Colorectal Cancer Health Center

In average-risk people, screening colonoscopies were associated with a 70 percent reduction in risk for new, late-stage colon cancer, including hard-to-detect cancers on the right side of the colon. Advanced colon cancer is the least curable form.

Although colonoscopy is widely used as a screening test for colon cancer, there is little research that proves it is effective in reducing colon cancer deaths, according to the study authors. The researchers wanted to answer a simple question: If you ended up with late-stage cancer, were you more or less likely to have had a screening colonoscopy as many as 10 years before the disease was discovered?

The study authors also wanted to show whether a colonoscopy is able to evaluate the entire colon, including the right side, which is harder to adequately cleanse before the test, more difficult to reach, and often has pre-cancerous areas that are tougher to spot and identify.

"Colonoscopy has the ability to identify both left- and right-sided colon cancers before they have progressed to an advanced stage," said lead study author Dr. Chyke Doubeni, associate professor in the department of family medicine at the University of Pennsylvania.

The researchers also discovered that screening sigmoidoscopy, a less costly procedure that enables a physician to look at the part of the large intestine closest to the rectum, was linked to a significant reduction in late-stage disease in most of the large intestine, but not in the right colon.

However, the study does not show that colonoscopy or sigmoidoscopy is better than the much easier, far less expensive "fecal occult blood test" (FOBT), which is done at home by swiping a tiny amount of stool onto a card for three days, said Doubeni. "There is strong evidence showing the effectiveness of the [fecal occult blood test] when done annually. There is no reason, based on the knowledge we currently have, that you should switch to a colonoscopy if you're getting a FOBT every year," said Doubeni.

If simpler tests are effective, why are patients encouraged to undergo a colonoscopy? "Let me just say there are other factors beyond the evidence that are driving the use of colonoscopy in the U.S.," said Doubeni. "No other country uses colonoscopy for screening purposes as much as the United States, although Germany comes close," he noted.

The U.S. Preventive Services Task Force recommends that people 50 to 75 years old be screened for colon cancer in one of three ways: a home fecal occult blood test every year; a sigmoidoscopy every five years combined with a home fecal occult blood test every three years; or a colonoscopy every 10 years.

A colonoscopy examines the inside of the large intestine with a camera-tipped tube. The test enables the physician to remove any precancerous growths -- adenomatous polyps -- which sometimes develop into cancer. Colorectal tumors are a major cause of death from cancer in the United States, with about 137,000 new cases and 52,000 deaths every year, according to the U.S. Centers for Disease Control and Prevention.

For the study, published in the March 5 issue of the Annals of Internal Medicine, the authors reviewed health records of more than 1,000 average-risk adults between the ages of 55 and 85 who were members in four health management organizations (HMOs).

The researchers identified 474 people with late-stage colon cancer and then looked back 10 years to see if they had been screened for the disease with colonoscopy or sigmoidoscopy. They compared them to 538 "control" patients and used additional information from state or local tumor registries to see whether there was an association between having had a colonoscopy or sigmoidoscopy and developing cancer.

Dr. David Bernstein, a gastroenterologist at North Shore University Hospital in Manhasset, N.Y., said the study had a critical design flaw. "Making assumptions that any cancers that were found would have been seen 10 years prior doesn't make sense," he said. "It doesn't prove that these cancers didn't occur two years ago."

A key part of effective colon screening is getting the tests at the recommended interval, experts say. To better understand what might be effective in prodding people to get screening, another study published this month in the same journal found that people who were mailed a letter, a pamphlet and a fecal occult blood test kit completed recommended screening twice as often and for less cost than those who were not reminded or got automated and other reminders by nurse coaches.

Doubeni recommends something far more simple: doing the fecal occult blood test every year right around the time of your birthday.

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Do Men Need Earlier Colorectal Screenings?

The Austrian study, published today in the Journal of the American Medical Association, found that men frequently have advanced polyps that could lead to colorectal cancer at ages 45 to 49, a decade earlier than women. These findings have prompted the researchers to conclude that men should likely have their first colonoscopy earlier than 50, the age that current guidelines recommend.

