11 Surprising Facts About Fertility That OB-GYNs Wish You Knew
March 21, 2018
By Lindsay Tigar
If you’re trying to get pregnant or even thinking you may want to in the next couple of years, you may have a few questions about your fertility. To help answer them, we spoke to OB-GYNs about common misconceptions and important things to know about our reproductive systems.
Age is not the only obstacle to fertility
If you’ve ever felt the pressure from a family member to get crackin’ on the starting-the-family song-and-dance, then your age is usually brought into question. While the number “35” is traditionally tossed around, Brian Levine, MD, the founding partner and practice director of the fertility clinic, CCRM New York, says many women much younger than their mid-thirties could be infertile, but don’t discover it until they begin trying to conceive. As a general rule of thumb (that definitely varies by the woman, the couple, and family history), women who are under 35 years old should try to get pregnant for a year before seeking medical attention, while those 35+ should give it six months before buckling down, according to Dr. Levine. Here are 15 other factors that may be harming your fertility for both men and women.
Both quality and quantity of eggs decrease over time
The reason why our fourth decade—those pivotal 30s—receive so much attention for family planning is that, like it or not, the older women get, the less fertile they become and the more likely their infants will have health issues. “The number and quality of eggs decreases as women get older, more precipitously after the mid- to late-30s making it more difficult to conceive,”says Paula Amato, MD, associate professor of ob-gyn at Oregon Health & Science University. “In addition, the risks of miscarriage and chromosomal abnormalities in the fetus increase as women get older.” Make sure you know these eight infertility myths you can finally stop worrying about.
Infertility isn’t just a woman’s disease
Though you might spend a lot of time stressing over how well you’re taking care of your body, Dr. Levine makes a note that while women tend to carry the burden of fertility, it takes two to make a baby. When you’re being tested for infertility, both partners will be examined to see what issues are going on. He says that approximately 40 percent of infertility is due to female disorders, another 40 percent is due to male disorders, and approximately 20 percent is of an unclear reason. Dr. Amato notes that certain lubricants, including KY Jelly, used during intercourse can decrease sperm motility or survival. It’s important that both you and your partner are doing all that you can to make getting pregnant easier, which means he should keep a careful look on his diet and life, too. Here are 13 things men should try to boost their fertility.
An infertility evaluation isn’t expensive or difficult
Even if you’re 25 and nowhere near the time when you’re prepared to take the next step and start your family, if you’re curious about your ability to get pregnant one day and just want to be reassured, Dr. Levine says there have been many advances in medicine over the past few decades to make the evaluation seamless. “In the early days of treating infertility patients, many of them underwent diagnostic surgeries to look for cysts, endometriosis, and other abnormalities,” he explained. “However, because of high-resolution ultrasounds, highly accurate blood work, and other imaging techniques, there is no need to do surgery on a patient unless there is a clear abnormality.” So what does it consist of today? Basically drawing blood and a few shots.
Fertility is dynamic, and the decline is unpredictable
The long and short of explaining fertility is that everyone’s body is an individualized, personal case and often times, unpredictable. While not having your period on a regular basis could hint to something wrong down there, it could also just mean you’re super-stressed. Everything has to do with what’s going on, right that second, when you get tested. “Many assessments of fertility are impacted by the timing and type of test, and we know that when people make lifestyle changes, fertility can change. For example, if a woman takes up marathon training, she may notice her period goes away. If she stops training and regains her body fat, the normal cycle may resume,” Dr. Levine explains. “Along the same lines, without testing at an interval, it’s hard to tell from a single test whether someone has high, moderate, low, or declining fertility.
Many causes of infertility are reversible
If you’re sitting in your ob-gyn’s office and they’re calmly explaining your fertility issue and you find yourself completely overwhelmed with the information, take heart. Dr. Levine says that while it’s scary to hear at first, many causes of infertility can be easily reversed and solved with simple surgeries. These include blocked fallopian tubes, fibroids in the uterus, cysts on the ovaries, thyroid abnormalities, and others. After these procedures, most women go on to get pregnant on their own, or with the help of IVF treatments, Dr. Levine says.
Egg freezing is a good option, but it’s not foolproof
One option to preserve your fertility is egg freezing. While prices vary depending if you go to your own ob-gyn or a fertility clinic, most of the time, patients aim to get as many eggs stored away as possible. Dr. Levine says the earlier in your life that you freeze your eggs, the better chances of success you will have. “A woman who freezes her eggs at 30 may get 10 to 20 oocytes frozen. However, If she were to wait to seek treatment until she is older, say 37, it’s possible that if she needs IVF, she may only get 4 or 5 eggs. Early preservation is always cheaper than multiple cycles later in life,” he explains. It’s also important to note that there are no guarantees once you go to thaw and you use your eggs, but for many women, it’s not only a physical but a mental reassurance that they can have a family one day.
Having sex every day is not the best get-pregnant strategy
Though it might seem counterproductive to hold back on the under-the-sheets action when you’re trying to make a baby (that’s how you do it after all, right?), Dr. Amato says couples should really capitalize on those brief moments in which your fertility window is wide open. “The window is usually during the few (~5) days just before and around ovulation. Ovulation generally occurs approximately 14 days before the onset of the next menstrual period,” she said. “Couples should have intercourse every 1 to 2 days during the fertile window.”
Drugstore buys can be helpful
Still in those first six months of trying to get pregnant, and you’re curious on the stats? While it might not be time to set up a frantic visit with your doctor (who will just advise you keep trying for a few more months), Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale Medical School, suggests seeking some help from your local drugstore counter. “You can do an ovulation predictor test at home. I like basically all the First Response products—they are quite easy to use, and quite accurate,” she recommends. “If you do an ovulation predictor kit, and it says you aren’t ovulating, you definitely want to check in with your gynecologist. If you are ovulating, then you can exactly time when to have intercourse, to make sure you are hitting your most fertile time.
STIs can have lasting impact
Though practicing safe sex is always something you know you should do, experiences happen, and you find yourself with some unwanted and unexplainable symptoms the next morning (or a few weeks after). Dr. Minkin says that having sexually transmitted infections (STIs), including gonorrhea or chlamydia, can lead to permanent damage to your fallopian tubes, which bring the eggs into the uterus. That’s why when you begin the process of trying to conceive, you should let your ob-gyn know about your medical history, so he or she can provide the best care possible.
Keep your weight manageable and take vitamins
Even on those days when you don’t feel like hitting the gym or you’d rather reach for those mini cupcakes your co-worker brought in instead of your salad, consider that your lifestyle choices have a big impact on your ability to conceive one day. And that goes for both ends of the spectrum, Dr. Minkin says women who are overweight or underweight might both have issues getting pregnant, and a balanced number on the scale, based on your height, is your best choice. Also as Dr. Amato says, “Before attempting pregnancy, a woman should ensure she is healthy, make sure her immunizations are current, and take prenatal vitamins. Smoking, heavy alcohol consumption, heavy caffeine consumption, and the use of recreational drugs such as marijuana have all been associated with reduced fertility.”