Defining Fertility

Deciding to have a baby and getting pregnant can be an exciting time for any potential parent. Every person is different. Not all pregnancies will happen at the drop of a hat. For some, getting pregnant takes time, requires a little patience and perhaps, a little luck too.

Fertility is essentially defined by a state or quality of being fertile (the ability to reproduce or produce offspring). As a woman, understanding when you are at your most fertile during your cycle can help to make getting pregnant a little easier.

For both men and women, maintaining a healthy weight, refraining from excess smoking or alcohol consumption, and having regular sex (without the use of contraception methods or birth control) near the time of ovulation are some of the factors that can help things along without a hitch.

Most healthy individuals should be able to conceive within a year of trying. If you, or you and a partner experience trouble getting pregnant, health care providers and fertility specialists can help. These days, there’s little reason to have absolutely no hope. Infertility equally affects both men and women. There are successful methods and treatments available, and many individuals are able to have healthy pregnancies and babies.

For the most part, healthy individuals are likely to have healthy babies. If you and or/ your partner are healthy, you’re off to a good start. There are things you can do to ensure that, as a healthy and fertile individual, you don’t potentially sabotage your chances of being able to successfully conceive. Health basics include updating your vaccinations, maintaining a nutritious diet, getting in regular exercise and ensuring that you take prenatal vitamins (women) and vitamin supplements (men and women).

If you and or/ your partner is managing a health condition (chronic or otherwise) with medications, it’s a good idea to work closely with your medical health professional to ensure that care is taken both before and during a pregnancy. Taking the best care of your own overall health ensures the most ideal condition of a pregnancy and baby too.

Fertility and age

Biological clock ticking - woman holding clock in front of stomach. Biological clock and pregnancy concept with female hands and belly.

There is no way around it, we age. With age in both men and women, fertility decreases. Men may still be able to release active sperm well into their golden years, but quality decreases with age, making possible pregnancy an increasingly unlikely possibility.

Women are born with all the eggs they will ever have (estimated at 1 to 2 million). The number of eggs decreases through a woman’s reproductive years (from puberty), released during her menstrual cycle (monthly periods). This is why it becomes increasingly difficult to fall pregnant after ‘a certain age’.

For both men and women, the benchmark age is around 35. Around this period of a person’s life, fertility begins to decline, a stage often referred to as the ‘ticking of the biological clock’. Thus, a person’s age does play a role in influencing the physical aspects of pregnancy.

For women, ‘the ticking of the clock’ can become an ever-increasing background noise in her daily life as her ability to fall pregnant decreases with age.

What are the odds for a woman during the reproductive years of her life?

  • In your twenties: Physically speaking, your 20s are your ‘prime time’ for reproduction. Puberty may be the beginning of reproductive potential, but cycles are irregular. By a woman’s 20s, her cycle is generally more regular and her body ideally primed to produce babies. A woman’s eggs are healthy and fresh, and her body is at its most physically fit to handle the changes that come with pregnancy. In your twenties, pregnancy complications, such as miscarriage, are generally at their lowest. Risks are also generally low for having a baby with Down Syndrome, spina bifida and other chromosomal birth defects. Conditions such as preeclampsia (pregnancy-induced hypertension) is, however, higher in a woman’s 20s.
  • In your thirties: 35. This is the age many women, particularly those who wish to become mothers, dread. It’s been dubbed the official start of ‘high-risk pregnancies’ as it has been proven that fertility begins to wane around this age. That said, a woman’s ability to reproduce doesn’t suddenly stop. Doctors use this age as an indicator for when to start watching for common pregnancy / fertility – related problems. A woman is still capable of conceiving and carrying to term, as well as having a healthy, happy baby. The conception timeline (time it takes to fall pregnant) may require a little more patience though. Women in their 30s typically need about 3 to 6 months longer to get pregnant than younger ladies. There are risks which do need to be taken seriously though. With a decline in fertility, risks for pregnancy-related health concerns, such as gestational diabetes, high blood pressure, placenta previa (placenta grows near the cervix causing severe bleeding, especially during birth / delivery), increase. Organ and tissue damage from chronic conditions such as diabetes and high blood pressure can also cause complications during pregnancy. The risk of Down syndrome babies also increases from around the mid-30s mark. The risk of miscarriage in the second half of your 30s almost doubles what it was in your 20s.
  • In your forties: Many women choose to put off starting a family until nearing, or during, their 40s. It is possible to have a healthy pregnancy and baby, but this advanced maternal age comes with risks that no woman should ignore. Difficulties conceiving (naturally and medically assisted) and infertility increases in women during their 40s. For a woman in this decade of her life, health risks associated with being pregnant are similar to those in their late 30s. The main differences between the two decades are the potential effects on a baby. Chromosomal abnormalities increase dramatically, as does miscarriage and Down syndrome. Multiple gestations (the conception of more than one baby) also increase during a woman’s 40s (naturally or with medical intervention). Hormonal changes which naturally occurs during this decade mean that more than one egg during ovulation may be released at a time, conceiving more than one baby. If a woman in her 40s is in good overall health, complications can be significantly reduced and healthy pregnancies and babies achieved.