“Our study underlines the results from previous studies on this field, and I hope that now is the time for sex-specific age for referring patients to screening colonoscopy,” researcher Monika Ferlitsch, MD, of the Austrian Society for Gastroenterology and Hepatology in Vienna, writes in an email. “Try to go at age of 45 if you are a man and at age of 50 if you are a woman.”

Not everyone agrees, however. David Bernstein, MD, chief of gastroenterology at North Shore University Hospital in Manhasset, N.Y., says that more research needs to be done before doctors change what they tell their patients. Also, given that the study was conducted in Austria, its results may not apply to American patients.

“Making recommendations based on gender rather than age is something that needs to be explored,” says Bernstein, who was not involved in the research, “but our current screening regimen seems to be impactful for reducing the risk of colorectal cancer.”

Risk Factors Appear in Men 10 to 15 Years Earlier Than in Women

The study, conducted across Austria between 2007 and 2010, included 44,350 people whose average age was 60. A nearly equal number of men and women participated in the study.

Each of them underwent a colonoscopy, a procedure in which a tube-mounted video camera is inserted into the rectum and then snaked through the colon, where it is used to identify cancerous and potentially precancerous growths. Colonoscopies are considered the gold standard tests for detecting colorectal cancer.

Just over 60% of the study participants were given a clean bill of colon health -- no abnormalities were found. Among those whose exams revealed a type of precancerous polyp known as an adenoma, men were much more likely to develop them at a younger age than women. For example, 18.5% of men aged 50 to 54 had adenomas compared to 10.7% of women that age.

It isn’t until women are 65 to 69 years old that their likelihood of adenomas matches men in their early to mid 50s, the researchers note.

According to the study, the likelihood that women have polyps increased as they entered their 60s. For men, a similar increase occurred when they were much younger, between the ages of 45 and 49.

Men were also twice as likely as women to have advanced adenomas, growths that have greater potential to lead to cancer. Overall, men were twice as likely to be diagnosed with colorectal cancer.

Colorectal cancer is the third most common cancer for men and women, according to the American Cancer Society. They estimate that just over 100,000 new cases ofcolon cancer and nearly 40,000 new cases of rectal cancer will be diagnosed this year. In 2011, nearly 50,000 people will die from both cancers combined.

Diagnosing precancerous colon polyps and colorectal cancer at an early stage -- the goal of screening -- vastly improves a patient’s chances of survival. For colorectal surgeon Meagan Costedio, MD, of the Cleveland Clinic, the study results may influence current recommendations on when men should have their first colonoscopy.

“People might be willing to decrease the age to 45 in men and see if it changes things,” says Costedio, who was not involved in the research. “If we see a drop in incidence of cancer, that would be a good change in practice.”

However, she cautions that colonoscopies are not risk-free procedures. Tears, bleeding, and perforations of the colon are rare but possible complications.

“We don’t want to increase the risk of hurting people,” Costedio says.

Another closet corrects the cry.

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The Top 5 Mistakes Divorced Parents Make

Breaking up is hard to do, and it may be especially hard for kids. Kids of divorce can feel they've been hit the hardest by the end of their parents' relationship. Some are asked to broker peace between warring exes, even as they are grieving the loss of a parent who has abruptly moved out. Others must deal with parents who suddenly can't cope with everyday tasks, like making dinner or helping with homework.

Many children carry the battle scars of divorce well into adulthood -- wounds that never needed to be inflicted in the first place. But broken-up spouses can help stop the damage by managing their own behavior before the ink dries on the divorce papers. Family and divorce expert M. Gary Neuman, LMHC, gives exes pointers on how to split up without emotionally destroying their kids long term.

1. Don't make your child the messenger ...

"Too many parents attempt to communicate through their children," Neuman says, "which causes undue emotional stress on them and forces them to negotiate a situation their own parents could not handle.  Email is an excellent tool nowadays to communicate with your ex-spouse. It allows you to specifically discuss the practicalities of raising your child without detouring into negative areas and opening old wounds. It also provides a recorded message, admissible into court, so parents tend to be more careful when using it.

