal death.

Shaun’s comment: Calcium is necessary for healthy bones and teeth. In this study, the women in the treatment group took 1.5g of calcium each day from before the 20th week until the end of the pregnancy. This study confirms pregnant women need calcium for a healthy pregnancy. This is usually obtained from dairy products and other foods in a healthy diet. However, if you are concerned that your diet may be lacking in calcium, then it would be advisable to take a supplement during pregnancy.

Study Reference:

http://www.ajog.org/article/S0002-9378(06)00142-6/abstract

My twins were born TWO days apart

By Lucy Laing -- from www.mirror.co.uk

When Hayley Phillips gave birth to Ryan at 29 weeks, she expected his twin Lewis to put in an appearance soon afterwards, but she was in for a long wait.

When Hayley Phillips gave birth to her son Ryan 11 weeks early on her bathroom floor, she assumed his twin brother was on his way.

But by the time she got to hospital to give birth to the second baby her contractions had stopped as though she’d finished giving birth.

And it wasn’t until almost three days later that Hayley finally had her second

boy, Lewis.

“The doctors had never seen anything like it before,” says Hayley. “My body just shut down after giving birth to Ryan.

“I nursed Ryan for nearly three days before I finally went into labour again.”

Hayley, 31, a team manager for a bank, and her fiance Craig Selbee, 31, a bank manager, had been thrilled to discover they were expecting twin boys.

“We were so excited when the doctors told me I was pregnant with twins at my first scan, and then that they were both boys at the second scan,” she says.

The pregnancy went smoothly until at 29 weeks, in August last year, Hayley went into labour.

“We were at home one evening when I felt a sharp pain,” she says.

“I went upstairs to the bathroom and felt the sudden urge to push. It all happened so quickly.

“One minute I was watching TV, the next I was on the bathroom floor giving birth.”

Hayley and baby Ryan, who weighed 2lb 14oz, were taken to hospital where doctors expected her to give birth to her second twin in minutes.

But as hours ticked by, there was still no Lewis. “As I arrived at the hospital the labour pains had disappeared and it felt like I’d never even given birth,” recalls Hayley.

“Three hours later the doctors examined me and they told me that the contractions had stopped.

“They couldn’t understand it, as usually when one twin is born, the other quickly follows.”

The following day, Hayley still hadn’t gone back into labour. Craig and Hayley filled the hours waiting by tiny Ryan’s incubator.

“I still had this huge pregnancy bump and we were looking at Ryan in his incubator,” she says.

“Lewis was in no hurry to make his appearance.

“We’d told all our family and friends the good news, that Ryan had been born.

“None of them could believe I was still pregnant with Lewis.”

Concerned for Lewis’s well-being, doctors arranged for a scan.

“I’d been used to having scans and seeing my womb jam-packed with the twins, vying for room,’

says Hayley.

‘But now there Lewis was, wriggling around all by himself. It just looked like he was making the most of the extra space. He was almost doing somersaults.”

Despite her joy at seeing Lewis was thriving, she admits looking at the his image on the monitor was strange.

“During the scan, I was holding a photo of Ryan in his incubator,” she says.

“I kept glancing down at the picture and then up at the scan of Lewis and it was weird. I wanted my twins to be together again, like they were supposed to be.”

Hayley and Craig weren’t the only ones to be surprised by this unusual situation – medical staff at Sunderland Hospital were equally stunned.

“The sonographer told me she’d never come across such a long wait,” she says.

Hayley wasn’t allowed to remove Ryan’s umbilical cord or breast-feed him because doctors feared either could trigger a premature second labour.

So Hayley had to endure the discomfort until she finally went into labour the next day, and Lewis appeared weighing 3Ib 3oz, after a six-hour labour – 51 hours after his brother.

“It was such a relief,” says Hayley. However, the twins were still not able to be together as, although Ryan was doing well enough to be moved on to a low dependency ward in the neonatal unit, Lewis needed more intense

treatment.

“He had to be ventilated for three weeks as he needed four operations as his lungs weren’t properly developed,” says Hayley.

