From the time a girl gets her first period, much of the health information she learns about her body focuses on how easy it is for her to become pregnant. As a result, many of us spend a good amount of effort trying not to get pregnant until we are truly ready for a baby. And when that day comes, many women are surprised to find that fertility doesn’t work exactly as they believed. Myths about fertility abound, some dating back to your mom’s generation. If you’re planning to have a baby, here’s what you need to know about your reproductive health.
As more women postpone childbearing—about one-fifth wait until after age 35 to begin their families—more couples are learning that age is a big player in the baby game. Women are born with more than a million eggs in their ovaries, but by puberty, only about 300,000 remain. As time marches on, your eggs slowly degenerate. Fertility begins to decline in your late 20s and decreases even more after age 35. A healthy woman at age 30 has about a 20 percent chance of conceiving each month. By age 40, it’s down to just 5 percent.
With stories in the media about women having babies into their 50s, many believe they can postpone childbearing and use assisted reproductive technologies later. While these technologies have made great strides in helping many couples become
parents, they can’t overcome age-related fertility problems.
Men don’t experience as pronounced a change in fertility as women do. However, advancing age does diminish the shape and motility of sperm, as can lifestyle choices such as alcohol and drugs.
Your most fertile time lasts only about five to seven days each month. After ovulation, an unfertilized egg doesn’t survive for long—only 12 to 24 hours. To achieve pregnancy, a couple should aim to have intercourse around the time of ovulation, which can be tricky to predict. Combining several methods to identify when you’re most fertile usually works best. Try these measures to help you better pinpoint ovulation:
- Track your menstrual cycle on a calendar for a few months to better estimate when you ovulate. Women used to be told to aim for the 14th day of their cycle, but not all women ovulate on the 14th day.
- Chart your daily basal (at-rest) body temperature. A slight spike in temperature signals ovulation.
- Pay attention to your cervical mucus. You’re most fertile when the amount of mucus is at its highest level.
- Try an at-home ovulation predictor test, which can detect a surge in the leutenizing hormone that rises a day or two before ovulation.
Infertility affects men and women equally. When a couple encounters difficulty conceiving a baby, the problem is caused by factors in the man in about one-third of cases. The problem is related to the woman’s fertility another one-third of the time. The rest of the cases are attributed to a combination of both male and female factors or to unknown causes.
If you’re having trouble starting your family, well-meaning loved ones may try to boost your spirits by telling you to relax and give it time and it will happen. They’re partly right. Baby-making can take time, and relaxation is good for the body and soul, but infertility is an actual medical condition. You and your husband may seem perfectly healthy, but many medical conditions can impair fertility. In a woman, fertility may be affected by an ovulation disorder, blocked fallopian tubes, endometriosis, uterine fibroids, polycystic ovarian disease or pelvic inflammatory disease. Other factors like smoking, alcohol use, obesity, being underweight, athletic training and eating disorders can affect conception, too.
In men, fertility problems can be traced to problems with the number, shape or motility of sperm or problems with sexual function. Men can also have other health problems that impact fertility, such as diabetes, sexually transmitted disease, effects of prostate surgery or injury to a testicle. In addition, alcohol and drug use can affect sperm quality, and researchers continue to study the effects of toxins such as pesticides and lead.
For women who have already borne children, a delay in conceiving subsequent children often comes as quite a surprise. You may think, “What’s different now about my husband and me than two years ago?” The fact is, secondary infertility, or the inability to conceive after giving birth to one or more children, is usually caused by the same factors that cause primary infertility in couples who never had a baby.
Pregnancy is the result of a long chain of events in which every step must go right. The more you know about your reproductive health, the better you can maximize your chances of starting or adding to your family when you wish.