"If you want or need to speak with your ex over the phone or in person, be focused and stay on task, and most important, don't swallow the bait if he or she descends into anger. Simply say, 'I appreciate your feelings, but I am here to discuss our child's school assignment.' Take the high road. Your child's emotional health depends on it."

2. ... or your therapist.

"Teenagers like to feel in control, and divorce turns their world upside down," Neuman says. "Don't fall into the trap of sharing divorce details or your angry feelings about your ex with your older kids. Their own anxiety and need for control causes them to be 'understanding' of what you're going through, but you need to be the parent. Get outside help for yourself, get therapy if necessary, and maintain those boundaries. Making your child your cohort is wrong and does them damage."

3. Try to "get" your kid.

"Kids need to feel as if they are understood," Neuman says, and after a divorce their feelings may be in turmoil. "Listen to them. Don't tell them what to think. And it might be difficult, but never criticize your ex -- it's a criticism of your child, who, of course, is 50% of your ex-husband or wife. Respond specifically to what they are telling you. Say, 'It sounds like you are feeling sad/mad/upset about meeting your dad's new girlfriend, is that right?' As a parent, you don't have to have a solution. You just need to hear them.

"And don't editorialize. You can suggest your child write down his feelings and share them with your ex, but only if the child wants to do so. Stay trained on your child's feelings, not yours. Healing comes through a loving connection and from feeling understood."

4. Avoid the third degree.

"I tell parents to treat their child's weekend away with their ex-spouse as if the child has just visited an aunt or uncle," Neuman says. "Saying nothing will leave your child stressed, as if he must compartmentalize both worlds and tiptoe around this other experience. On the other hand, grilling the child puts him squarely in the middle, which is an impossible position emotionally. So ask your kid fun and general questions, which diffuses tension. And then let it go."

5. Repair the damage you've already done.

Many divorced parents reading these tips may recognize mistakes they've unintentionally made with their own kids. Is it ever too late to undo emotional fall-out from a nasty split? "No, children are remarkably forgiving," Neuman says, "at least until they reach their later teen years, when anger may be more cemented. If you've made mistakes, it's important to do the following:

• Apologize for them. Saying you're sorry goes a long way with your kids.
• Explain in detail exactly what you've done wrong, and then commit to changing your behavior from that moment on.
• Give your child a safe and specific signal -- for example, tell your child to raise his or her hand when you begin criticizing your ex -- which serves as a time-out for you, telling you in no uncertain terms you're doing it again and need to stop immediately."

Adapted from the cover story of WebMD the Magazine's February 2009 issue. Read the complete story  here .

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Managing Osteoporosis and Bone Health

If you have osteoporosis, or are at risk for it, you want to do all you can to keep your bones as strong as possible. Besides following your doctor's advice on diet and exercise, you should know that some medications are bone-friendly -- and others may have side effects that affect the bones.

Some medications prescribed for common health problems, such as heartburn or depression, could affect your bone health.

"That doesn't necessarily mean you should stop them," says Harold Rosen, MD, director of the Osteoporosis Prevention and Treatment Center at Beth Israel Deaconess Medical Center in Boston.

Rather, "it's crucial to weigh the pros and cons: the benefits of the medicine against the effect on the bones," he says.

The benefits of a drug may outweigh the risks. Or your doctor may prescribe a ''bone-maintenance" drug to offset the risk, Rosen says.

Corticosteroid Drugs and Bone Health

This type of steroid drug helps curb inflammation. Doctors prescribe them for conditions including rheumatoid arthritis, asthma, and ulcerative colitis.

Some examples include:

• cortisone (Cortone)
• prednisone (Deltasone, Meticorten, Orasone, Prednicot)

These steroids hamper bone formation and increase bone resorption, which can make a fracture more likely, notes  endocrinologist Ann Kearns, MD, a consultant at the Mayo Clinic in Rochester, Minn.