“At one point, the doctors had to put him in a coma so that his lungs could heal.

“It was very traumatic. I began to wonder when our twins would ever actually be together.”

The boys finally met after five weeks when Lewis was moved into the same ward as Ryan – and Hayley and Craig were able to cuddle their babies together.

“It was such an amazing feeling being able to hold both my boys, one in each arm,” says Hayley. “It was a dream come true and brought a tear to my eye.”

Another milestone moment came a week later when the twins were both finally strong enough to be taken out of their incubators and dressed.

“Until that point they’d only been able to wear vests and nappies but at six weeks we were able to dress them in matching blue Tigger outfits,” says Hayley. And after two months they were strong enough to go home.

“The day we were finally allowed to walk them out of hospital was the best day ever,” says Craig.

Now the boys are six months old and doing well.

“They both have heart murmurs but that’s common with premature babies and they’re having regular check-ups,” says Hayley.

“They’re both around 14lbs, which is fine considering they should really only be three months old, as they were 11 weeks premature.”

The non-identical twins not only have different birthdays – two days apart – but different star signs, too. Ryan is Leo and Lewis Virgo.

“It means their personalities will be very different, although I think we can already guess that Lewis will be the laid-back twin,” laughs Hayley.

“We’ll celebrate their joint birthday on the day in between both their birth dates, and then they can still have a party together.”

The couple are relieved they can now put their sons’ traumatic entrance into the world behind them.

“Looking back, those eight weeks were the worst time of our lives because our emotions were all over the place,” says Craig.

“But Hayley and I love each other so much we were able to get through it. The boys were all that mattered.”

Hayley says that when the twins are older, she and Craig will tell them all about their extraordinary birth.

“And this experience hasn’t put us off having more children,” she says.

“I’m just wary about having another set of twins!”

A spokeswoman for the Twins and Multiple Births Association said: “This is rare – we have come across cases where twins were born apart, but the gap has always been less than two days.

“It may have been her body protecting the second twin, as 29 weeks is very early to be born.

“After the first twin arrived, her body may have shut down to give the second twin longer in the womb.”

How Risky Is a Multiple Pregnancy?

By Jean Weiss for MSN Health & Fitness

MSN Health & Fitness Exclusive

The idea of having multiple babies at the same time at first might sound tantalizing. One grueling nine-month period and voilà: You're on your way to synchronized play dates and kids helping each other with homework. The reality is, if you birth multiples, meaning you house more than one baby in your womb, you are less likely to end up appearing on TV and scoring a book deal than you are to end up grappling with complex health issues that last a lifetime. It's worth it, then, to take a look at how multiple births occur, and how having one can affect a family in the short term and over time.

How are multiple pregnancies conceived?

Only 2 percent of multiples are conceived naturally, says William Schoolcraft, M.D., founder and medical director of the Colorado Center for Reproductive Medicine, a Denver fertility clinic widely regarded as one of the best in the world. When we think of a multiple birth, most of us think of in vitro fertilization, but the majority of multiple births, especially those with triplets or higher, are the result of injecting fertility drugs, says Schoolcraft.

In vitro offers a physician more control over how many eggs are implanted in a woman's womb. Clomid, a fertility drug taken orally, increases the likelihood of a twin pregnancy. A pregnancy with triplets, quadruplets, or more is usually the result of injected fertility drugs, along with sexual intercourse or artificial insemination.

"With injected fertility drugs, you can get lots of eggs, perhaps 10 eggs or more, and you really don't have control of how many eggs are produced," says Schoolcraft. "You can look and think you see three or four follicles, but there may be a couple more hiding. [They're] easy to miss." Because of this margin of error, many physicians steer clear of injecting fertility drugs, and instead use Clomid or in vitro. "More and more, doctors are shying away from these injectable drug treatments," says Schoolcraft.

Are multiple births regulated?

