Sunday, 27 April 2008

What happens during pregnancy

Timetable: Significant events you are expected to know about
{Mention for a detailed timetable see reference section}
Missed periods/blood spotting
Scans & blood tests

12 week “dating” scan
Nuchal scan When is it charged and what can you do about it?
20 week scan
Other scans: Some places insist that a scan to determine the sex should be a separate private scan. Sizing scan. Additional scans in case of problems.
The Birth

Visits
Injections
Scans
What are scans and what can we learn from them?
An example scan
For comparison purposes I have included the same scan on the next page without the labelling. See if you can also spot the cheek bones, the shoulders and the beginnings of the ears.
An interesting feature of this particular scan is that the hand is almost straight in front of the umbilical cord which is only not visible because we are looking on the near side of it and it is angled away. When the scan was taking place movement could be seen and this was much more obvious.


Figure 5 Foetus at eleven weeks (unlabeled).
Tests
The standard pregnancy test consists of soaking a stick in urine for about a minute to se if certain hormones can be detected. Generally a blue line is produced if this is the case, though as one line may already be present it could appear as a blue cross. To check your reading of the test is valid there is often a control window which should produce a blue line whether or not hormones are present.

Figure 6 Test showing a positive result.


Blood group id
Rh-factor
Anaemia/complete blood count
Rubella Immunity
Chicken pox
Hep b
Syphilis
HIV
Double test (for Spina bifida, downs syndrome and related problems).
Triple Test
Blood pressure
Screening tests (opt in/opt out)

Copyright 2005-2006 Rufus Evison

Throughout the pregnancy

IF ANYTHING IN THIS CHAPTER LOOKS INTERESTING LEAVE A COMMENT AND I WILL TAKE MY NOTES AND COMPLETE THE REQUESTED SECTION

Trust your partner. Throughout pregnancy she is going to be closer to feeling what is happening than you can ever be. Remember that and remember how much you love and trust her.

Pregnancy what a man experiencesWorries you may have and how to deal with them.

Supporting your partner and protecting your child.

{This Section will give you a view of what to expect from a pregnancy. It will help to prepare you for the role you will need to play and how to play it. The objective is to discuss your responsibilities, what you will need to change in your way of life, what to look out for, and what to do if difficulties arise.}

Stress
Hers how to avoid it
Stress is a recurring theme throughout this book as it is:
a) Actively harmful to the pregnancy
b) Avoidable.

There is more on stress under lifestyle below as some of the changes you will make to your lifestyle can either increase or decrease your (and her) stress levels depending on how you make them. What we are going to look at here are the changes during pregnancy that can cause stress for your partner, and so cause her to stress you. We are also going to think about ways you can try to alleviate the things she is going through and so create a less stressful environment for both of you.

Causes: Restrictions on what she can do
Causes: unpleasant effects on her body
Cf What to expect while she is pregnant
Causes Worries she may have
Tactics: Things to help her with
Tactics: Pampering
Massage

Yours how to cope


What to expect while she is pregnant

Fat, smelly and beautiful, or what you should expect of a pregnant woman.
There are many significant changes to a woman’s body throughout the pregnancy. Many of them are more properly the subject of books to tell her what to expect. While these may be mentioned in the relevant sections of this book they are not the subject of this chapter. What I am mentioning are things you may notice. These are worth spending some time thinking about for two reasons:

1. So you can consider how you will react and if it is not positive what you should do so as not to hurt your partner.
2. So you know what you are getting yourself (and your partner) into before you begin.



Sleeping
Farting
Acne
Hairiness
Weight gain (well duh!)
Cravings: real or imaginary
Anti-cravings
Giraffes (or not all cravings are for foods)
Memory problems/forgetting what she promised to get you.
Changes in sense of smell (more or less sensitive both possible)
Indigestion and toilet problems including waking you every hour as she goes to pee, or making the toilet awful when she finally gets past a week of constipation. NB meshes with a nausea that means you may be cleaning up, and can coincide with incontinence.
Bleeding gums leaving the shared toothbrush a funny colour.
Tendency to thrush and similar conditions.
Bigger breasts (covered with veins)
Stretch marks
Emotional outpourings
Excessive tiredness which looks like (but is not) laziness