However, she says, some people need these drugs. And the ''short-term risk is not a big deal for most people," Rosen says.

How you take the drugs may also matter. Pills or shots are the most powerful, but those you inhale or put on your skin are "less concerning," Kearns says.

Anti-Cancer Drugs and Bone Health

If you've had breast cancer and are taking certain drugs that affect your bones, your doctor should monitor your bone density and may prescribe a bone-maintenance drug.

Some breast cancer patients take a type of drug called an aromatase inhibitor. These drugs include:

• anastrozole (Arimidex)
• exemestane (Aromasin)
• letrozole (Femara)

These drugs target a substance your body makes called aromatase. That leads to lower estrogen levels, which can dim estrogen-fueled cancers.

That's good news for your cancer, but lowering your estrogen levels can be bad for your bones, since estrogen stops bone resorption. That's why doctors often prescribe improved lifestyle changes such as exercise, a diet rich in calcium and vitamin D, and bone-maintenance drugs to women who are taking the aromatase inhibitors. 

Men who have been treated for prostate cancer are sometimes prescribed anti-androgen therapy. Examples of these drugs include bicalutamide (Casodex), flutamide (Eulexin), and nilutamide (Nilandron).

These drugs block the action of the hormone testosterone, usually slowing prostate cancer growth. However, these medications can decrease bones' density and increase fracture risk, so doctors may prescribe changes in lifestyle such as exercise, smoking cessation, reduced caffeine intake, and a bone-maintenance drug.

Antidepressant Drugs and Bone Health

Some drugs used to treat depression, known as SSRIs, may affect your bones. Examples of SSRIs include:

• citalopram (Celexa)
• fluoxetine (Prozac)
• paroxetine (Paxil)
• sertraline (Zoloft)

That's not to say you shouldn't take them. When weighing risks and benefits, Kearns says to remember that depression itself has been linked with poor bone health.

However, most studies looking at the effects of SSRIs on bone health have found a greater chance of fractures in people taking drugs, Kearns says.

One study, for instance, found those currently taking the SSRI antidepressants were more than twice as likely to have a fracture not in their spine than those not taking an SSRI. Another study of women with a history of depression showed lower bone density in those who had taken  SSRIs  than those who didn't take the drugs.

Kearns' advice: Ask your doctor  each time they refill the antidepressant prescription: "Is this still the right drug?" "Is this the right dose?" Make sure the doctor prescribing your antidepressant knows about your bone health concerns, and consider asking about how much calcium and vitamin D you need.

GERD Drugs and Bone Health

If you have GERD (gastroesophageal reflux disease), your stomach acid backs up into your esophagus. You may be taking a type of drug called a proton pump inhibitor (PPI), which may or may not require a prescription.  PPIs include:

• esomeprazole (Nexium)
• lansoprazole (Prevacid)
• omeprazole (Prilosec, Zegerid)

Over-the-counter PPIs include versions of Prevacid 24HR, Prilosec OTC, and Zegerid OTC.

In 2010, the FDA warned that taking high doses of PPIs for a long time may make fractures of the hip, wrist, and spine more likely. The FDA ordered a labeling change on the medicines to note the risk.

Other drugs, called H2 blockers, curb the production of stomach acid. H2 blockers include:

• cimetidine (Tagamet)
• famotidine (Calmicid, Fluxid, Mylanta AR, Pepcid)
• ranitidine (Tritec, Zantac)

These drugs may be more bone-friendly, according to Kearns, but that's not certain yet.

Diabetes Drugs and Your Bones

Research about the effect of some diabetes drugs on bone health has been accumulating, says Chad Deal, MD, head of the Center for Osteoporosis and Metabolic Bone Diseases at the Cleveland Clinic.

Many recent studies have shown that a kind of diabetes drugs known as thiazolidinediones have a negative effect on the bones, according to Deal and Kearns. Examples of these drugs include:

• pioglitazone (Actos)
• rosiglitazone (Avandia)

There are other types of diabetes drugs, so that may be something for you and your doctor to consider when you're going over all your medications.