While no laws exist in the U.S. to dictate the occupancy limits of a woman's womb, the American Society of Reproductive Medicine has established clear guidelines by which reputable clinics and physicians abide. If a doctor is a member of ASRM, then he or she agrees to follow these standards. The standards are age-based and determined by the likelihood of successful embryo implantation. (The older you are, the more likely it is that you will need to try with more embryos to result in a viable pregnancy.) The ASRM recommends:

Women under 35 should ideally receive one embryo, but no more than two embryos

Women between 35 and 37 are to receive no more than two or three embryos

Women between ages 38 to 40, three or four embryos

Women older than 40 years, no more than five

"So with a 33-year old, you are going to be more careful, because her chance of keeping all embryos [is] greater," says Schoolcraft. "At the age of 41, twins, or more, are uncommon even with the transfer of multiple embryos."

It's a numbers game, and no one can be sure of the outcome. "We have to balance the desire to get pregnant against the risk of multiples, and at the same time we have to make adjustments for age," says Schoolcraft. "Our goal is to avoid triplets at all cost. We try to avoid twins, but the [health] risk [faced by] twins isn't nearly as great."

The ASRM guidelines used to recommend that physicians implant more embryos. That was until 1998, when Schoolcraft's clinic pioneered a method of in vitro fertilization called blastocyst transfer. Using this technique, doctors are able to grow embryos in a petri dish for five days, a longer period of time than had been previously possible. After the five-day time period, it's easier to identify which embryos are most viable, allowing a higher success rate of implantation—thereby lowering the need to implant more embryos than ideally wanted by the mother.

A focus on one healthy embryo

"Most researchers focus on identifying ways to access the best embryo, so we can make one viable pregnancy. We're getting close to the day where we can just put back one embryo and have success."

A woman in the U.S. would receive more than the regulated amount of implanted embryos only if her physician identified a special need. "Rarely, exceptions are made," says Schoolcraft. "You have to make a note in the chart, explaining what are the medical circumstances justifying this altered judgment."

"An octuplet scenario is extreme," says Schoolcraft.

Worldwide, in vitro standards differ from those in the U.S. "In Europe, there are many countries where the government pays for in vitro, and because they pay for it, they can regulate it." In many European countries, the governments allow a physician to implant only one embryo at a time, therefore the pregnancy success rates from in vitro are lower in Europe than in the U.S., says Schoolcraft. In more developing countries, where technology is less sophisticated and there are fewer regulations, physicians are implanting more embryos than what is recommended in the U.S., he says.

What are the health risks for multiple babies?

The ASRM establishes guideline for embryo implantation because the risk factors for multiples are concerning. The biggest risk factor for multiple babies is premature birth, which is defined as one that occurs before 37 weeks' gestation. The average gestation for a single birth baby is 40 weeks; the average gestation for twins is 35 weeks. For triplets, it's 33 weeks, and for quadruplets, the average gestation is 29 weeks. "There is a big risk for premature birth, and the risk goes up the more babies that are inside," says Schoolcraft. "The more premature the babies are, the more complications they suffer."

One issue is nutrition while in utero. Multiple babies and multiple placentas compete for nutrients from the mom, says Schoolcraft. "They can be undernourished, compared to babies who have a uterus all to themselves."

Premature babies are also more likely to have the following health problems, according to the March of Dimes:

Unformed organs

Brain bleeds

Feeding difficulties

Mental retardation

Jaundice

Breathing problems, including asthma later in life

Vision and hearing problems, including blindness and hearing loss

Cerebral palsy (which is three times as common in babies born at 37 weeks compared to full-term infants, and eight times as likely in those born between 30 and 33 weeks)

Developmental delays

Preterm birth is also the leading cause of death in the first month of life.

Sometimes, additional health problems surface later in life, says Schoolcraft. "This is what is behind these guidelines from the American Society of Reproductive Medicine," says Schoolcraft. "Clearly, most physicians in our field would consider triplets a complication to be avoided if at all possible."

What are the health risks for the mother?

And what about the mother? Not that any moms get much attention after the birth of their child, whether one or many. But having multiples does take an exponential toll. Any nutrient depletion the mother may undergo, due to her body's prioritizing the nutrients she eats and stores in her body to be diverted to her babies, can be made up after birth, says Schoolcraft.

