It‘s Not Too Late”

Your biological clock may be ticking furiously after age 40, but there are ways to improve your #ttc odds, as EVELINE GAN finds out.

Portrait of Tammy Strobel

Your biological clock may be ticking furiously after age 40, but there are ways to improve your #ttc odds, as EVELINE GAN finds out.

"Men should do their part too, by maintaining a healthy lifestyle with  a good diet and regular exercise."

Conceiving naturally after the age of 40 can be a struggle. The chances of achieving pregnancy is about 10 to 20 per cent each year for women aged 40 to 44.

If you’re 45 and above, it’s less than 5 per cent, according to Dr Lim Min Yu, consultant obstetrician, gynaecologist and fertility specialist at Gleneagles Hospital.

But while you may not be able to turn back your biological clock, there are ways to improve your chances. Here, doctors share tips on how you can boost your odds.

Have sex every two to three days, or around ovulation day

The highest chance of fertilisation occurs when you have sexual intercourse on the day before or on the day of ovulation, Dr Lim says.

You may predict ovulation by measuring your basal body temperature, using urine kits that detect a surge of a hormone called luteinising hormone or have a fertility specialist do an ultrasound scan to look out for ovarian follicle development, Dr Lim shares.

But why limit baby-making activity to just once or twice every menstrual cycle? Regular sex works, too. For couples trying to conceive, the recommended frequency of intercourse is every two to three times per week, or every two to three days, Dr Lim says.

Correct any gynaecological issues that may prevent pregnancy

A previous history of sexually-transmitted infections or appendicitis may sabotage your baby-making odds, the experts share. These conditions can cause inflammation and scarring in the fallopian tubes.

“If a woman’s tubes are damaged, the chance of sperm successfully meeting the egg are reduced. There is also a higher risk of ectopic pregnancy, where the pregnancy implants in the fallopian tube,” Dr Lim explains.

A common gynaecological condition, known as endometriosis, may also potentially damage the tubes and cause infertility, says Dr Christopher Ng, a gynaecologist and obstetrician at GynaeMD Women’s and Rejuvenation Clinic. This occurs when tissue that normally grows inside the uterus grows outside of it.

Fortunately, endometriosis can be treated using medications or surgery for more severe cases. If there’s blockage in your tubes, keyhole surgery may help to restore fertility, Dr Ng says.

But if surgery does not work and the tube remains blocked, the couple will be recommended to undergo in-vitro fertilisation (IVF), Dr Ng adds.

Stick to just one to two cups of kopi

Consider swapping your coffee, tea and cola drinks for a decaf or juice. Or limit caffeine intake to one to two cups of coffee or tea per day, Dr Lim advises.

Research has linked consuming too much caffeine with fertility issues and early pregnancy loss. Caffeine reduces muscle activity in the fallopian tubes that carry eggs from the ovaries to the womb, which lowers chance of pregnancy, according to a study published in British Journal of Pharmacology in 2011.

Another new study by the National Institutes of Health and Ohio State University in Columbus suggests that your husband’s caffeine habits matter, too. The researchers looked at 344 couples trying to conceive, and found that drinking three or more caffeinated beverages, such as coffee, tea, soda and energy drinks, a day raised the risk of early pregnancy loss by 74 per cent.

Weight matters

The general recommendation for women hoping to conceive is to have a healthy, balanced diet. Being on the extreme ends of the weighing scale can wreak havoc on fertility, so keep your weight in check.

Dr Lim says increasing intake of antioxidants may help improve egg quality although there still isn’t much research in this area. Antioxidants can be found in fresh fruits, vegetables and nuts.

Some studies suggest that myo-inositol may improve egg quality and pregnancy outcomes in IVF cycles, particularly in women with a hormonal disorder known as polycystic ovarian syndrome, Dr Ng says.

This vitamin-like substance can be taken in the form of supplements, and is also found in a variety of food such as unprocessed grains (oats, wheat, bran), fresh citrus fruit (except lemons), cantaloupe, brewer’s yeast, lima beans, raisons, peanuts and cabbage, he adds.

Women trying to conceive should take folic acid, say the experts. It does not improve fertility but if you get pregnant, it can reduce your baby’s chance of being born with a neural tube defect.

Daddies-to-be, get healthy too

The number of eggs a woman has, and their quality, are the most important factors to conceiving naturally after 40, Dr Lim says.

But men should do their part too, by maintaining a healthy lifestyle with a good diet and regular exercise. This means, not smoking or taking illicit drugs, and limiting alcohol to the occasional glass of beer or wine with dinner, Dr Lim advises.

Avoid wearing tight underwear, which can reduce sperm production, Dr Ng advises. To boost sperm health, Dr Ng recommends daddies-to-be to take supplements for a minimum of three months.

For example, zinc, glutathione, L-carnitine, L-arginine may improve sperm production, coenzyme Q10 and L-carnitine to boost sperm motility (movement), selenium and folate to boost sperm quality and quantity, Dr Ng adds. Remember to check with your doctor before starting any supplements.

Don’t wait too long

Seek medical advice if you have tried for six months but have not succeeded in conceiving. Dr Lim advises seeing a fertility specialist earlier if you have any existing medical conditions or have had abdominal surgery.

The doctor can perform appropriate screening tests and her condition optimised before embarking on the fertility journey. For example, those with endometriosis, polyps or fibroids may need to undergo surgery before having fertility treatments.