Giant eye roll incoming: bookies are already putting odds on Harry and Meghan announcing a pregnancy by the end of the year, and Meghan’s comments on being shown baby products on a recent royal visit to Northern Ireland (“I’m sure at some point we’ll need the whole lot”) provoked a flurry of tabloid headlines. Never mind the fact that the couple aren’t married yet, although Paddy Power have put odds of 13/2 that Meghan will be pregnant on the wedding day itself. Quite frankly, it’s none of our bloody business, and at 36 and 33 respectively, Meghan and Harry are hardly unusual in keeping family planning to “some point”- 54 per cent of mothers and 59 per cent of fathers in the UK were over the age of 30 in 2016 according to the Office for National Statistics.
Given that, as most of us are more than well aware, women’s fertility begins to decline in the mid thirties, with both the number and quality of our eggs taking a dip (men’s fertility starts to decline between 40 and 45 according to the British Fertility Society), “preserving” fertility and increasing our chances of getting pregnant later on is becoming more of a focus with the shift in how we live our lives and when we consider starting families. Chances are that, if we decide to have children, myself and most of my group of friends will fall into the group of 35+ geriatric mothers (whoever termed this can take a hike), and while some of us have engaged with our fertility early in taking future baby planning steps such as freezing our eggs (a major advance but undeniably expensive and by no means a guarantee of a later pregnancy), it’s helpful to know what we can on our own terms to maximise our chances of starting a family when we choose to.
Here’s a rough timeline for factoring in fertility and baby planning when you’re looking to conceive in the near-ish future according to the experts, bearing in mind that there’s no “right time” when all of the ducks align- women are under enough pressure to tick life’s boxes already, so you do you.
What you can do…
In a year
Of course it’s not possible to schedule a pregnancy, but the outlook for women in their mid-thirties isn’t always as bleak as headlines might have you imagine. Rather than your ovaries taking a leap off a cliff in your mid to late thirties, the NHS reports that 82 per cent of couples trying for a baby between the ages of 35-39 will conceive within a year, and 90 per cent within two years.
Information is power, but don’t put yourself through hell to analyse your present and future fertility
By all means follow baby making advice, but sticking to a strict sex schedule and piling on the pressure isn’t the answer according to fertility and women’s health expert Emma Cannon :
“First of all I think that it is important for couples not to put too much pressure on themselves to ‘make a baby’ while on a honeymoon. Pressure does nothing for your sex life and sets up problems for later. The best approach is to keep things light and playful; joke about making a baby by all means, but don’t schedule in baby making sex sessions as, even if this starts as fun, it can end is disaster.”
Emma emphasises that conception doesn’t always happen as quickly as you might think, but it is possible to test your baseline fertility if you’re hoping to conceive:
“Basis male and female tests can be carried out with a consultant and there are also basic home tests available to measure sperm and ovarian reserve, alongside omega 3 and vitamin D levels. These can give an idea of fertility in both partners.”
Completing any tests you might wish to carry out as soon as possible will give you a better estimate of where you’re at, and you can adjust your diet and supplementation accordingly with the advice and support of a specialist. Komal Kumar, Senior Dietitian at The Lister Fertility Clinic, part of HCA UK :
“Following a good nutrition plan can help to regulate ovulation cycles affected by weight, improve the health of a woman’s eggs, improve the success of assisted reproduction therapies such as IVF treatment , and improve chances of bringing a healthy baby to full term. Therefore, it’s an important aspect to consider when considering trying for a baby.
“If yourself or your partner have been told by your doctor that you have a significant amount of weight to lose or that you need to make big dietary changes, it is better to allow 12 months to give the body time to get used to the changes and for hormones to rebalance, as they can be affected by drastic changes in weight.
“It is always important to remember that, if you’re looking to make a drastic lifestyle or dietary change, everyone should first consult the expert opinion of a GP or ideally a qualified dietitian. This will ensure that the body isn’t deprived of vital nutrients, which can very often do more harm than good.”
Once you’ve got the all clear, if you’re booking your honeymoon in advance, Emma has a destination suggestion to consider:
“You could do far worse than booking somewhere in the Med for your honeymoon; research suggests that the Mediterranean diet is the most beneficial for fertility, being full of antioxidant rich foods and oily fish and plentiful in healthy omega 3 rich fats such as olive oil. Vitamin D , which is mainly made from sunshine, is also widely available in the Med…”
Even if you’re honeymooning in the UK, or just you know, living here, everything from heart heath to beneficial gut microbes serve to benefit from a Mediterranean style of eating, so it’s a healthy approach all round, whether you’ve got fertility in mind or not, but always adhere to any advice given by your doctor or a dietitian.
To go back to the issue of testing, while Emma is of the opinion that “information is power”, don’t put yourself through hell to analyse your present and future fertility:
“Any tests should be weighed up and balanced with a calm approach- just because you are investigating your health and fertility, it does not imply that anything is wrong, so please don’t worry.
“Try not to panic and keep things in perspective, as although pregnancy can take longer at this age, most people remain fertile into their late 30s early 40s, and some longer. Ask your mum when she went through the menopause if you can, as it can give you some clues about your own own fertility and when you might be able to expect the menopause”
In six months
Make getting in tune with your body the priority:
“Six months is a good length of time to familiarise yourself with your menstrual cycle- keep a diary and learn about your body at each phase.”
Emma also prescribes pleasure and intimacy over and above peeing on sticks:
“Just enjoy trying for a baby without putting too much pressure to fit in baby-making sex in the fertile window. Try to have sex throughout the month and do not get into the habit of peeing on sticks and only having sex when the ovulation stick says so. Having sex every three to four days throughout the month, and every other day in the fertile window (from day eight onwards in a 28 day cycle).”