Copyright 2005-2006 Rufus Evison

Tuesday, 8 April 2008

It should be noted that this book is a work in progress. The reason I am publishing it in this way is that it has not been progressing so i am trying to add some momentum. As such I would greatly appreciate any comments people can supply. In the munuscript below the {} mean that this needs to be filled in. I have notes on everything in the document but have not been collating them and adding them. In some cases I will need to go back to the original research and re-read it as it has been a while. All of the following is useful information so if you know anyone who is trying, or thinking of trying do recommend that they visit thsi blog and have a look. If there is something they (or you) wish to know add a comment and I will either publish the bit with it in or find out for you as appropriate.

Rufus Evison

Lifestyle

Stress
{Why stress matters, effects on sperm count, hormone levels etc.}
{A short few paragraphs about a positive attitude to enjoying creating a child}
{A little on how to de-stress without stressing your partner. }
{Book recommendations on stress.}


Her stress matters too!

Telling People
As I have explained, one of the major factors affecting the ability to conceive is stress. To know that everyone knows you are trying and that they are all waiting to see what happens, how you do and how long it takes can be stressful. Personally I recommend you avoid that stress by not telling people you are trying.

For the first three months I would even say do not even admit to yourselves that you are trying. Do not do any of the things recommended in the section about sex, do not get too uptight about any of the other suggestions. Generally relax. After three months you can start looking at gently introducing a little method into your behaviour, but avoid at all costs spoiling sex by making the purpose of it procreation to the exclusion of all else. If sex is recreation you are much more likely to produce a conception than if everything is cold, clinical and planned.

Once you have been without contraception for three months your partners hormones should have settled down, and you can think about trying, but that does not mean it is time to tell people. Far from it. The standard advice from the medical profession is not to tell people you are pregnant until you are three months pregnant. Until you can tell them that there is no real reason to tell them anything that can set their expectations and so apply stress to you as a couple.

Trying for a baby is exciting, and you will naturally want to shout it to the world. Also you may well be looking for advice and reassurance. It is possible to do this without adding stress to your lives and without being deceitful. Tell people that you are thinking about trying.

If you are at the stage of not yet doing all the different things in this book, and are not having IVF then you could say that you are not yet really trying; you are just providing an opportunity for nature to take its course. This is a positive and non-pressuring way of looking at things as well as being an attitude that allows you to ask advice from people with children. It is a natural thing to do if you are thinking about trying. It is even something that I would suggest you should do while you are still on contraceptives.

Often things work best when they feel right and natural. This is true of sports, for example golf swings, it is true of love matches and it is true of creating children. Relax into your role as someone who will try if they need to but at the moment is just letting their life flow towards having children. Explore the new ideas in discussion with your partner, your friends and your family. Let it happen and do not start trying until you have no choice.

When you reach three months and feel safe telling people about the baby they will not be surprised as you will have talked to them about it in the abstract. At the same time if you go a year or two without moving on to actually having children they will not be surprised as you have not set any sort of time line in their heads. This is open and honest, yet at the same time non-stressful without expectations you feel you have to fulfil.

It is even reasonable for both you and her to change your diet, cut down on alcohol and all those sort of things while you are on contraception to give the child a good chance. Folic acid for instance both of you should take 3 months (in your case 100 days) before there is a possibility of conception. People will probably understand that if they happen to notice. Certainly if you have been discussing things with them you will have had an opportunity to bring it up.

If you are reading this through before you have decided to try then I would suggest looking at your diet or taking supplements now, as it will do you good whether or not you decide to have children yet. Feel free to point out this recommendation to people who may otherwise assume that you are already trying despite your protestations.

Every-day causes of every day stress that you can avoid for her.
Everyday ways to lower her stress levels.


Paying attention
There is a fine line to walk here between on the one hand bugging her, and on the other hand seeming uninterested. On that line is paying attention, and be warned the line wiggles. I will be making things harder by giving you more things to watch without bugging her to find out.

Romance
She is going to need continual reassurance that you love her and romance is a good way to do this, providing it is not totally out of character for you.