Before you start trying

Young woman with pregnancy test writing on calendar planning her pregnancyPlanning a pregnancy is the most ideal way to start a family and produce healthy children. If you and or/ your partner are in general good health, problems with fertility may never even cross your mind. You can help things along though, and achieve pregnancy in a healthy way.

Steps you can take to boost your fertility include:

  • Checking in with your primary health care providers: Pre-conception guidance and support (prenatal care) from those in the know is always a good idea. If you or your partner have health concerns that may affect fertility, your doctor can ensure to work closely with you to help reduce potential risks. Conditions, and related medications for treatment, such as high blood pressure, asthma, diabetes, thyroid disease, endometriosis (women), fibroids (women), cancer (or a history of) and STIs (sexually transmitted infections) can either impact fertility or a developing baby. Regular appointments to monitor your fertility and overall health is highly recommended. Regular check-ups once you have conceived is also important.
  • Folic acid: Women intending to fall pregnant must ensure that they take the required daily dosage (0.4 milligrams or 400 micrograms) of folic acid at least one month before conceiving. Folic acid significantly reduces the risk of serious birth defects and miscarriage.
  • Diet and nutrition: Eating well is key to your overall health and wellness. It is also vital for a healthy pregnancy and baby. A balanced diet should incorporate all the vitamins and minerals you need. You can also supplement with multivitamins to ensure you are at your absolute best when trying to conceive.
  • Lifestyle: A healthy weight (for you and or/ your partner) matters. Fertility in both men and women can be dramatically reduced if you are underweight or overweight. Your weight directly relates to your nutrition habits and activity levels. If in balance, you should be able to maintain a healthy weight. Exercising for a minimum of 30 minutes (moderate exercise), 5 to 7 days a week will ensure that you build physical strength, maintain a healthy weight and reduce your stress levels. Overly intense exercise can be too much of a good thing, causing problems with fertility for both men and women. If you have certain vices, such as high alcohol and caffeine intake or a smoking or drug habit, it is highly recommended to cut back or cut out altogether. For a woman wanting to fall pregnant, the best time to quit smoking is before conception. Health complications and birth defects increase when a woman smokes, or is exposed to smoke during pregnancy. Conception is known to become increasingly difficult for women who drink excessive amounts of caffeine or alcohol. Both substances can increase the risk of premature birth, birth defects, and even infant death. Toxins found in the home or workplace can potentially impact fertility, a pregnancy or a developing baby. Take measures to reduce exposure to toxins wherever possible by wearing gloves or masks when cleaning or doing repair-work.
  • Knowing your family history: Genetics can play a role and it’s important to know what health concerns may run in both your and or/ your partner’s family. It’s also important to ensure that you discuss these with your doctor during check-ups before trying to fall pregnant.

Fertility issues

Female fertility problems

There are a number of causes behind fertility problems in women and include age-related hormonal changes and a history of STIs. Many women who encounter a speed hump en route to falling pregnant, can eventually conceive with medical intervention. Of the speed humps, age is the biggest issue for many women, particularly those in their mid-thirties and older.