As well as sex in abundance, checking in with your overall health is also a good idea at this stage. If you’ve not had any testing done yet, Nutritional Therapist Jackie McCusker , who specialises in fertility at Grace Medical , suggests starting a preconception plan “at least four months prior to trying for a baby”.
“The most important factors for preconception care for women post 35 are: assessing ovarian reserve, indicating both the quantity and quality of eggs, looking at hormonal status, both reproductive and thyroid and considering toxin exposure, for instance reducing exposure to endocrine disrupting chemicals, as these can have a major impact on egg quality (avoid BPA found in plastic bottles, plastic food containers and on receipts). Assessing nutrient status and managing stress is also helpful.
“Considering these factors at least four months prior to when you want to become pregnant is ideal because it takes up to 120 days for sperm to mature and approximately 100 days for the ova (eggs) to mature. If a woman is post 35, she and her partner should still follow the preconception plan but at the same time might want to start having some preliminary tests to assess fertility status.
“Such tests would include bloods (hormone profile for oestrogen, day 21 progesterone, day two or three FSH, LH, anti mullerian hormone (AMH) and prolactin. The AMH is a measure of ovarian reserve of eggs, which diminishes as we get older. For men, tests would include bloods for male hormone profile (including testosterone and SHBG) and a comprehensive semen analysis for the quantity, motility and morphology of sperm.”
“Otherwise, adopt a holistic approach, addressing your diet and nutritional status and take lifestyle factors into consideration, for example limit alcohol intake and exposure to toxins (quit smoking) and take appropriate exercise.”
In three months
This is a crucial time to make sure you’re eating a healthy, balanced diet according to Komal:
“Following a good nutrition plan can help to regulate ovulation cycles affected by weight, improve the health of a woman’s eggs, improve the success of assisted reproduction therapies such as IVF treatment and improve the chances of bringing a healthy baby to full term. Therefore, it’s an important aspect to consider when considering trying for a baby.”
A total diet overhaul isn’t normally called for, however, and now is not the time to take extreme weight loss measures or cut out food groups. Komal advises a measured approach:
“It’s no secret that nutrition plays a key role in both natural and assisted reproduction. However, there isn’t a specific ‘special’ diet to follow in order to improve the chances of conception- instead, it’s all about balance. For most people, following the ‘eatwell plate’ principle will be sufficient to ensure nutritional adequacy, and increase the chances of conception. This principle is based on consuming a balanced diet of carbohydrates, fats and proteins, with women aiming for 2000 calories per day and men 2500. For women looking to conceive it is also advised that they take 400mg of folic acid per day, in addition to consuming folate rich foods such as spinach, kale and broccoli, as this helps in promoting the health of the child generally and is important for preventing birth defects.”
It’s never too late to start making healthier choices when it comes to diet and nutrition
For a holistic three month baby prep plan, Emma has just launched her 90 Days Fertile digital programme, £90, designed to support you and your partner though the baby making process, whether you’re looking to try immediately, in the future or are undergoing fertility treatment. The online programme brings together elements of Eastern and Western medicine to promote optimum physical and mental health. It focuses on ‘five pillars of fertility’, including open mindedness and creativity, nourishment, flexibility, relaxation, self-belief and fostering hope over negativity or putting pressure on yourself or your partner. It’s a kind of ‘put your own oxygen mask on before serving anyone else’ situation, designed to get you into a ‘good place’ for conception on every level. Practically this translates to daily meal plans and recipes, guided meditations, fertility tips and information and general advice from Emma.
If you’d like to go down the holistic therapy route, Emma also can’t recommend acupuncture enough:
“Acupuncture is the ideal complementary therapy with the longest recorded history of treating fertility than any other system of medicine, in both men and women.”
Emma offers it in her clinic, as does Grace Belgravia as part of its Medical Membership and fertility support plan, or check the British Acupuncture Council to find a professionally qualified acupuncturist.
If you’re thinking of stopping hormonal contraceptives , depending on your method of choice, now could also be the time, as the NHS underlines that your periods may be irregular when you come off the pill, for example, and you should allow up to three months for your menstrual cycle to regulate itself. Jackie also notes that it could take this amount of time for your nutritional status to optimise after taking the pill:
“Research has shown that there are key nutrient depletions concerned with oral contraception including folic acid, vitamins B2, B6, B12 , vitamin C and E and the minerals magnesium , selenium and zinc. These are key nutrients for conception, maintaining a healthy pregnancy and for the development of a healthy baby in-utero.”
If you’re got a wedding or important event coming up that you’d rather not be pregnant for, however, it’s best not to risk it, as the NHS also highlights that some women conceive immediately after coming off the pill.
In a month
Komal explains that there’s never a bad time to make beneficial nutritional tweaks:
“It’s never too late to start making healthier choices when it comes to diet and nutrition. Optimising nutritional status at any stage leading up to conception and throughout pregnancy will help to positively influence the genetic make-up of any resulting baby, so the earlier positive nutritional changes can be made, the better the outcome.
“Everybody is different and so the rate at which the body ‘recovers’ from previously poor nutrition can vary significantly and depends on how drastic the dietary changes are. If someone is looking to make minor changes, such as introducing more protein or nutrient dense foods into their diet, then a couple of weeks will be adequate to see change - provided the new plan is stuck to.”
As with everyone’s varied nutritional needs, metabolism and response to changes, so fertility status and conception is a different ride for every couple. If, like seven in ten couples in the UK, you’re having difficulty conceiving, see your GP after a year of trying, or sooner if you’re aged over 36 or know that you have a preexisting condition such as PCOS or endometriosis that could affect fertility. Your doctor will be able to advise on what could be causing your fertility problems, suggest appropriate treatment and refer you a specialist if required.