However, a mother carrying multiples has an increased risk of the following complications during her pregnancy:

Preeclampsia (high blood pressure, which can lead to eclampsia, which is sometimes fatal)

Gestational diabetes (which has been linked to a greater likelihood of diabetes later in life)

Blood clots

She also, obviously, has an increased chance in having a C-section, especially if pregnant with more than two babies.

She's also at higher risk for postpartum complications, including:

Hemorrhaging

Exhaustion

Postpartum depression

This last one is, once again, a numbers game. Any parent knows it would clearly be easier to secure and ride an elephant through the streets of New York, than to try and coordinate the nighttime sleep habits of two or more newborns.

Can multiples be emotionally healthy?

It can be tough attending to every little need of a baby, yet interaction with a primary-care provider is integral for a child's emotional development. In fact, some theories suggest that close attention to your child's needs during the first year of life, especially between six to 12 months, is a sound start to his or her emotional well-being.

Studies have shown that multiples are at risk for receiving less of this critical caregiver attention, despite a parent's best efforts. One study published in the Journal of Advanced Nursing in December 2001 found that twins and triplets received less individual attention than single infants. Though parents in this study were capable and had proficient childcaring strategies in place, they simply were unable to provide the same level of care. Their multiple children were talked to, held, and looked at less, and left alone more often, than the children of parents who'd birthed one child at a time.

Preemie babies also are at risk for lack of human touch and attention. Though, according to information from the Hospital for Sick Children in Toronto, Canada, any deficiencies that develop during a preemie's stay in the hospital—when incubators and medical equipment can prevent a preemie from being held—can be made up through adequate parental attention within the subsequent two years. If a parent has enough resources in place to offer the right attention and care, it's possible to develop a strong attachment bond.

The book Preemies (Pocket, 2000), co-authored by neonatologist Mia Wechsler Doron, M.D, and Dana Wechsler Linden and Emma Trenti Paroli (both parents of preemies), states that if, for some reason, the child does not receive enough loving care for a long period of time, he or she can develop failure to thrive, a disorder in which a child doesn't grow normally. There's also the risk of developing attachment disorder. Children with attachment disorder are unable to form trusting affectionate relationships and are unable to comfort themselves.

How to get pregnant

Wondering how to get pregnant? Maximize your fertility — and know when to seek help.
From MayoClinic.com

Some couples seem to get pregnant simply by talking about it. For others, it takes plenty of patience and a bit of luck. If you're wondering how to get pregnant, start the old-fashioned way. Here's what you need to know — and when to seek help.

Baby-making basics

Conception is based on an intricate series of events.

Every month, hormones from your pituitary gland stimulate your ovaries to release an egg, or ovulate. This often happens around day 14 of the menstrual cycle, although the exact timing may vary among women or even from month to month.

Once the egg is released, it travels to the fallopian tube. If you want to conceive, now's the time. The egg has about 24 hours to unite with a sperm. Since sperm cells can survive in your reproductive tract for two to three days, it's best to have regular sex during the days leading up to ovulation.

If the egg is fertilized, it'll travel to the uterus two to four days later. There it'll attach to the uterine lining. You're pregnant! Your periods will stop as your body begins to support the embryo.

If the egg isn't fertilized, it'll break down and you'll have your next period as usual.

Understanding when you're most fertile

Learning how ovulation works is one thing. Determining when it's actually happening is something else. For many women, it's like hitting a moving target.

Keep an eye on the calendar
Use your day planner or another simple calendar to mark the day your period begins each month. Also track the number of days each period lasts. If you have a consistent 28-day cycle, ovulation is likely to begin about 14 days after the day your last period began.

If your cycles are somewhat long, subtract 18 from the number of days in your shortest cycle. When your next period begins, count ahead this many days. The next week is a reasonable guess for your most fertile days.

• Pros. Calendar calculations can be done simply on paper. And they're free!
• Cons. Many factors may affect the exact timing of ovulation, including illness, stress and exercise. Counting days is often inaccurate, especially for women who have irregular cycles.

