You’ve tried every trick in the book, so why hasn’t the stork arrived? EVELINE GAN rounds up the top fertility roadblocks, and asks the experts how you can boost your chances of getting pregnant.
FERTILITY ROADBLOCK #1
Age isn’t on your side
It is said that age is just a number. Not when it comes to making a healthy baby.A woman’s age is the most important factor for a successful pregnancy, says Dr Fong Yang, fertility specialist, and obstetrician and gynaecologist at Virtus Fertility Centre.
Your fertility heads downhill gradually from your early 30s, and more rapidly after the age of 40. “Not surprisingly, the average age of a woman undergoing a fresh in vitro fertilisation (IVF) cycle is 36 years,” Dr Fong shares. Age also affects your chance of IVF success. Based on statistics from Virtus, a woman under the age of 30 undergoing IVF has at least a 70 per cent chance of becoming pregnant. Once she hits 40, it drops to 20 per cent.
BOOST YOUR CHANCES The first step is to ensure that your body is in tip-top condition. Take control of any medical conditions you might have, and work on a healthy diet and lifestyle, advises Dr Julinda Lee, gynaecologist at Singapore Medical Group’s Wellness and Gynaecology Centre by Dr Julinda Lee. She explains: “Having a baby is often perceived as an important priority to the body. So if your body is unhealthy in any way, you are less likely to become pregnant, especially when age catches up.” Biologically, the early 20s is the “best” age to have children. “That’s when the eggs are fresh and the body is at its peak. At this age, you are also least likely to have chronic health problems that put you and your baby at risk of pregnancy and delivery complications,” Dr Fong says. So, seek medical advice if you’re 35 or older and haven’t conceived naturally despite trying for six months. Younger women can afford to wait up to 12 months before doing so, he says.
FERTILITY ROADBLOCK #2
He has a sperm issue
More men are now grappling with poor sperm quality, say the experts. For couples struggling to start a family, this can be a double whammy if the woman has fertility issues as well. The proportion of couples with male fertility issues now form about 40 per cent of all infertility cases now – up from 30 per cent in the last 10 years, according to Professor William Ledger, who spoke at the Singapore International Congress of Obstetrics and Gynaecology in August last year.
He is the head of obstetrics and gynaecology at The Royal Hospital for Women in Sydney, and advisor to Virtus. The culprits: An unhealthy lifestyle and poorer health, including having a chronic disease like diabetes at a younger age. Men with this condition generally have poorer sperm quality and a higher risk of erectile dysfunction, which can interfere with the baby-making process, Prof Ledger says. “The ‘sell-by date’ is later for men than women, but male fertility declines with age, too. For men, the decline starts from the age of 45,” he adds.
BOOST YOUR CHANCES The good news is that lifestyle changes help – having a good diet, exercising more, reducing stress and no smoking. The bad news: They work only if Hubby has mild sperm health issues, Prof Ledger says. “If the problem is severe, you’ll need to talk to a fertility expert about your options, especially if the woman is over the age of 30, and you’re hoping to have at least two children.” Fortunately, new-generation fertility treatments mean that it is now possible for men with severe sperm issues like low sperm count to father their own biological children, he adds.
FERTILITY ROADBLOCK #3
You lost a lot of weight recently
Your body will give out signals that you don’t have enough reserves to grow a baby, warns Dr Lee of Singapore Medical Group’s Wellness and Gynaecology Centre by Dr Julinda Lee. In extreme cases, ovulation and periods can stop. But excess weight is equally harmful – obesity is linked to chronic stress, an underactive thyroid and ovulation problems, all of which can affect fertility. Extra kilos on Hubby may also affect his sperm health, which, in turn, lowers your pregnancy chance. A 2013 study published in the British Journal of Sports Medicine found that overweight men who led sedentary lifestyles and watched over 20 hours of TV per week had nearly half the sperm count of those who didn’t watch much telly.
BOOST YOUR CHANCES Work out your weight issues, but do it in a realistic manner. Use the body mass index (BMI) as a guide. The healthy range is between 18.5 and 22.9. Calculate your BMI at www.tinyurl.com/KnowYourBMI. Instead of being fixated on a particular weight, aim to just get healthier, Dr Lee advises. “A healthy diet and exercise programme will often prep the body for pregnancy. A natural pregnancy may then be possible without unnecessary medical intervention.”
Women with gum disease take two months longer to conceive, because poor oral hygiene affects overall health.
FERTILITY ROADBLOCK #4
You have bad oral health
What do teeth and gums have to do with fertility? Plenty, it seems, according to several studies, including one published in Human Reproduction (Oxford, England) in 2012 on over 3,700 expecting women. It found that women with gum disease took an extra two months to get pregnant compared with those with healthy teeth and gums. Experts believe that the main culprit is inflammation. Poor oral hygiene can trigger gum disease. When unchecked, it can affect the body’s immune system and overall health. Poor oral hygiene is also linked to an unhealthy diet – for instance, eating too much sugary foods, Dr Lee adds. This increases in flammation in the body and affects fertility. And If you do get pregnant, studies have found that gum disease may also put you at a higher risk of delivering a premature or low birth-weight baby. BOOST YOUR CHANCES Add regular flossing and a trip to the dentist to your pre-pregnancy to-do list. At the same time, cut down on sugary foods and smoking.
FERTILITY ROADBLOCK #5
You’re stressed
“Relax and it’ll come naturally.” If you’re struggling to conceive, this unwanted advice can be jarring on the nerves. But don’t dismiss it as another old wives’ tale. A research published in Human Reproduction in 2014 found that women who experienced high levels of stress took 29 per cent longer to conceive than those with lower stress levels. The highlystressed group was also two times more likely to be infertile. Working over 40 hours a week and lifting heavy weights regularly may also affect your chances, according to another study published in Occupational and Environmental Medicine last year. Dr Fong of Virtus Fertility Centre says more research needs to be done to draw a clear link between stress and fertility. “But we know that stress and fatigue can affect the different hormones in women, and this can lead to ovulation disorders which may account for 40 to 50 per cent of all fertility issues,” he adds. BOOST YOUR CHANCES Manage stress levels with sufficient sleep, exercise and other relaxation techniques like meditation, Dr Lee advises. She adds that a good diet can also regulate hormones, which encourage ovulation and pregnancy. Understand your menstrual cycle and fertile window, which usually occurs on Day 11 to 17 of your cycle, Dr Fong says. Fertility experts usually recommend sexual intercourse every two to three days – that’s how long sperm can survive in the fallopian tubes during this fertile window. But don’t stress yourself too much while keeping count. “It is best to enjoy your sex life together. Have sex as often as you like, paying special attention to the few days before ovulation,” he advises. If you have irregular or no periods, see a doctor, because that indicates ovulation problems.
FERTILITY ROADBLOCK #6
You could have unchecked illnes ses
Health conditions like diabetes and high cholesterol used to be common only in older adults. These days, they’re starting to affect men and women in their 30s as well, Dr Lee notes, adding that these chronic illnesses can lower your pregnancy odds.
BOOST YOUR CHANCES Go for annual health checks. The better control you have over your body, the higher chance you have of becoming pregnant naturally, Dr Lee says. Fertility treatment results are also better when medical conditions are well-controlled. You should also review medications you are currently taking with your doctor, in case they affect pregnancy, Dr Fong adds. He also advises getting antenatal blood tests done to check for diseases – such as rubella, chickenpox status, Hepatitis B and C, HIV and syphilis – which are dangerous during pregnancy.