{little gifts e.g. soft toy, T-shirt with scan print on, jewellery, random flowers, a single chocolate hand wrapped, a note waiting where she would not expect it}

Environmental factors
The three things which lower the sperm count are:
1. heat
2. tightness
3. electrostatics

Clothing
There is a study which illustrates how extreme some of the effects clothing can get.
{Details of study. Things to check in terms of your current wardrobe. Places that sell good garments. Include underwear and artificial fibres on trousers and similar. }
Scuba Diving
Hot Baths
Hot working environment

Fitness, anorexia and obesityAnorexic, bulimic or just plain thin?
{Underweight effects}
{Ways to gain weight}
Periods, thinness and long term effects

Are you obese?
What is your BMI?
{overweight effects}

Are you unfit?
Exercise is good for both of you. Exercise together to help encourage her, prevent injuries, etc. Make sure she does not strain herself, over-exert or anything like that. Very easy to do have your altered posture cause injury as bones are rearranging themselves.

{Relaxin.}

Encourage her to stay active as better for the birth as well as better for her.
BMI, fat measuring weighing machines and callipers
Too much exercise, hormones and conception
Steroids

A word of warning, the BMI can be quite misleading. It does not take into account differing levels of fitness or how fat you are versus how muscular you are. Body builders who typically have very low levels of body fat appear to be obese if the measure used is the BMI.



Underweight men who had a BMI under 20 also suffered from similar reductions in sperm counts.

"Body mass within the ideal "normal" range was associated with higher sperm concentration, higher total sperm count, and a lower percentage of abnormal sperm," write researcher Tina Kold Jensen, MD, PhD, of the University of Southern Denmark, and colleagues.

Researchers say these findings may have important implications for the future procreation potential of men worldwide in light of rising obesity rates.
The study also showed that as men's weight increased blood testosterone levels decreased.

We are still waiting to see if the current obesity ‘epidemic’ leads to a parallel infertility epidemic due to poor quality sperm.

For example, men with a high or low BMI were more likely than normal-weight men to have a sperm count below 20 million per millilitre of semen, which is abnormally low.
Overweight men -- those with a BMI over 25 -- had a 24 percent lower sperm count compared with average-weight men.

Smoking, drinking and drugs

Illegal Drugs to Avoid
Obviously I have to advise against all illegal drugs as they are generally illegal because they are damaging in some way. The further from peak condition your body and mind are, the harder it is to have a baby, or to be in the right state to look after it. If you have been thinking about giving up then having a child can be the incentive you need to make it happen.

In either case, what follows is some information about the particular illegal drugs that prevalent research seems to show to have negative effects relevant to creating a baby. I have described the problems that there is some research to support. Most of the research only covers women taking drugs during pregnancy, where this is the case I have not included warnings on the man taking drugs prior to conception. This does not mean there are no effects from you taking things prior to conception, nor does it mean it is safe for you to take the drugs during the pregnancy. All it means is I have not seen research to prove quite how bad it is likely to be.

The research I have seen has tried to control for confounding factors, but this may not always have been possible. One problem is that known drug users often introduce other problems that affect the child. It is not always possible to separate the effects of the prenatal dose from the post natal factors of living with parents who use drugs. That said the research does vary across a widely ranging set of populations and does appear to be meaningful.

Another problem of drug use is that the partners of drug users often use themselves, and find it much harder to stop on their own. Unless you stop, your partner will probably not stop either, and may hide their use from you. I have included under each drug some information about the effects of women’s drug use during pregnancy. A foetus is vulnerable enough that having a rare steak for dinner could have a drastic effect, so it is no surprise that effects of women’s use during pregnancy can make fairly distressing reading.

Any drug that can be consumed by smoking carries the dangers of passive smoking. Passive smoking is not just from the smoke being inhaled. It has been shown that infants suffer from the smoke absorbed into clothes, furniture etcetera and need a smoke free environment. The same is presumably true for partners carrying babies. So in summary:

• Drugs you take can lower your chances of causing a conception.
• Drugs you take before conception can affect child health after birth including
o Lower birth rate
o Deformities
o Child cancer
o Learning difficulties
• If you use drugs then your partner may use them during pregnancy leading to an even higher chance of:
o Miscarriage
o Birth defects
o Child cancer
o Child learning difficulties at a later age.
• Drugs you take after conception can passively affect your partner and cause all of the above.



