TUESDAY, Nov. 10 (HealthDay News) -- Although many wedding vows include the phrase "in sickness and in health," a stroke can put that promise to the test by causing major relationship problems for married couples, according to British researchers.

The University of Ulster study included 16 married stroke survivors (nine males, seven females), aged 33 to 78. The time since their stroke ranged from two months to four years, with an average of 18 months.

The researchers found that the stroke significantly affected sexual activity, led to blurred relationship roles, and feelings such as anger and frustration were confounded by persistent fatigue and lack of independence.

Among the findings:

• All but one of the stroke survivors experienced a reduction or total loss of sexual desire. Some believed this was due to the effects of medication or fear of another stroke.
• Most of the females lost interest in their appearance, regardless of age.
• All the survivors said they'd changed since their stroke. Many said they experienced irritability, anger, agitation and intolerance due to their frustration at not being able to perform daily activities. In some cases, over-protective spouses increased feelings of anger and frustration.
• Many survivors were reluctant to resume social activities with their spouses because of fatigue, anxiety and swallowing problems.
• Fatigue was often associated with reduced independence and guilt because survivors didn't know how they'd feel from day to day and couldn't plan ahead.

"All the participants perceived a stroke as a life-changing event. They faced a continuous daily struggle to achieve some sense of normality and that required huge amounts of physical and mental effort," study co-author Assumpta Ryan, of the University of Ulster's Nursing Research Institute, said in a university news release.

The study was published online in the Journal of Clinical Nursing.

More information

The National Stroke Association has more about life after stroke.

THURSDAY, Oct. 29 (HealthDay News) -- Women who lie flat for 15 minutes after being artificially inseminated greatly boost their odds of becoming pregnant, new research suggests.

"Allowing women treated for subfertility with IUI [intrauterine insemination] to remain in supine position will yield a 50 percent higher chance at conceiving," said Inge Custers, lead author of a study to be published online Oct. 30 in the BMJ.

Custers and colleagues aren't sure why this simple step yields better results, but they hypothesize that the supine position prevents sperm "leakage" from the vagina.

IUI involves placing sperm directly into the uterus, where conception then hopefully takes place. It differs from in vitro fertilization, which involves fertilizing the egg in a test tube before implanting the embryo in the uterus.

According to the editorial, IUI offers several benefits, including minimal drug involvement and low cost. It is also more accessible, being offered in smaller clinics. A main downside is a pregnancy rate lower than that achieved by in vitro fertilization.

IUI remains one of the most common fertility treatments worldwide, the study authors stated.

This study involved almost 400 couples in The Netherlands who were undergoing intrauterine insemination. The women were randomized to lie prone for 15 minutes after insemination or to get up right away.

Twenty-seven percent of women who stayed still for 15 minutes became pregnant vs. 18 percent in the other group. Live birth rates followed a similar trend: 27 percent in the first group and 17 percent in the control group.

The main problem with this method would be taking up more time and space at fertility clinics.

On the other hand, achieving conception the first time around would mean fewer repeat visitors, the experts noted.

"Over the years, subfertility is an increasing problem, which causes higher demands on busy offices, trying to treat as many patients as possible," said Custers, a student and registrar at the Centre for Reproductive Medicine at the Academic Medical Centre in Amsterdam. "With increased efficacy of the procedure, these women will therefore not return for subsequent cycles. A positive effect of this study was observed in The Netherlands: more and more women have been allowed this treatment strategy. Whether this will be implemented globally remains to be seen."

One expert said it wasn't yet clear whether this was the best way to maximize pregnancy odds.

First of all, it's not known what common practice is currently in clinics: lying down for 5, 10, 15 minutes or longer, said Dr. Peter McGovern, director of the division of reproductive endocrinology and infertility at Hackensack University Medical Center in New Jersey.

"These authors didn't test other times," he said. "And studies in the past found that sperm deposited in the vagina could be found at the end of the fallopian tubes within 5 minutes. I think probably any time period over 5 minutes would probably give you the same difference. It's probably a good idea to have people lay flat for some period of time as opposed to just leaping up."

Another expert agreed.

The Dutch study's conclusions are "plausible," said Dr. Roger Lobo, president-elect of the American Society of Reproductive Medicine and professor of obstetrics and gynecology at Columbia University, although the 15-minute time span used in the study does appear "artificial."

"Five minutes is probably sufficient," he said. "Sperm travels very, very rapidly. If you get up within the minute there may be some leakage."

"In our practice I've never heard of anyone who gets up immediately," Lobo said. "The standard is 10 minutes. Women who are asked to get up immediately may have a stress response." Volume of sperm also plays a role with more sperm upping the odds of pregnancy, he added.

More information

There's more on infertility at the American Society of Reproductive Medicine  .

WEDNESDAY, Aug. 12 (HealthDay News) -- New mothers are getting older.

In the United States, the average age of women giving birth for the first time rose from 21.4 years in 1970 to 25 in 2006, according to a new report from the National Center for Health Statistics (NCHS).

Births to older women are partly responsible for the upward trend.

"In 1970, just 1 percent, or one in 100, [of] births were to women 35 and over," said study author T.J. Mathews, a demographer with the NCHS, which is part of the U.S. Centers for Disease Control and Prevention. "In 2006, it was one in 12 births. It's a dramatic transition."

On the other hand, the United States still has the youngest age of first-time mothers in the developed countries studied. In Britain, Switzerland and other nations, the average woman now has her first baby at nearly 30 years of age.

"The U.S. is only now caught up to where other countries were in 1970 [for average age of first-time mothers]," Mathews said.

Despite the surge in older moms, a high, but improving, teen birth rate keeps the U.S. figures down.

"We still do have a good number of unplanned and teen pregnancies," said Dr. Jennifer Wu, an obstetrician/gynecologist with Lenox Hill Hospital in New York City.

This new data is somewhat different from past analyses.

"We hadn't really looked at the component of average age of first births," Mathews said. "In the past, we looked at all births."

And first births are an important gauge of future trends, such as how many children a woman has, which affects population, as well as birth weight and birth defects.

The trend toward later motherhood was seen in all racial and ethnic groups and in all states plus the District of Columbia, but some areas saw larger gains than others.

The biggest jumps were 5.5 years in DC, 5.2 years in Massachusetts and 5.1 years in New Hampshire.

New Mexico, Mississippi and Oklahoma had the smallest increases: 2 years, 2.3 years and 2.4 years, respectively.

Three-and-a-half decades ago, Arkansas had the youngest average age (20.2 years) while the eastern states of Connecticut, Massachusetts and New York had the highest (22.5 years). In 2006, Massachusetts' first-time moms were the oldest (27.7) and Mississippi's the youngest (22.6).

Among racial/ethnic groups in the United States, Asian and Pacific Islander women now have the highest average age at 28.5 years, while American Indian/Alaska Native women have the youngest at 21.9 years.

The average age for first births in non-Hispanic white women is 26 years, 22.7 years for non-Hispanic black women and 23.1 years for Hispanic women.

The upward slope was most pronounced in the 1970s and 1980s and seems to be leveling off with differences between 2006 and 2007 appearing minor.

Some reasons for delaying starting a family might include younger women choosing to focus on advanced education and careers earlier in their lives, Wu said.

More information

Visit the National Center for Health Statistics for more on this and other health topics.