Posts filed under ‘Prenatal’

Fertility Facts and Considerations When Trying To Conceive

By D’Andrea Bingham

For pregnancy to occur, an egg is released from the ovary, fertilized by sperm as it travels from the ovary to the uterus, and then implants into the uterine lining. Women can have trouble getting pregnant if there is a problem with any of these steps.

Sometimes these steps all appear to be normal, and a woman still may have problems conceiving. Certain things such as age, cigarette smoking, obesity, and excessive caffeine or alcohol intake in both women and men can decrease fertility.

Most couples will not conceive immediately when they start trying. You should see your doctor if you do not get pregnant after having unprotected intercourse for one year. If you are over 35 years old, see your doctor if you do not conceive after 6 months of trying. This is because a woman’s fertility begins to decline after age 35.

A general obstetrician/gynecologist can do initial testing for infertility. At the first office visit, it is helpful to bring a menstrual calendar from the last 6-12 months, which is a calendar that indicates what days your period starts and ends. This can be written down, or recorded with one of several apps available.

Ovulation predictor kits can also be useful. These are available overthe- counter and test for a hormone in the urine that precedes ovulation by about 24 hours. They can be used to time intercourse when chances of conception are highest. It will help your doctor if you also record results of theovulation predictor kits on your menstrual calendar.

At the initial visit, your doctor will usually do a detailed history on you and your partner, and a physical exam. Evaluation includes testing of the male and female. For a man, this usually starts with a semen analysis to see how many sperm he makes and how healthy those sperm are. For the woman, tests may include:

• blood tests to check hormone levels

• ovulation tests to see if eggs are being released from the ovaries

• Tests to check the uterus and fallopian tubes- These can include ultrasounds, x-rays to see if the fallopian tubes are open (hysterosalpingogram), or even surgeries to look at the inside of the uterus and/or the tubes and ovaries.

After the tests are done, your doctor may or may not be able to identify a problem. Treatment is usually aimedat fixing whatever problem is identified. Even if a problem cannot be identified (unexplained infertility) there are still treatment options available that can help a woman get pregnant.

Many initial treatments can be done by your local gynecologist. For patients that need more advanced treatments, referral may be made to a reproductive endocrinologist, which is a doctor that treats infertility. In Texarkana, we usually refer to specialists in Shreveport, Dallas, or Little Rock.

Fortunately, the majority of couples who desire pregnancy do end up conceiving. However, it can be very stressful and frustrating when it takes longer than normal. It may be helpful to talk to a counselor or support group for couples who are having trouble getting pregnant. The American Society for Reproductive Medicine has an excellent website that provides additional resources and information for patients about infertility (


July 3, 2012 at 2:35 pm Leave a comment

Nutrition Before and After Pregnancy

by D’Andra Bingham, MDImage

Most moms to be will change some things about their nutrition while they are pregnant.  In fact, dietary changes should actually begin prior to conception.  One of the most important things to do prior to pregnancy is to begin taking a multi-vitamin or prenatal vitamin with folic acid.  Women need at least 0.4 to 0.8 mg of folic acid daily for a minimum of one month prior to pregnancy to prevent certain types of birth defects.  It is best to visit your health care provider prior to pregnancy to see if there are any additional things you may need to change based on your health and history.

Eating the right foods will help your baby’s development and help you have a healthier pregnancy.  Eating the wrong foods could harm your baby.  The best diet for a healthy pregnancy and baby includes lots of fresh vegetables, fruit, whole grains, low-fat dairy products, and protein.  Women who do not eat much dairy will need to take a calcium supplement as well.

Pregnant women need to be careful about avoiding germs in food.  Beef, chicken, fish, eggs, and other meats need to be fully cooked.  Fresh fruits and vegetables need to be rinsed under lots of running water before eating them.  Listeria is a bacteria that can be especially dangerous to pregnant women because it can cause miscarriage and fetal death.   It can be found in ready to eat foods and can grow at refrigerator temperatures where most other foodbornebacteria do not.