Bone-Maintenance Drugs

Bisphosphonates are a type of osteoporosis drug. They include:

• alendronate (Binosto, Fosamax)
• ibandronate (Boniva)
• risedronate (Actonel, Atelvia)
• zoledronic acid (Reclast)

Some studies linked their long-term use to a greater chance of an uncommon fracture of the thigh bone.

If someone who's been taking a bisphosphonate for a long time has that rare type of thigh bone fracture, their doctor should switch them to another type of osteoporosis drug, Deal says.

The following drugs are among the alternatives to bisphosphonates for either treating or preventing osteoporosis:

• calcitonin (Miacalcin)
• denosumab (Prolia). This is a biologic drug that slows bone loss.
• raloxifene (Evista)
• teriparatide (Forteo). This is a type of parathyroid hormone that increases bone formation.
• Hormone replacement therapy

If you've been taking a bisphosphonate for five years, Deal says your doctor may check to see whether you should continue, stop, or switch to another bone-maintenance drug.

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5 Foods to Boost Your Child's Immune System

Could the snacks you feed your kids cut their chances of getting sick? Healthy things in everyday foods -- from yogurt to walnuts -- may help boost a kid's natural defenses.

"We know that what you eat has a clear impact on your immunity," says Leo A. Heitlinger MD, chair of the American Academy of Pediatrics section on gastroenterology, hepatology, and nutrition. So whether you're arming your kid for cold and flu season or just aiming for good, year-round health, immune-boosting snacks may help.

5 Foods That Boost Immunity

• Yogurt. Yogurt contains helpful germs called probiotics. You may already know that these critters live in your gut and can improve the way your body uses food. But they're also important in helping your body fight sickness. One study found that kids who had a yogurt drink had a 19% lower risk of colds, ear infections, and strep throat.
  
  
  
  What type of yogurt should you get? Heitlinger suggests looking for brands that say they contain live cultures. "If it's separated when you open it, and there's a little liquid on top, that's a good sign," he says.
  
• Kefir. This tart milk drink also packs lots of healthy probiotics. While the biting taste can be a surprise at first, it's catching on in the U.S. "You can buy it in single-size packages that you could pack in your kid's lunchbox," says Jennifer McDaniel, MS, RD, a spokesperson for the Academy of Nutrition and Dietetics. There isn’t much proof about kefir yet. But early research suggests it can help your immune system.
  
• Walnuts. Walnuts have healthy omega-3 fatty acids, which are good for you in lots of ways. Experts believe that omega-3s help your body fight illness. One small study found omega-3s cut the number of respiratory infections in kids. Walnuts are easy to sprinkle into a snack mix or on cereal.
  
• Fruits and veggies. To help your immune system, McDaniel suggests aiming for ones that are high in vitamin C, like citrus fruits, strawberries, bell peppers, broccoli, and sweet potatoes. Experts aren’t entirely sure how much vitamin C helps colds and flu.
  
• Lean meats. You might not think of a leftover pork chop as a snack -- or that it would boost your body’s disease fighting system. But lean meats can help. First of all, they have protein, which is important for keeping up strength. Second, lean meats also contain zinc, which seems to help white blood cells fight off infections, McDaniel says.

Tips for Boosting Immunity With Foods

• Choose a range of healthy foods. Don't get hung up on this month's hottest superfood, like a berry or grain that supposedly works miracles, McDaniel says. It may be healthy, but it's not going to be a cure-all. Instead, offer kids a range of vegetables, fruits, whole grains, and lean proteins.
• More isn't better. If one kiwi is good, that doesn't mean your kid should eat 10. Mega-dosing with foods won’t help. Once your kid's body has what it needs, the rest gets wasted. It's like pumping gas into a tank that's already full.
• Know the limits. Remember, no food can prevent colds and flu. No food can cure them, either. So if your kid gets sick, it's not a sign that you didn’t give him a diet that was healthy enough. It's just life.
• Go for whole foods. Sure, orange juice has vitamin C, but your kid is better off with an orange instead. It has vitamin C and a lot more. "You get a lot more nutrients from the whole food than you would from a juice or supplement," says McDaniel says. There are lots of healthy natural chemicals in foods that we haven't isolated in pills or juices -- or that we even know about yet.

