The intersection of reproduction health and our community is a mostly quiet one.
Though she’s been helping people conceive her entire career, Dr. Carolyn Kaplan admits that, relatively speaking, there’s “very little information” that targets our community at large. Perhaps it’s because, biologically speaking, we encounter the same reproductive issues as those outside the rainbow, which is probably for the better. As a board-certified reproductive endocrinologist and obstetrician-gynecologist, Dr. Carolyn Kaplan is a wealth of information on the topic. She gave us some insight on a few issues hopeful parents may encounter, and preemptive ways to better the odds of conceiving.
Gather ’Round, All
First things first: Though rarely spoken of, but worthy of note, men and women have the same odds of fertility problems. “Most people think it’s just the women,” Dr. Kaplan says. (Paging, “Handmaid’s Tale.”) A good rule of thumb for all: “Stop smoking — even sidestream smoke is an issue,” she says, adding that it affects the DNA of eggs and sperm, and can increase the likelihood of miscarriage. Ditto everyone involved maintaining a healthy body weight, as sperm count can be affected by excess weight as can the quality of a biological female’s eggs. “Taking vitamins is important for everyone, too,” Dr. Kaplan says. “If you can get them through a healthy diet, meaning lots of fruits and vegetables — and a B12 supplement if you’re a vegetarian — that’s good, too.” Sensible enough.
For The Bio-Gals
To begin, those with female reproductive systems need to make sure they’re fertile, and the only way to do that is to go in for a checkup. Any number of conditions can throw a wrench in the works, from hypothalamic amenorrhea (common in athletes) and obesity to polycystic ovaries and endometriosis, just to name a few. “Make sure to get annual checkups,” she advises. “Come in preemptively, just in case, to get the basics.” Dr. Kaplan urges trans-men who wish to conceive to come off hormones, citing that it’s not as difficult as it may seem. For all, prenatal vitamins are significantly helpful. Avoiding alcohol is crucial too, as is refraining from smoking. What about pot?
“Marijuana is understudied and it’s probably not as bad as cigarettes, but it definitely affects the neurological development of the fetal brain in a pregnant woman.” In fact, in three separate studies from Auburn University in Alabama, the University of Maryland School of Medicine, and Washington State University in Pullman, dosing pregnant rats with cannabis lead to “cognitive flexibility” in their offspring, as well as underdevelopment in the hippocampus region of their brains. Again, understudied, but why not play it safe if the goal is to conceive a healthy child?
For The Bio-Guys
The biological males among us who wish to provide DNA for the pregnancy will need to be healthy and tested for HIV, Hep B, Hep C, and syphilis. “They also need a semen analysis to determine whether [the] sperm count is normal,” she says. “Good testosterone doesn’t equal good sperm. There are home kits for semen analysis for a ballpark, but it doesn’t look at the shape of the sperm.” (The shape?) “They’re not all the same,” she shares, adding that typically, about 5–10 percent of the sperm in the ejaculate is normal. “Some have two heads!”
Bio-males would do themselves a favor to stock up on supplements, with an especial nod to zinc, E, C, and B vitamins, as well as L-Carnitine which gives sluggish sperm some pep for their long, arduous journey. They’ll need it as, according to Dr. Kaplan, “the vagina is a hostile environment for sperm!” Again, she stresses the need to extinguish those butts. “The toxins found in cigarettes have shown up in seminal fluid, and it’s carcinogenic.”
Dr. Kaplan tells us that all parties using a surrogate to carry their baby to term will need an attorney and a psychological evaluation before embarking on the journey. She regales with a late-’80s case involving “Baby M,” the child of a surrogate mother who decided to keep the baby, forgoing the $10,000 from a couple who couldn’t conceive themselves. “It was a mess.” To avoid that, you’ll need solid attorneys. (Note: Those who are using sperm from a sperm bank are safe, as the donor who contributed has waived paternity rights — all that is taken care of in-house.) But “with a gestational carrier, everyone needs to be lawyered up,” she warns, with a shout out to the efficacy of Southern Surrogacy’s legal team.
Though conceiving a child in an intricate process with an uncanny amount of roadblocks, Dr. Kaplan remains positive — and humble. “I have lots and lots of patients who’ve said to me, ‘You’re so wonderful! You helped us get pregnant!” she tells us. “But I always say, ‘I was a helper in a group effort.’ If I take credit for the successes, I have to take credit for the failures.” With nearly three decades of practice to her name, the modest doctor is no doubt responsible for lots of healthy human beings and their proud, loving, sometimes-LGBTQ parents.
Dr. Carolyn Kaplan is the owner/director of Atlanta’s own Reproductive Endocrinology and Infertility Group. For more information, visit ReiGeorgia.com.