>> William M. Callaghan, MD, MPH: Healthiest women.
>> There you go.
>> William M. Callaghan, MD, MPH:
And healthiest couples have the healthiest babies.
Healthiest couples are going to have the best chance
of successful assisted reproduction.
>> April: I'm April.
What's your name?
Julie Ann.
>> Michael: I'm Michael.
What's your name?
Gwen. Gwendolyn.
>> William M. Callaghan, MD, MPH: Conception and growth
and development of a fetus does not take place
in an abstract world.
It takes place within the whole construct
of this couple's health.
>> Michael: I quit smoking right off the bat.
>> April: You quit smoking before we did IVF.
>> Michael: Yeah.
Before.
>> April: Yeah.
>> William M. Callaghan, MD, MPH:
And there's probably nothing more important
that a woman can do prior
to ever becoming pregnant than to stop smoking.
The second thing is obesity.
Women who are obese have higher chances
of developing gestational diabetes,
which is diabetes that's brought on during pregnancy.
They're more likely to develop pregnancy associated high
blood pressure.
Women who are obese are actually more likely to have stillbirth
for reasons that are not yet known.
That means that attention needs to be to nutrition.
Eating less and better-quality foods, and physical activity,
which can be done throughout the time that you're trying
to achieve pregnancy and even through the pregnancy.
>> April: I cut out anything that could possibly harm a baby
or potentially prevent me from getting pregnant.
So for three years I was on a very strict diet.
Making sure I got enough omega 3 fatty acids, got enough calcium.
A lot of different things.
>> William M. Callaghan, M.D., MPH:
Folic acid is a very important nutritional supplement
for all women who are contemplating pregnancy.
There's really strong evidence that folic acid protects
against a specific kind of birth defect we normally call spina
bifida, which is an opening in the baby's spine.
>> April: Well, when you go through something like IVF,
you want to make sure you have the best chance possible.
Yeah.
[ Music ]
>> Maurizio Macaluso, MD, DrPH:
Infertility is a common condition.
The National Center for Health Statistics estimates that about
over seven million couples
in the United States have experienced problems
with conceiving a baby or carrying
out a pregnancy to term.
>> Tina: I'm Tina, and this is our daughter, Mia.
Sweet girl, born October 9th, no, October 6th -
>> Effer: October 6th, 2009 -
>> Tina: [Inaudible] 2009.
>> Effer: And I'm her husband, Effer.
>> Tina: Mia was born with the help of a very special lady.
That's what we call it.
She was born with a donor egg and my husband's sperm
through in vitro fertilization.
>> Maurizio Macaluso, MD, DrPH:
Assisted reproductive technologies are a series
of procedures that entail using the egg
and the sperm outside of the human body.
So they are combined in the laboratory to create an embryo
that then is put back into the uterus to establish a pregnancy.
In 2007, there were about 150,000 procedures
of IFD were done in the United States.
These 35 percent led to a pregnancy,
but about 29 percent ended up with the desired result,
which is a live birth.
>> Tina: It took us quite a long time to get Mia here with us.
Six years of calendar time, five attempts.
>> Juliette Kendrick, MD: Making the decision
to actually go ahead with ART can be a very difficult one.
ART is expensive, it's time consuming, and it puts a woman
through a tremendous emotional upheaval.
You can feel like you're on a roller coaster,
not knowing from one minute to the next whether you're going
to be able to get pregnant, how the pregnancy's going
to turn out, and whether in the end you will have a healthy baby
to take home with you.
We recommend that all women
who are considering ART have conversations
with their health care providers,
not just the ART provider but also the doctors
who will be taking care of you throughout the pregnancy
and potentially those who will be caring for the infant
to help give you emotional support
and tell you what you might expect during this
challenging time.
>> April: Our health insurance covered the diagnostics
and the medication, but the rest of it was not covered.
We were fortunate that we had my mother, who could help out.
>> Tina: As I encourage people to get help, get support,
leverage the different networks that are around,
leverage your relationships that you have with your partner
or your friends and family.
What do we got here?
What do we have here?
We're both pretty blessed with good health.
I'll share with you that when Mia was conceived,
our doctor had said you might want to try yoga.
You might want to try some relaxation therapy.
He said I have no proof that any
of this works, but it can't hurt.
>> William M. Callaghan, MD, MPH: Anything that women can do
to obtain the highest state
of health will increase their chances
of successful assisted reproduction.