With 1 in 6 couples experiencing fertility problems, expert Susannah Makram looks into the top facts we should all know before embarking on the road to pregnancy
Infertility is a rising problem. According to statistics, 'one in six couples has problems starting a family, with the number of couples seeking medical help having risen dramatically.’ Most experts suggest these increasing problems are due to larger amounts of environmental chemicals that affect the body's hormones, as well as societal and cultural changes that have seen more women choosing to delay starting a family until established in their careers - the older both men and women become, the more likely they are to encounter difficulties conceiving.
The problem however, is that unless specifically trying to get pregnant, most women don’t know enough about fertility and the factors that can affect our chances. So, with the aim of getting us all a little more clued-up we reached out to fertility and nutrition expert, Susannah Makram , for a little more information on the possibilities and problems of getting pregnant.
“We know that lifestyle choices during pregnancy can have a big effect on the health of your baby, but can the choices we make before getting pregnant affect fertility? Yes,” says Susannah. “Indeed the lifestyle factors of both the female and the male partners can affect a woman’s odds of getting pregnant by natural and assisted conception. Here are my top 15 facts to consider if you’re looking to start a family.”
1. One in six couples have difficulty having a baby
In 40 per cent of these cases the difficulty is in fact associated with the man. However, having equal responsibility is about sharing knowledge and creating an open line of communication.
2. Timing is everything
In a normal cycle of 28 days, the woman ovulates normally on day 14 (14 days after the start of menstruation). The most fertile day would be on day 14 and the most fertile week is that which goes from day 11 to 17.
3. Infertility can be classed after only a year
The medical definition of infertility is the failure to conceive following twelve months of regular unprotected intercourse. After this time your GP will refer you for a blood test to measure ovulation that is required. The most common cause of ovulation problems is polycystic ovaries. Chlamydia can also cause pelvic inflammatory disease and fertility problems, so this might be tested for too (vaginal swab or urine test). Meanwhile your partners sperm count and motility will also be measured using a sperm sample.
4. Secondary infertility accounts for 60 percent of infertility cases
This is when a couple has trouble conceiving after they’ve already had a baby or more and it is actually more common than primary infertility, when first-timers have trouble.
5. Women are at their most fertile between the ages of 20-24
There are both advantages and disadvantages to giving birth at different ages. Overall, being healthy parents puts you in good stead.
6. Female fertility begins to decline at age 30
If you’re over 40, you may want to start off your quest for a second pregnancy with a fertility expert on hand. Similarly, if your partner is over 40, you may want to get a specialist on board from the beginning.
7. Sperm DNA damage has been identified as a major contributor to male infertility
The quality and quantity of the sperm diminishes from the age of 25. Damage to sperm DNA (sperm DNA fragmentation) affects every fertility checkpoint and can increase the risk of miscarriage.The Sperm Comet assay is a second generation sperm DNA test - and it is the ONLY test that can measure the extent of damage in individual sperm.
8. Men do have a biological clock
While males can produce viable sperm and father babies well into their senior years, older men are more likely to have fertility issues - this is due to dipping testosterone levels, the decrease in quantity and quality of sperm, as well as its strength and motility and a host of other factors.
9. Donor eggs are popular
More than half of all pregnancies conceived through IVF in women over age forty are produced through donor eggs - indeed contrary to previous years egg freezing or (new techniques like) vitrification is not a taboo subject any more.
10. There are 4 common causes for female infertility
In addition to other factors, the following four causes are typical in women who are having difficulty conceiving: damage to fallopian tubes (tubal infertility), endometriosis uterine, cervical causes or ovulation disorders.
11. Success in assisted conception is dependent on the quality of the sperm and eggs
Egg quality falls with age, which is why one of the strongest predictors of whether an IVF cycle will be successful is based on the age of the woman. A major cause of this is the development of chromosomal abnormalities in the egg as it matures, which can in turn be passed on to the embryo. Genic screening is available to help choose the best embryo(s) to replace them and thus increase the pregnancy rate.
12. Everyday items can help and hinder your chances of getting pregnant
Cough medicine can help you get pregnant while laptops and briefs can impair sperm production. Expectorants (type of medication) loosen up mucus in your chest but they’re also able to loosen up cervical mucus – if antihistamine-free – and looser cervical mucus makes it easier for sperm to hitch a ride in! Not all bodily fluids get along though. In fact saliva is a sperm killer. The truth is that most lubricants and massage oils are fertility unfriendly, so it’s best to go without when you’re baby making. Some studies have also shown that the now-infamous Bisphenol A (BPA) can decrease fertility in women. Perfluorinated chemicals (PFCs), used in Teflon, have also been shown to affect the menstrual cycle.
13. Both prescription and recreational drugs affect fertility
Some antidepressants (like SSRIs) can raise a woman’s serum prolactin level, which can then interfere with normal ovulation. Even certain antiemetic (anti-nausea) medications can alter prolactin levels. Using any drugs, even cannabis, can affect the menstrual cycle. Heavier drugs like opiates have been shown to suppress the reproductive cycle by affecting the centers of the brain that control the release of female hormones. Smoking cigarettes – even secondhand smoke – has also been shown to reduce fertility time and time again.
14. An unhealthy body weight may prevent you from having children
Being heavily overweight or even severely underweight can have negative consequences for one’s ability to conceive. In particular, obesity can interfere with normal hormone function and fertility. Let us not forget that the only treatment available to successfully reverse sperm DNA damage is largely dependent on nutrition and nutritional supplementation.
15. Fertility is a sensitive subject
It’s a sensitive topic for a reason - but there are plenty of support groups, fertility groups and therapeutic counseling groups available for couples trying to conceive naturally and also those using assisted fertility methods.
Susannah works with private GP and specialist Dr Shauna Mukherjee MBBS DRCOG DCH DFSRH MRCGP to offer joint consultations. For more information and advice from Susannah head to her website, www.susannahmakram.com .
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