Here are some specific things regarding nutrition that pregnant women need to know:

Fish:  You should avoid fish that may have high levels of mercury in them.  These include swordfish, tilefish, king mackerel, and shark. (Fortunately, not found too often on the menus around here, but may be if you travel during your pregnancy.)  It is okay to eat other cooked fish and seafood during pregnancy.  Women can safely eat 12 ounces of cooked fish per week during pregnancy.  A typical serving size is 3 to 6 ounces, so this is around 2 to 3 servings per week.  This includes shrimp, canned light tuna, and catfish.  Tuna steaks should be limited to one serving per week.  Raw fish (sushi) or raw shellfish (oysters) should be avoided.

Sprouts:  Alfalfa, clover, and radish should be avoided.  Bacteria can get into the sprout seeds before the sprouts grow.

Juice:  Fresh squeezed juices sold by the glass may not be pasteurized or otherwise treated to ensure safety.  Pregnant women should avoid all unpasteurized juices.

Lunch meats and hot dogs:  These should be heated well prior to eating.

Soft cheeses:  These include feta, brie, camembert, queso blanco, and quesofresco.  These are typically made with unpasteurized milk and should be avoided during pregnancy.

Caffeine:   There has been an observation between high caffeine intake and several adverse pregnancy outcomes.  Caffeine consumption should be limited to less than 200 mg a day (between  2 to 4 beverages).

Artificial sweeteners:  There is no clear cut evidence that use of these are associated with increased risk to the developing baby.  Studies are conflicting on risks with high doses of saccharin (Sweet ‘N Low) so most clinicians recommend trying to avoid it.  Aspartame (Nutrasweet) and sucralose (Splenda) are currently considered safe to use in pregnancy.

Herbs:  It is recommended to avoid herbal preparations during pregnancy.  The strength and purity can vary widely and there is limited data on their safety .  It is also important not take vitamin supplements in addition to your prenatal vitamin unless approved by your health care provider.  Certain vitamins can be toxic if taken at too high dosages.

Eating the right foods (and avoiding the wrong ones) is important for your health as a mother and for your baby’s development.  A well-balanced, common sense diet with a prenatal vitamin both before and during pregnancy is one of the best gifts you can give your new baby.

May 9, 2012 at 8:29 pm Leave a comment

Umbilical Cord Blood: to bank or not to bank?

By D’Andra D. Bingham, MD

ImageUmbilical cord banking is just another subject with which expectant parents need to familiarize themselves. Cord blood banking refers to the collection of blood from a baby’s umbilical cord by a physician or midwife immediately after delivery. These cells can serve as stem cells for reconstitution of bone marrow. This means that cord blood cells can be used as a treatment option for a wide variety of diseases such as leukemia, lymphoma, sickle cell anemia and a number of other genetic and acquired disorders. If parents decide to bank their child’s cord blood, it is collected at delivery and then stored indefinitely at a bank’s site. There are two types of cord banks. Public cord banks collect and store blood, usually for free, for the use by any individual who needs a bone marrow transplant. Private cord banks are for-profit companies that store cord blood reserved for exclusive use by the donor or donor’s family. Private cord banks charge a fee from $1500-$2000 for the initial collection, then $100-$200 annually for continued storage. When weighing the decision on private cord blood banking, parents should realize that the use of cord blood stem cells is still considered investigational. The chances of the cord blood actually being needed by a family has been estimated at approximately 1/2700 or less. Also it is not known how long cord cells remain viable in storage. Cord blood stem cells should not be considered “biologic insurance” for a child. If needed, the stem cells are most likely to be used by a sibling or other family member. Stem cells cannot be used to treat genetic diseases or certain cancers in the individual from which they were collected because the cells would have the same genetic abnormality as the individual has. The decision to bank cord blood, public or private, must be made before the onset of labor, as parents need to bring the collection kit to the hospital with them. Parents should thoroughly investigate available companies. Confirm the companies are accredited by a reputable agency such as AABB, how long they have been involved in cord blood banking, whether any units banked through the company have been used for transplantation, and the outcomes of those cases. Parents should, of course, read all contracts carefully. Additional noncommercial information on potential benefits and limitations of cord blood donation is available at,, and

April 24, 2012 at 7:58 pm Leave a comment