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Foods for Your Anti-Aging Diet

You already know that eating the right foods helps keep you healthy. Here's more good news: A healthy diet can also make you look and feel young. It may even slow the aging process.   

Eating foods such as fruit, vegetables, fish, nuts, and whole grains protects against many chronic conditions that could limit your life, including diabetes and heart disease. These foods help keep your blood vessels in top shape. That’s important for your heart -- and for every organ of your body. Certain foods can protect vision and hearing. Eating healthy foods may even help preserve memory and protect against Alzheimer's.

"Even your skin will stay younger looking if you eat right," says Allison T. Pontius, MD, an expert in anti-aging and regenerative medicine at Williams' Center of Excellence in Latham, N.Y.

Help Yourself to These Age-Defying Foods

Colorful fruits and vegetables. The antioxidants in colorful vegetables and fruits, such as leafy greens, deep red tomatoes, blueberries, and carrots, help stop unstable molecules from damaging healthy cells. You cannot feel it when some cells are damaged or dying, but you can see it in the signs of aging, such as wrinkles. So at each meal, fill about half your plate with fruits and vegetables. Your goal is five to nine servings a day.

• Three particular antioxidants -- vitamin C, zinc, and beta-carotene -- help protect your vision from macular degeneration, the leading cause of blindness in adults 65 and older. If you already have macular degeneration, eating foods with these nutrients may slow its progress. Dark green leafy vegetables -- spinach, kale, collard, and mustard greens -- help the most. But you also help your eyes when you eat bright-colored produce, including corn, peppers, oranges, and cantaloupe.
• A powerful antioxidant in grapes and red wine, called resveratrol, helps reduce your risk of cancer, heart disease, and premature aging.
• Antioxidants like vitamin C can even keep your skin younger-looking. A 2010 study showed that eating lots of yellow and green vegetables was linked to fewer wrinkles.  

Whole grains. Eating whole grains rich in fiber -- oats, quinoa, barley, wheat, and brown rice -- lowers your chance of developing type 2 diabetes. A healthy diet that contains whole grains also keeps blood vessels in peak condition. Your goal is three servings of whole grains a day.

Fish. Omega-3 fatty acids in fish oil offer many anti-aging benefits. They protect your heart, reduce your risk of stroke, and may even lower your risk of Alzheimer’s disease. Help yourself to two servings a week of fatty fish such as salmon, lake trout, or tuna. If you typically get tuna from a can, choose albacore packed in water for the most omega-3s. If you don't eat fish, ask your doctor if you should take fish oil supplements. 

Help Yourself to These Age-Defying Foods continued...

Dairy. The calcium and fortified vitamin D in dairy foods are crucial to strong bones. They help prevent osteoporosis and keep you active into your golden years. Include 3 cups of low-fat milk, yogurt, or other dairy products a day to ensure strong bones for life. By choosing low-fat instead of regular dairy, you’ll help keep your cholesterol levels in check, making you less likely to get heart disease.

Nuts. The fatty acids in nuts are among the healthiest you can find. If you avoid nuts because you think they're high in fat, think again. In fact, one study showed that snacking on nuts reduced the risk of high blood pressure and high cholesterol by about 20%. You only need to eat 1/4 of an ounce a day to get the benefits -- that’s about 4 almonds.

Beans and lentils. These foods give you loads of plant-based protein, so they’re an age-protecting alternative to red meat with saturated fat, which is linked to heart disease and diabetes. Beans and lentils are inexpensive and easy to add to soups, casseroles, and side dishes.

Aging Foods to Avoid

For the best anti-aging diet, it’s important to limit foods that can harm your body. It’s easy if you follow these three guidelines.