Marijuana
Some statistics on how large a proportion of the populations uses Marijuana.
Marijuana can affect the brain chemistry responsible for releasing reproductive hormones. Marijuana decreases testosterone, sperm count, and potency. A father's drug use can also cause birth defects, particularly higher rates of heart abnormalities.

More, if you smoke then how can you tell your partner to stop? Women who smoke marijuana have increased risk of abnormal ovulation and are less fertile. Scarily this can be affected by past use, though it is worst when taken within a year before you start trying. The risk does not really change much with how often you use, nor with how long you use for. Even occasional use of small amounts of marijuana can decrease women's fertility.

Leaving aside risks to conception, women who smoke marijuana have higher rates of miscarriage, pregnancy problems, and difficulties with labour and delivery. Birth defects are associated with marijuana use.

A mothers' use of cannabis is associated with increased rates of various childhood cancers. The newborn babies can experience some withdrawal symptoms and other effects on their nervous system. Some of the other effects are not so obvious in newborns. These include neurological delays in the brain. These affect the so called ‘higher functions’ which cannot really be measured until the child starts to grow up. They tend to exhibit as poor memory, low attention span, poor reasoning and analysis, poor reading and language learning and various other learning disabilities at ages anywhere from 4 years to fully grown. All in all it is not a nice thing to arrange for your unborn child, and even if your partner gives up the second hand consumption from your clothes and body could have an effect.

Only one study showed Marijuana to have a positive effect. That one was taken in Jamaica where there was a possibility of cross contamination (some of the non-users turned out to be drinking marijuana teas regularly and were removed from the non-user category, others may have been using intermittently in a social context). The positive effects were all found at an early age (one month or less) where higher functions cannot be measured and docility is considered a good thing.


Cocaine
{}
Heroine

Speed
{}

(c) Rufus Evison 2005-2008

Thursday, 3 April 2008

Becoming a father Chapter 5 - Sex: timing, effectiveness and gender

This chapter is going to cover the mechanics of sex and fertility as well as how they affect both the chances of conception and the potential gender of the baby. Clearly if the act of sex affects both of these things then there is going to be overlap if I try to separate them completely. This means that while there are bits specific to how effective at producing conception sex is and specific bits on gender selection there are also bits such as the female orgasm that affect both. Because it is not clear until you have read them what the subtle effects are I would suggest reading through the whole chapter before going back and looking properly at the bits that interest you.

Effective Sex
The first thing to be said on this is that if you turned here first you are already in trouble. Stress is very counter-productive, and if you are too hung up about the effectiveness of your sex you will be stressed, which is not good.

Having said that, there are things related to sex that can stop it resulting in conception. You should know about these things as this can stop you consistently falling into unexpected traps.

The most important thing to ensure your sex is effective is timing. Unlike a man, a woman is only fertile for part of her monthly cycle; this limits when sex can cause conception. Sperm can survive for up to 7 days in perfect conditions. In practice most sperm die within 24-48 hours. The timing section below will explain how long either side of ovulation is practical for conception. There are ovulation tests available to check that ovulation is occurring when you think it is. Conveniently enough a woman experiences a large surge of hormones just before ovulation. These hormones show up in the urine so, just like the pregnancy test, peeing on a stick is the way these tests work. This is hormonal rush provides a heads up that it is time to start having sex. There are many kits and books that will tell you the exact time of ovulation, but in my opinion the stress of trying to work to a strict timetable is sufficiently counter-productive to make a rough knowledge of the day preferable.
Remember, the rhythm method is a form of contraception based on timing your sex to avoid fertile periods. It is not 100 % effective, but it has worked for millions of people for hundreds of years, so the time of the month when you have sex is probably the most significant factor over which you have control.

Just as conception is unlikely to occur unless you ejaculate it is less likely if the woman does not orgasm than if she does. This is because the muscular contractions that take place during orgasm help move the sperm towards the egg.

