Clomiphene, gonadotropin, and


At Boston IVF, we have two goals for your
is no detrimental effect of caffeine on male fertility. treatment. The first goal is to help you achieve a pregnancy. The second goal is that the pregnancy Recreational Drug Use
is uncomplicated and results in the delivery of a The use of recreational drugs is contraindicated healthy baby. To this end, there are certain things while attempting to conceive and during pregnancy. that you can do to help achieve this goal, which are Some drugs, such as marijuana, may decrease sperm production. Drug use by the woman during pregnancy, such as cocaine and heroine, may lead to severe withdrawal reactions in the baby after it is The detrimental effects of smoking on general born. Further, the use of intravenous drugs health are well established (e.g., heart disease, increases the risk of acquiring an HIV and hepatitis cancer, and chronic lung disease). Smoking also impacts on reproductive health, as well. Women who smoke during pregnancy are at increased risk Medication use
for premature labor, decreased fetal growth and All non-fertility medications that have been other complications. In addition, studies have prescribed should be discussed with a Boston IVF demonstrated that men and women who smoke have physician. It is also important that you contact the a decreased chance of achieving a pregnancy either physician who originally prescribed these naturally or following infertility treatment. medications to make sure he/she is aware that you Therefore, if you smoke, we feel strongly that for are attempting pregnancy. You should avoid taking general and reproductive health concerns, you must aspirin and aspirin-like compounds (e.g., Advil®, stop. If you are unable to stop on your own then Aleve®, Ibuprofen® and Motrin®) around the time you should contact your primary care physician to of ovulation, since these medications can interfere get enrolled in a smoking cessation program. with ovulation. Tylenol® is a suitable alternative. Herbal remedies should be completely avoided since their effect on fertility and pregnancy are Alcohol should be completely avoided during pregnancy because it increases the chance of the birth defects. In addition, alcohol can interfere with Vitamin Supplementation
the establishment of pregnancy. A previous study Neural tube defects are abnormal developments of concluded that any amount of alcohol ingested by the spine and skull. One type of neural tube defect the woman decreased the chance of pregnancy and is spina bifida. Several studies have confirmed that increased the chance of a miscarriage. Therefore, folic acid supplementation started before we recommend that if a woman is attempting conception will reduce the occurrence of neural pregnancy she should completely avoid alcohol or tube defects in infants by almost half. It is now limit intake to the first week of the menstrual cycle. recommended that all women who are attempting There is no detriment of mild to moderate alcohol pregnancy ingest at least 0.400 mg of folic acid per day for this protection. Folic acid supplementation can be achieved by taking an over-the-counter Caffeine Intake
multivitamin or a prenatal vitamin on a daily basis. Several studies have concluded that caffeine intake by the woman decreases the chance of establishing There is published data that has confirmed that a pregnancy and increases the chance of a excessive intake of vitamin A increases the miscarriage. Caffeine is present in coffee, tea, some soft drinks and chocolate. It is our recommendation of birth defects. Prenatal vitamins and over-the- that you should avoid caffeine altogether or limit counter multivitamins contain 5000 IU of vitamin intake to one caffeinated beverage per day. There Page 1 of 2 F-MD-8005 Rev 2 Copyright March 2007 by Boston IVF. All Rights Reserved A, which is a safe dose. However, daily intake Exercise
The benefits of exercise on general health and Nutrition
mental well being are established. Further, exercise Our general health is influenced by what we eat, during pregnancy has also been shown to be how much we eat and how much energy we expend beneficial. If you are already in an exercise with activity and exercise. In addition, our program, we would encourage you to continue. nutritional state can impact on reproductive health, However, the medications used to stimulate the as well, and can influence the establishment and ovaries as part of your treatment can cause maintenance of a pregnancy. As a general temporary ovarian cysts to form. Therefore, we recommendation, women should be encouraged to would advise you to avoid exercise activities that maintain a balanced diet of fruits, vegetables, result in a lot of vertical movement (i.e., running, breads, meats and dairy products. Foods with high step aerobics). Exercise activities such as content of fats and oils should be used at a swimming, bicycle riding, walking and using the minimum. During pregnancy ingestion of some treadmill or step exercise are acceptable. fish, which contain higher amounts of mercury, can affect the development of the nervous system of a Routine Gynecologic Care
fetus. Before and after pregnancy is established a During your infertility treatment, it is important for woman should avoid eating these fish- shark, you to continue your routine care with your swordfish, king mackerel, tilefish and canned tuna gynecologist or primary care physician. This fish. In addition, the ingestion of all other fish should include a yearly blood pressure check, physical examination, pelvic examination and Pap smear. A baseline mammogram is recommended Body Weight
for every woman at age 40 and every 1-2 years A major concern about increased weight is the higher chance of complications during pregnancy including diabetes, high blood pressure and clot formation. Women who are overweight tend to have larger babies, more difficult deliveries and a higher chance of requiring a cesarean section. Further, a cesarean section that is performed on a woman who is overweight is associated with a higher incidence of anesthetic and surgical complications that could jeopardize the health of the mother and baby. The body mass index (BMI) is a standard to determine whether a person’s weight is appropriate for their height. It is a calculation that takes into account the weight and height [weight (kg)/ height (m2)]. An easy way to calculate the BMI is as follows: multiply the weight in pounds by 704 then divide by height (in inches) squared. Example: A woman is 5' (60") tall and weighs 207 lbs; her BMI would be calculated as follows:
207 x 704/ 602 = 40.5
An optimal BMI is 20-24. All women with a BMI of >30 should be encouraged to loose weight. For women who have a BMI >40 it is recommended to lose weight prior to attempting pregnancy or undergoing infertility treatment. Page 2 of 2 F-MD-8005 Rev 2 Copyright March 2007 by Boston IVF. All Rights Reserved


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Normalization of Information Processing Deficits in Schizophrenia With Clozapine Veena Kumari, Ph.D., William Soni, M.B., B.S., M.Sc., and Tonmoy Sharma, M.Sc., M.R.C.Psych. Objective: The authors tested the hypothesis that the use of an atypical drug, clozapine, for patients with schizophrenia is related to less impairment in information processing def- icits (assessed by prepulse

Appendix 2: Gender analysis of the HM Treasury and tax revenue (See Article 2) Gender analysis in HM Treasury There is no equality impact statement in the HM Treasury and Department for Business, Innovation and Skills joint document The Plan for Growth ,1 published alongside the Budget. Under the moratorium exempting micro and start-up businesses from new domestic regulation for thr

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