Other causes include:

  • Weight problems (overweight or underweight)
  • Lack of ovulation (anovulation)
  • Abnormal hormone levels
  • PCOS (Polycystic ovary syndrome)
  • POI (Primary ovarian insufficiency – whereby a woman’s ovaries stop working by the age of 40) 
  • Luteal phase defect (insufficient progesterone levels following ovulation)
  • Damaged fallopian tubes
  • Endometriosis (abnormal growth of the lining in the uterus)
  • Fibroids (benign tumours in the uterus)
  • Irregular uterine shape
  • Cervical stenosis (narrowing or blockage of the opening to the uterus)

Male fertility problems

Male fertility can be complex, and as with women, problems can occur due to a number of different health issues and lifestyle habits.

Some of the main issues men face with fertility include:

  • Varicocele (swelling of the veins that assist with draining the testicle)
  • Infections
  • Problems with ejaculation (such as retrograde ejaculation where sperm ejaculates backwards and into the bladder)
  • Anti-sperm antibodies
  • Tumours
  • Undescended testicles
  • Hormonal abnormalities and imbalances
  • Tubule defects (blockages in tubes that carry sperm)
  • Inherited disorders (chromosome defects)
  • Erectile dysfunction and other anatomical abnormalities (hypospadias)
  • Medication interference (testosterone replacement therapy, long-term anabolic steroid use, chemotherapy etc.)
  • Environmental causes (exposure to industrial chemicals, heavy metals, radiation o elevated temperatures which impair sperm production and overheat the testicles)

Fertility Treatments

New life beginningNot every fertility issue means that you and or/ your partner is infertile. These days, medical interventions have successfully helped individuals conceive healthy babies in their numbers. Many fertility issues, for both men and women, merely need a little help, and specialists have all the tools required to make the process as hopeful as possible.

That said, treatment can be an invasive process and options will come with risks, costs and potential side effects, as well as benefits. When undergoing treatment for a fertility difficulty, weigh up all the advantages and disadvantages. Treatment is ultimately a personal decision. It will be you, and you alone who goes through it. You and or/ your partner should be mentally, physically and emotionally prepared for what will be.

Female treatment can include:

  • Medications for ovulation abnormalities and problems
  • Surgery (particularly if there are problems or blockages with her fallopian tubes)
  • ART (Assisted reproductive technology, such as in vitro fertilisation, zygote intrafallopian transfer and intracytoplasmic sperm injection)
  • IUI (intrauterine insemination)

Male treatments can include:

  • Surgery (to repair varicocele, hormonal abnormalities and tubule defects)
  • Medications
  • ARTs

Debunking Fertility Myths

Can saliva kill sperm cells?

If a man has a normal sperm count, saliva will have no impact on its motility. Some studies have indicated that large quantities of saliva may impair sperm motility, especially in men with a reduced sperm count.

Most fertility specialists will be able to provide you with sexual practice guidelines if you and your partner are struggling to conceive. You can try avoiding oral sex if it is assessed that there is any reason this may be impacting your ability to conceive.

If not saliva, can the use of lubricants kill sperm?

Some lubricants can indeed affect the sperm’s ability to reach the cervical mucus of a woman and ultimately fertilise an egg. Your fertility specialist or health care provider can advise on a fertility-friendly lubricant, but may also encourage more time on foreplay which increases a woman’s production of more natural lubrication.

Is the missionary position the only way to get pregnant?

Yes, this has been researched, but no studies can conclusively prove that one sexual position is more effective than another. Any position can result in pregnancy. Some positions (deeper penetration) may assist sperm a little better in getting to where it needs to be easier and quicker though. If in doubt, you shouldn’t feel shy about talking to your doctor or specialist about what you can try to help the baby-making process along.

Do you need to have sex all the time in order to conceive?

It is true that abstaining from sex for lengthy periods can decrease the quality of sperm cells. Similarly, more frequent sexual activity can impair sperm counts. Once a day or once every other day will suffice, especially during a woman’s most fertile period during her cycle (usually five days before ovulation and the day of ovulation).

Must a woman keep her hips elevated for 20 to 30 minutes after having sex to improve her chances of falling pregnant?

No, sperm cells typically reach a woman’s fallopian tubes within minutes of ejaculation. A single ejaculate can contain hundreds of millions of sperm cells. A woman will not need to change her body movements following sex in order to improve her chances.

Disclaimer - MyMed.com is for informational purposes only. It is not intended to diagnose or treat any condition or illness or act as a substitute for professional medical advice.