As female orgasms are a factor in effective sex it is important that the sex is enjoyable. One problem often encountered by couples trying for a child is that they become too obsessed with timing, fertile periods, nutrition and all the other things which can effect conception and become stressed. This stress in itself will affect a woman’s ability to conceive, but worse than that it can effect the enjoyment of sex. Couples report it becoming “automatic”, “clinical” or “just not sexy”, and unsurprisingly the female partner is less likely to orgasm under these circumstances.
Different positions can also affect the chances of conception. The further into the vagina the sperm are deposited the less distance they have to swim. Not only that, the vagina is the least friendly environment that the sperm will have to swim through, so minimizing that part of the swimming distance can have a disproportionate effect on the chances of success. Similar effects can be produced by the position assumed after sex, as this can allow gravity to work in favour of the swimming sperm. This is why some films have women posed on their backs with their legs in the air after sex when trying to conceive.

The sperm count of a man can be affected by the frequency with which you have sex. Abstention for a set time before the fertile period can alter the chances of conception, as can changing the frequency with which you have sex during the fertile part of your partner’s cycle. It used to be that they reccomended abstinence for ten days before ovulation. This is not longer considered to have a significantly different effect to two days of abstinence.


Timing
Sperm levels are highest in the morning. This may be related to an some men’s desire being heightened in the mornings. The sperm levels, to some extent, drop off throughout the day. If you want to take advantage of this then have sex as soon after waking as you feel comfortable with, so mornings or early afternoons might be good.

As was made apparent in the previous section there is only an egg available for a few days each month. Ovulation is generally about two weeks before the first day of her next period. This means that if she has regular cycles you can assume ovulation will be about 14 days before that. If her cycle is not regular (and one in five are not) then start by guessing and if things are taking a while (a few months) check your guess by persuading her to use a test (clearblue?). If her cycles are particularly irregular it is worth using some sort of check on a regular basis to ensure you do not miss the window.

It is worth noting at this point that ovulation test kits do not test for ovulation. They test for the rush of hormones preceding ovulation. This rush can occur even if ovulation does not. In the event of a significant amount of time with no success at conception it is worth having a check that she is ovulating. This is usually done through your medical practitioner. The good news is that if this is the problem then in many cases there is a simple injection that can fix things by jumpstarting ovulation. This is particularly frequently the case for second or later pregnancies.
It is also possible to check for ovulation using the temperature profile of the woman. {more on how this is done, the timing of ovulation and different techniques for estimating and checking}

Once you know when ovulation is occurring you need to work out when her fertile period is. This is generally from 4-5 days before ovulation through to 1-2 days after. Male sperm survive longer than female sperm once they are out of the acid environment of the vagina so having sex at the start of this period creates a slight bias towards male children; the day either side of ovulation creates a slight bias towards female children. You can buy programs to tell you that her most fertile period is the days mentioned above, but as you have now read this it is probably not worth the bother.


The rhythm method of contraception:{To be completed}

Further background Information
The menstrual cycle of a woman determines when she is fertile. Cycles vary in length from around 20 days to over 35 days. Changes in the cycle of up to around a week are fairly common. Unless a woman is on the pill her cycle is not likely to be completely regular.
Signs that she is entering her fertile period can include:
• The cervix becomes higher and softer and open (you can feel this with your fingers)
• Cervical mucus produced in the cervix changes to an environment that is better for the sperm. This can be observed in the texture and taste.
• Increased fluid ; up to 10x increase in mucus volume can be seen.
• Highly-fertile mucus is nearly all water – This gives a transparent, glistening, slippery, stretchy - spinnbarkeit effect.
• The structure of fertile mucus includes a particularly loose network to help the sperm get though. Again can be discerned through the texture.
• Increased salts, sugar and amino-acids to nourish sperm, again noticeable as it affects the taste.

The female orgasm
One thing that is often important is lack of stress. Many couples become pregnant shortly after they give up and stop trying. When applying for IVF the time while you wait for treatment is one of the most likely times for conception.
You are more likely to cause conception if your partner has an orgasm after you have ejaculated. This is because the vaginal contractions that take place during the female orgasm act as a pump to move sperm from the acid vagina to the relative safety of the uterus. More female orgasms mean more pumping of sperm, mean more chance of conception.