• Go easy on high-fat meat, high-fat dairy, and bakery treats. The saturated fat found in these foods can clog your arteries, which can lead to heart problems.

• Limit sugar as much as possible. Eating too much sugar can send your blood sugar levels on a roller-coaster ride of ups and downs. Over time, excess calories may make you insulin resistant, which can lead to type 2 diabetes. Diabetes damages your blood vessels and often leads to heart disease. "The less sugar you eat, the healthier you'll be," Pontius says. 

• Spare the salt. Eating too much salt, a form of sodium, can raise your blood pressure. Over time, high blood pressure can damage many parts of your body, including your kidneys, your eyes, and your brain. Limit sodium to 2,400 milligrams -- about 1 teaspoon of table salt -- throughout your entire day. If you have high blood pressure, your doctor may suggest you eat even less, about 1,500 mg a day. Check labels for the sodium content in canned, frozen, and boxed foods. Packaged foods typically pack in a lot of salt -- you may be eating more than you realize.

Give Your Body the Fuel It Needs

Can you get the benefits of nutrients through supplements, instead of thinking so much about what you eat? Not really, says dietitian Manuel Villacorta, author of Eating Free.

You need calories from food to have the energy to do everything you want to do. For steady energy, Villacorta suggests you eat three modest-sized meals a day, and keep healthy snacks handy for between meals. Drink plenty of water. Becoming dehydrated can rob you of energy and cause your skin to dry out.

Also, research shows that nutrients in whole foods interact in complex ways to protect your body. Isolating a single nutrient in a supplement rarely offers the exact same benefit.

“It's smarter -- and easier -- to plan your diet around foods, not nutrients," Villacorta says. "What you eat makes a huge difference in how you age and how you feel."

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How to Boost Your Fertility

If you're like most couples who are trying to conceive, you want to get pregnantsooner rather than later.

Having intercourse as close as possible to ovulation  definitely helps. But fertilityexperts say there are other ways couples can boost their fertility. A few simple measures may make the next month the month you'll squeal: "We're pregnant!"

See When You're Most Fertile During Your Monthly Cycle

1. Her Fertility Booster: Weight Control

Being underweight or overweight can delay the time it takes a woman to conceive.

William Gibbons, director of the division of reproductive endocrinology and infertilityat Baylor College of Medicine, says weight before getting pregnant is often an overlooked factor in fertility. Keeping a healthy weight can help with conception.

In onestudy, researchers evaluated the body mass index (BMI) of 2,112 pregnant women. Women in the study who had a pre-pregnancy BMI of 25-39 – considered overweight or obese -- had a twofold increase in the time it took to get pregnant. A BMI less than 19 (18.5 to 24.9 is considered normal) is even worse, the researchers found. Time to conception was increased fourfold in women with a BMI below 19.

Gibbons tells women to stay at a healthy weight when trying to conceive.

2. His Fertility Booster: Protect Those Sperm

According to Dale McClure, president of the American Society for Reproductive Medicine, the idea that changing to boxers instead of briefs will boost fertility by keeping genital temperatures down is basically an old wives' tale. Earlier studies seemed to point to boxers as the better choice, McClure says. But more recent studies haven't shown a major difference.

What about exposing the testicles to other sources of heat? The American Society for Reproductive Medicine says controlling temperature doesn't play much of role in boosting fertility. Some doctors, though, recommend staying away from certain sources. For instance, sitting in a hot tub day after day should be avoided, McClure says, even if a man has no known fertility problems. In at least one study, repeated exposure to high water temperatures through hot tubs or hot baths was shown to affect men's fertility.

Still, no research has clearly shown a link between exposure to other sources of heat and a man's fertility. One study did show that scrotal temperatures went up in laptop users who held the computer on their laps and warned that long-term exposures to high temperatures could harm sperm. Another study found that exposure to radiation from cell phones could adversely affect sperm that had been collected from participants. Researchers in that study speculated that keeping a cell phone in a pants pocket could affect the health of a man's sperm.

