Page 3 2012 Vol 2
Pregnancy planning and your health
Health and timing matter when starting a family, or having another child, yet many Australians are unaware of when they are at their most fertile – and when fertility declines.
A recent national survey found 80% of Australians don’t realise a woman’s fertility declines from her early 30s. Media stories featuring celebrity mothers aged in their 40s who’ve recently had babies, and reports about the increasing age of first time mothers, are distorting the facts around fertility.
As a result, couples may be leaving pre-pregnancy health and pregnancy too late, says Professor Robert Norman, Director of the Robinson Institute at the University of Adelaide.
The Robinson Institute, together with Jean Hailes, the Victorian Assisted Reproductive Treatment Authority (VARTA) and Andrology Australia are members of the Fertility Coalition.
These organisations have created the Your Fertility website to raise awareness of how age and other key factors affect your chances of having a baby.
“If you are thinking of having a baby in the near future, see your GP with your partner to work out if there are any key issues that might impact on your ability to become pregnant,” says Prof Norman.
Five key fertility factors are an important part of ‘getting baby fit’ according to the Your Fertility research:
“Increasing numbers of 45-year-old women come to me and say ‘we’ve been trying to have a baby for two years and now we’d like to try IVF’,” says Prof Norman.
“Our awareness of time frames has been muddied by celebrities having babies in their 40s and a few women who do get pregnant naturally in their late 40s. In reality, by the time a woman reaches this age, her chance of getting pregnant is only around 2 to 5%.”
Fertility begins to decline at 32, and at the age of 37 that decline gathers pace. By 40, female fertility has halved. Male fertility also declines after the age of 45.
Additionally, when a woman reaches 40 she is five times more likely to have a stillbirth, and her risk of miscarriage is greater than the chance of a live birth.
“You need to be aware of time frames, although sometimes there is nothing you can do about this, for example if you don’t have a partner, or have a partner who isn’t keen,” says Prof Norman.
“In some cases people are saving for a home or can’t afford to lose a second salary. Often those situations are probably more responsible for≈people delaying pregnancy than any lack of knowledge about fertility timeframes.”
For women, being underweight or overweight can reduce fertility by causing hormonal imbalances and disrupting ovulation. There is also emerging evidence that sperm count and quality are affected if men are overweight.
“Women who are underweight usually stop having periods. Once women become overweight they may still be having their periods but their fertility drops,” says Prof Norman. The risk of pregnancy complications, such as high blood pressure, pre-eclampsia (a serious condition including high blood pressure, protein in the urine and swelling), diabetes, infection, Caesarean birth and stillbirth, rises in women who are overweight or obese.
Maintaining a healthy weight can be challenging, but it is possible to change daily routines to increase healthy eating and physical activity with practice and making small changes.
Research tells us that even small changes to lifestyle can make big improvements to your health.
Fertility Coalition research suggests the risk of infertility among smokers is doubled. Women who smoke are at least 1.5 times more likely to take over a year to become pregnant than do non-smokers. Passive smoke also harms fertility.
“On average, women who smoke go through menopause two years earlier than women who don’t smoke, and there’s good evidence that cigarette smoking damages eggs and leads to premature loss of eggs,” explains Prof Norman.
“If someone is smoking more than 20 cigarettes a day at the age of 30, it’s equivalent to being 40 and never having smoked, in terms of fertility. For males and females, smoking is very bad for fertility – so smokers need to try and quit.”
The good news is that most of the negative effects on fertility disappear a year after quitting. Find out how to stop smoking by visiting www.quitnow.gov.au or calling Quitline on 13 78 48.
While there are conflicting messages about alcohol and fertility, the National Health and Medical Research Council (NHMRC) recommends women who are trying to get pregnant should not drink alcohol at all. Men who drink too much can experience episodes of impotence. Heavy drinking does have a negative effect on fertility, confirms Prof Norman.
“But it’s not yet widely accepted by the community that if you are trying to get pregnant then you should stop drinking,” he says. The NHMRC recommends men and women drink no more than two standard drinks per day on average and no more than four standard drinks on a single occasion.
Couples need to know when in a woman’s menstrual cycle she is able to conceive. Pregnancy can occur in the five days before ovulation – when an egg is released from the ovary and travels down the fallopian tube – and on the day of ovulation.
Count ‘day one’ as the first day of your period. The last day of your cycle is the day before your next period starts. Ovulation happens about 14 days before the start of a period. So in a 28-day cycle, ovulation happens on day 14 and the peak fertility time starts on day 11. Physical signs that ovulation is imminent include vaginal mucus becoming slippery, abdominal pain, tender breasts, bloating and moodiness.
“If you have a regular menstrual cycle, it’s a good idea to work out when you ovulate. It may be more difficult to work out if you have irregular cycles and you might need some help from your doctor,” says Prof Norman.
There are a number of tools to help women recognise when they are ovulating. Urine test kits test for the ovulating hormone, luteinizing hormone (LH). Your health practitioner can also assess when you are ovulating. Monitoring body temperature is not a reliable indicator of ovulation.
“Having intercourse every two to three days in the week before ovulation will give you the best chance of conception. Sperm can survive in the female genital tract for three to five days, so it’s not essential to have intercourse every day,” clarifies Prof Norman.
Getting baby fit
Content Updated September2012