There is a theory to suggest that that multiple groups of multiple orgasms throughout the days following the fertilisation of the egg by a sperm can cause sufficient movement within the uterus as to lower the chances of successful embedding by the fertilised egg. I have been able to find no research to either confirm or deny this.

Some women come more violently on their second or third orgasms than on their first, others find each orgasm weaker than the preceding one. For those in the latter category the effect on the chances of conception will be lowered if her first orgasm is before yours. If she is likely to feel like stopping after she has had an orgasm, then make sure you save her orgasm until after yours.

As well as affecting the probability of conception the female orgasm, or lack of female orgasm will affect the gender distribution. For more details see ‘gender selection’ below.

Technique
Given the advantage if your partner orgasms after you have, it is worth talking briefly about some ways to achieve this. There are suggestions that men have a tendency to roll over and go to sleep after they have ejaculated. In terms of conception this is not optimal. While we all know that in actual fact there are really only about 10 men who ever did that, and they are reformed characters now, it is still interesting to find out how other people have sex, so below are a few suggestions. Another thought you might want to consider is that what you do and how you do it will be more restricted during pregnancy, so taking advantage of your relative freedom at this point may be a good idea.

It is also worth noting that your ejaculate (the combination of sperm and seminal fluid you produce) will change consistency a short while after you ejaculate. This is useful in adding to the motility of the sperm. It is best if you have a rough idea how quickly this will take place. This varies from man to man, and also depends to some extent on your diet and how hydrated you are. In practice we are going to have to assume your diet and level of hydration are pretty much constant, so that we can gauge how long it is in your case. You will then want to see if you can induce an orgasm just after the sperm has de-jelled.

To test this you want to ejaculate onto a non porous surface of about body temperature. A hot water bottle or a plastic sheet you have been lying on would be perfect. If your sperm takes longer than 15-30 minutes to liquefy then do not worry about trying to time things to match, as it will just detract from the sex and add to stress. If your sperm takes more than 120 minutes then you have an agglutination problem and may need to look to your diet or consult a qualified doctor. Anything up to 60 minutes is considered normal. Most common times are on the order of five minute, but the spread is really quite large which is why this is actually worth checking. On the subject of which you might as well do this when it is not going to affect fertility, so a week or more from ovulation. This could be viewed as a good excuse to persuade her to make you come.

Tongues
One of the more sort after sexual acts amongst women is, apparently, for the man to go down on her. How much women actually want this is culturally biased as well as varying significantly on an individual basis. Like everything else in this section it is worth discussing with your partner to see what she would enjoy most. If she does enjoy it then it is worth bearing in mind as an eminently practical way of allowing her to orgasm after you have.

Fingers
It may seem obvious, but you both have fingers and they are one of the most sensitive and agile parts of your bodies. Her using her fingers to ensure she has an orgasm just after yours is a very satisfying way to achieve good timing. You doing the same for her after you have come can provide her with some excitement and variety and is another worthwhile alternative to relying on friction and motion from the penis.

Vibrators
Contrary to popular myth a vibrator is not just a dildo that makes a funny noise. In pornography you will generally find that the purpose of a vibrator is to be inserted into the vagina and there to be used as a penis replacement; that is to say they are used as a dildo. In practice this is not how vibrators are used except by the very inexperienced. Certainly some people will use a vibrator as a dildo when they do not have a dildo and something else is doing the job of the vibrator. Also this use does look sexy (that being why it appears so frequently in pornography) so using it this way for you watch is quite reasonable.

In general use however the vibrator is there to apply vibrations to the clitoris where all the nerve endings are and not to the vagina where they are not. A vibrator can be used, by either of you, while you are making love. If the purpose is to ensure the female orgasm then it would be applied to her and the position that you used would need to take account of this. Best access is generally provided either during sex where you are behind her or where you are kneeling up between her legs as she lies down. Either of these positions provides fairly deep penetration, though the rear entry has the edge. That said you have more control over depth of entry when you can see what is going on so either of these is preferable to the missionary position in terms of gender selection. If you are trying for girl you might want to delay her orgasm for a while after you come, so a vibrator is good for her to make herself come while you watch after a pause.