Watch for changes in cervical mucus
Just before ovulation, you might notice an increase in clear, slippery vaginal secretions — if you look for it. These secretions typically resemble raw egg whites. After ovulation, when the odds of becoming pregnant are slim, the discharge will become cloudy and sticky or disappear entirely.

• Pros. Changes in vaginal secretions are often an accurate sign of impending fertility. Simple observation is all that's needed, particularly inside the vagina.
• Cons. You have to check your vagina for the secretions. And judging the texture or appearance of vaginal secretions can be somewhat subjective.

Track your basal body temperature
This is your body's temperature when you're fully at rest. Ovulation may cause a gradual rise in temperature or even a sudden jump — typically between 0.5 and 1.6 degrees Fahrenheit. You'll be most fertile during the two to three days before your temperature rises. You can assume ovulation has occurred when the slightly higher temperature remains steady for three days or more.

Use an oral thermometer to monitor your basal body temperature. Try the digital variety or one specifically designed to measure basal body temperature. Simply take your temperature every morning before you get out of bed. Plot the readings on graph paper and look for a pattern to emerge.

• Pros. It's simple. The only cost is the thermometer. It's often most helpful to determine when you've ovulated and judge if the timing is consistent from month to month.
• Cons. The temperature change may be subtle, and the increase comes too late — after ovulation has already happened. It can be inconvenient to take your temperature at the same time every day, especially if you have irregular sleeping hours.

Try an ovulation monitoring kit
Over-the-counter ovulation kits test your urine for the surge in hormones that takes place before ovulation. For the most accurate results, follow the instructions on the label to the letter.

• Pros. Ovulation kits can identify the most likely time of ovulation. They can even provide a signal before ovulation actually happens. They're available without a prescription in most pharmacies.
• Cons. Ovulation kits often lead to excessively targeted sex — and timing sex so precisely can invite being too late. The tests can also be expensive, often ranging from $20 to $50 each.

Maximizing fertility

When you're trying to conceive, consider these simple do's and don'ts.

Do:

• Have sex regularly. If you consistently have sex two or three times a week, you're almost certain to hit a fertile period at some point. For healthy couples who want to conceive, there's no such thing as too much sex. For many couples, this may be all it takes.
• Have sex once a day near the time of ovulation. Daily intercourse during the days leading up to ovulation may increase the odds of conception. Although your partner's sperm concentration will drop slightly each time you have sex, the reduction isn't usually an issue for healthy men.
• Make healthy lifestyle choices. Maintain a healthy weight, exercise regularly, eat healthy foods and keep stress under control. The same good habits will serve you and your baby well during pregnancy.
• Consider preconception planning. Your doctor can assess your overall health and help you identify lifestyle changes that may improve your chances for a healthy pregnancy. Preconception planning is especially helpful if you or your partner have any health issues.
• Take your vitamins. Folic acid (vitamin B-9) plays an essential role in a baby's development. Taking a prenatal vitamin or folic acid supplement beginning at least one month before conception through the first trimester of pregnancy can reduce the risk of spina bifida and other neural tube defects by up to 70 percent.

Don't:

• Smoke. Tobacco changes the cervical mucus, which may keep sperm from reaching the egg. Smoking may also increase the risk of miscarriage and deprive your developing baby of oxygen and nutrients. If you smoke, ask your doctor to help you quit before conception. For your family's sake, vow to quit for good.
• Drink alcohol. Alcohol is off-limits if you're pregnant — or hope to be.
• Take medication without your doctor's OK. Certain medications — even those available without a prescription — can make it difficult to conceive. Others may not be safe once you're pregnant.

When to see your doctor

With frequent unprotected sex, most healthy couples conceive within one year. Others need a bit of help.

If you're in your early 30s or younger and you and your partner are in good health, try it on your own for one year before consulting a doctor. You may want to seek help sooner if you're age 35 or older, your periods are more than 35 days apart, or you or your partner has known or suspected fertility issues.

Infertility affects men and women equally — and treatment is available. Depending on the source of the problem, your gynecologist, your partner's urologist or your family doctor may be able to help. In some cases, a fertility specialist may offer the best hope.