While neither study was sufficient to prove that exposure to sources of heat could harm sperm enough to affect fertility, McClure still says a man who wants to be a father probably shouldn't keep his laptop on his lap for extended periods of time. But even considering the above findings, McClure says he is "more concerned about hot tubbing."

3. Her Fertility Booster: Watch the Beverages

Drinking too much coffee or too much alcohol can impair a woman's fertility.

Experts say that drinking more than five cups of coffee a day -- the equivalent of about 500 milligrams of caffeine -- is associated with lower fertility. But don't give up your daily cup of coffee just yet. Moderate caffeine consumption, Gibbons says, seems to be OK. Having one or two cups a day is fine. His advice for women who are coffee or soda drinkers: "Stay under 200 to 250 milligrams of caffeine a day."

Studies on alcohol intake and women's fertility have produced mixed findings. But Swedish researchers have found that women who drank two alcoholic beverages a day decreased their fertility by nearly 60%. Once again, moderation is key. Although higher levels of alcohol -- two drinks or more a day -- should be avoided when trying to get pregnant, there is no evidence to show that moderate alcohol consumption adversely affects fertility.

You will, though, want to cut out alcohol completely once you are pregnant. Drinking while pregnant increases the risk of serious birth defects.

4. Couple's Fertility Booster: Stop Smoking

Smoking cigarettes can impair both a woman's and a man's fertility. Smokingaffects how receptive the uterus is to the egg. And in men, smoking can reduce sperm production and damage DNA. Experts also strongly suggest quitting smoking before you’re pregnant. Smoking while pregnant boosts the risk of miscarriage.

5. Couple's Fertility Booster: The Fertile Window

Taking advantage of what doctors call the "fertile window" can boost your chances of pregnancy. The fertile window is the six-days that end on the day of ovulation. Pregnancy is most likely to occur with intercourse within the three days before ovulation.

Richard Paulson, chief of the division of reproductive endocrinology and infertility at the University of Southern California Keck School of Medicine, says that couples often wait until the day of ovulation or later to have intercourse. But if you really want to get pregnant, “Err on the early side,” he says.

Paulson also advises keeping close track of ovulation -- either by the calendar method, figuring ovulation occurs about 14 days before the menstrual period is due, or by using an ovulation predictor kit, widely sold online and in drugstores.

6. Couple's Fertility Booster: Have Frequent Sex

Delaying lovemaking -- or as some couples say, ''saving up'' -- isn't going to boost the chances of pregnancy, McClure says.

"After about a week, the [sperm] count goes up a bit, but the motility decreases," he says. Not having sex for more than five days may affect sperm counts adversely. But intervals as short as two days don't harm sperm density.

Although daily intercourse produced the highest pregnancy rate in one study, it may pose too much stress for some couples. The same study showed that having sex every other day produced nearly as good a pregnancy rate.

7. Couples Fertility Booster: Choose Lubricants Wisely

With more frequent intercourse, couples may turn more to vaginal lubricants. That's OK, doctors say, if the lubes are picked wisely. Some lubricants can actually decrease fertility.  When you're trying to get pregnant, be sure to avoid products that have spermicidal agents.

So what is a good lubricant to use? "Canola oil," Gibbons says.

"Even peanut oil is good," McClure says. But impromptu household lubes may not be good. "I had a patient yesterday with a great sperm count and no motility [swimming ability]," McClure says. When he asked a few more questions, he got to the root of the problem. "He was using soap for a lubricant," and soap was killing the sperm.

You also want to avoid commercially available water-based lubricants. Water-based lubricants, such as Astroglide, KY Jelly, and Touch, may inhibit sperm motility by 60% to 100%.

8. Couple's Fertility Booster: Avoid Pesticides and Other Harmful Exposures

Exposures to pesticide, especially agricultural pesticides, may harm both men and women's fertility. And exposure to some solvents and toxins -- including those used in printing businesses and dry cleaning establishments -- can adversely affect women's fertility.

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