Fantasy
Fantasy is strong element in all sex, whether through investing significance in what is going on or through imagining something else entirely is happening. As a couple it is worth talking through what your sexual fantasies are and what you would enjoy most. This will give you a whole range of things to play with, metaphorically speaking. If you can fulfil a few fantasies then you will probably create that much stronger orgasms. Some couples even find fantasising about the fact that they are creating a baby and bringing into existence new life a trun on.

Caressing, stroking, kissing and other ‘foreplay’.
{to be completed}

Other toys:
Benoit balls (not a good idea?), Penis rings, tens devices, S/D, textured gloves, etc.
{insert notes on foreplay, after-play and producing orgasms after the so called main events.}
Foreplay: Kissing, stroking, cuddling, setting the mood, oral sex, role playing and fantasy fulfilment, talking dirty.
Pornography, a personal taste.
After-play: Vibrators, oral sex, manual stimulation by him, manual stimulation by her, breasts, maintaining the mood, cuddling, kissing.
Vibrators: The different types, how to use, when to use, why to use, a toy for both of you. Worth noting that mains powered ones can bring about male orgasm as well as female orgasm. Mention of the rabbit vibrator and it’s plus and minus points fro conception. Also mention hygene.

Frequency
Effects of frequency on sperm count and on probabilities of different genders.

Sexual positions
Affects on probability of conception and on gender distribution.

As described above, sperm swim at only 3mm an hour and cannot survive long in the acid conditions of the vagina. Girl sperm can survive for significantly longer in this environment than boy sperm.

Gender Selection
Warning Words
Selecting for gender often lowers the chance of conception
There are differences between boy sperm and girl sperm, and these allow us to change the chances each have of surviving. Outside of a medical procedure pretty much all the things we can do to alter the chances of a particular gender involve making the other gender less likely to survive. This means that many of the ways of trying to produce a particular gender reduce your overall chances of conception. Ther are exceptions, and in fact many of the things you can do to increase your chances of conception will, in themselves bias the gender distribution at least a bit.

Beware of anecdotal evidence
The fact that we start with around a 50/50 chance of either sex has led to a wonderful confidence trick:

• Offer a 100% money back guarantee.
• Provide none some or all of the suggestions below as being proprietary.
• Do no work and keep about 50% of the money you are given.

The original version of this used a “potion” made simply of water. The later more sophisticated version used injections of saline solution. Clearly neither had any effect on the gender of the child, but it did not matter.

Clinics using the salt water injection had a whole set of satisfied customers willing to testify to how well it had worked for them. The ones who did not get what they want were given their money back and so kept quiet as they did not feel they had a cause for complaint.

Some of the confidence tricksters out there now get a better than 50% chance of keeping the money they are paid as they get you to do the things below to lower your chances of conceiving the unwanted gender. Some of them even believe in their proprietary products. So far I have not found any that can offer an independent study that shows a better success rate than someone using the tricks below. If you do, please feel free to get in touch with me and let me know. If on the other hand you use one and it works do not bother to let me know, as at least half of their customers will be in the same boat as you.

Gender Selection Overview
Back to the factors that really have an effect on the gender of the child. There are a lot of old wives tales about selecting the sex of your child by how and when you have sex. Interestingly many of these tales turn out to have some basis in fact.
It is easy to dismiss all of them by bringing up counter examples, where people followed all the advice to select a child’s sex and it did not work. This is because we are dealing with millions of sperm which means that no matter what you do there is a chance that an unexpected sperm can sneak around and surprise you. In effect we are dealing with probabilities, and while we can stack the odds by being careful with our sex we cannot fix the race.

If you absolutely have to select the sex of your child, for reasons related to genetic diseases for instance, the only way to do it is through artificial insemination where they can select individual sperm and individual eggs. Doing this because of simple preference is not a good idea as cultures tend to have a gender bias.

An example of this took place in Asia, where most couples wanted boys. Through a variety of means from abandonment and infanticide through to genetic selections, people managed to select for male children. Suddenly there was a shift in the population bias so that hundreds of thousands of male children had no realistic potential partners as there were not enough girl children to go around. That said in some parts of Asia the government is making progress at rectifying the situation.
In China's Huaiyuan County, a pilot program gives parents of girls tax breaks and $240 in cash. As their local official says, after two years of this campaign, they have achieved remarkable results. The sex ratio in Huaiyuan has changed from 160 boys for every 100 girls to 120 boys for every 100 girls born there.

The 1990 Human Fertilisation & Embryology Act allows sex selection only for couples carrying a genetic disease which would be passed on to their children, and not for social reasons. None the less I am going to detail the things that can affect the gender of the child. This is not illegal as the act is referring to the medical arena, not to things you do as part of your sex lives at home. You can use the following tips to try to stack the odds a bit if you want, or equally you can look back at what happened and try to guess the sex of the child before the scan makes it possible to tell, or the birth shows you the reality.

In all of the following when I refer to “boy sperm” I mean sperm, which if they successfully fertilise an egg will probably produce a male child, and when I refer to “girl sperm” I mean ones which will produce a female child.

Keep an eye on the weather and wait for a cold snap. Research found that more boys are conceived after heatwaves and more girls after cold snaps. Sex ratio seemed to correlate with temperature about one month before conception. Hot summers or unseasonably warm patches were followed by the birth of more boys, while unusually cold weather favoured girls. This may be because of the effect of temperature on maturing sperm in the testes, with sperm carrying a female X chromosome more sensitive to heat. Equally there could be some non-causal link.

Missionary for a girl, doggy style for a boy due to the acid swimming distance.
Finally, in trying for a boy, ‘How to Choose the Sex of Your Baby_, by Dr. Landrum B. Shettles, MD, and David M. Rorvik. Published by Doubleday & Co.; copyright 1984.’ recommends a nice cup of caffeinated coffee for the man, right before sex -- he isn't clear on how or why this works, but apparently it gives the Y-sperms a jolt!
Scuba diving biases towards girls

http://www.obgyn.net/english/pubs/features/presentations/hennawy02/choosingsex.ppt has a whole lot of myths, most with no validity at all, but I found it funny.

Old wives tale: In a couple if the woman comes first a girl child is more likely, if the man comes first a male child is more likely.

It looks ridiculous at first glance, but there is a basis in fact here. If the woman does not come with or after the man then no pumping of sperm will take place. As well as lowering the overall chances of conception this will bias things against the boy sperm because they are less likely to survive a swim though an acid vagina.

Extreme measures for gender selection
Some American books and articles I have come across recommend using douches to select gender. Acid douches make girls more likely; alkali douches make boys more probable. So a lemon juice and water mix would kill a load of the boy sperm giving the girl sperm a competitive advantage.

Bicarbonate douches (alkali) can help to improve the chance of conceiving for a few people with unexplained infertility. But there's no evidence that it affects the sex of the baby, and douching may also be harmful.

A pure lemon juice douche would cause pain and kill off any chance of actually having sex that night, so be aware extreme measures are not necessarily a good idea. I have to say that the idea of douching with water and bicarbonate of soda for a boy also seems a bit too far to me anyway, and I am not really in favour. That said it is as well to know what could be done, even if you are too sensible to actually do it.

Inertial separation of sperm into dizzy girl sperm and dizzy boy sperm through size (girl sperm are bigger). This is a recognised successful mehod but is usually only available through expensive clinics.

Anal sex
As I mentioned under Nutrition above, around 8% of couples of who use anal sex as a method of birth control have pregnancies each year. It used to be said that sperm can sometimes penetrate the membrane between the anus and the vagina after being deposited during anal sex. The current theory is that these are “splash conceptions” where the sperm actually find their way around to the vaginal opening from the anus.
A pregnancy conceived by anal sex carries a significant risk of the bacteria associated with feces being sealed in with the developing embryo. During the first months a foetus does not have an immune system and bacteria can cause severe disabilities. Even apart from the odds against conception, the risks mean this is not a good way to conceive. If you are trying to conceive I would suggest avoiding anal sex for the duration.

If you do practice anal sex whilst trying for a baby at the very least wash the penis after engaging in anal sex and before inserting into the vagina, otherwise, the risk of bacterial transmission from anus to vagina is extremely high.