Planning to have kids? The 6 truths a fertility doctor wants you to know
WITH women having babies later than ever, one fertility expert separates fact from fiction to help you get informed.
Dr Helen O’Neill, lecturer in reproductive science and molecular genetics, and founder and CEO of Hertility Health.
More women than ever are turning 30 without having become mothers.
Whether that’s because they can’t afford to or they’re not in the right place, the modern woman is putting off having babies.
But the facts around fertility remain: while women under 30 have around a 25% chance of getting pregnant naturally each menstrual cycle, that chance drops to 20% at 30, and 5% by 40.*
Advances in IVF and egg freezing give women more options, but it’s not as straightforward as people often think.
Here’s what every woman needs to know…
IF YOU’RE UNDER 35…
If you see kids in your future, it’s best to keep your alcohol intake to a minimum, or avoid it completely in the pre-conception phase, if you want to give yourself the best chance of getting pregnant.
Steer clear of smoking or vaping tobacco and cannabis, too, as these can affect your fertility.
If you are under 35 and have been trying to conceive for a year with no success, you may want to seek medical advice.
Although, if you have a condition that could impact your fertility, such as endometriosis or PCOS, you should seek help after trying to conceive for six months.
It can be scary to take that step, but the sooner you check your fertility, the sooner you can take action.
IF YOU’RE OVER 35…
The changes in the quantity and quality of your eggs play the biggest role in why conceiving gets more difficult as you get older.
After your mid-30s, you lose eggs at a more rapid rate, while the quality of your eggs also declines more quickly.
This means that they are less likely to get successfully fertilised and/or implanted into your uterus, and there is a higher risk of complications, such as pregnancy loss, gestational diabetes and genetic conditions in the baby, such as Down’s syndrome.
Plus, the chances of conceiving via IVF also decrease with age.
INVESTIGATE THE QUALITY OF YOUR EGGS
The most important thing to understand is that the size and quality of your ovarian reserve – and how much this declines with age – varies hugely from one person to another.
This is partly why some people are able to get pregnant at 40 without help, while others struggle in their 20s.
Testing the anti-müllerian hormone (AMH) is currently the most accurate and least invasive way – it’s done via a blood test – of checking your egg reserve.
You may also wish to have an internal scan of your ovaries to estimate egg count.
However, neither of these tests can tell you about the quality of your eggs, and unfortunately there is currently no test available for this.
There are also other factors that can affect fertility, such as your weight, or conditions of the uterus, such as polyps or endometriosis.
IF YOU’RE USING HORMONAL CONTRACEPTION…
Once you stop taking any hormonal contraception, your cycles should go back to what was normal for you.
Having said that, it is widely accepted that long-term research into women’s health is insufficient.
No studies have been conducted over a long enough period of time on a single form of contraception to definitively say whether being on hormonal contraception has a long-lasting effect on your fertility.
Currently, there is no evidence to suggest this is the case.
SUCCESSFUL FERTILITY TREATMENT ISN’T A GUARANTEE
While fertility treatment has helped millions of couples to conceive, not everyone will get pregnant and give birth.
In 2019, almost 53,000 patients had IVF cycles with fresh or frozen eggs, or donor insemination.**
For women aged under 35, there is a 32% chance of a live birth per embryo transferred; for women aged 43 and over, this figure is closer to 5%.**
CONTEMPLATE EGG FREEZING
Egg freezing is often thought of as a last-chance saloon for women over 35, but women should be encouraged to freeze their eggs earlier, and be made aware of the risks and low likelihood of success when doing it in their late-30s and 40s.
Although 38 is the average age for egg freezing in the UK, waiting until your late-30s onwards means that a lower quality and quantity of eggs will be retrieved, and you may need more cycles to collect enough eggs.**
THINK ABOUT THE COST
Freezing your eggs is a huge decision, so take time to consider it.
If you’re in a good financial position – egg freezing is around £4,000 per cycle – and are aware of what is involved, it may be a good option.
When looking at success rates for frozen eggs, numbers tend to be quite low.
Recent research by the Hertility team shows that out of 373 women who froze their eggs, 36 returned to use them, which resulted in 12 live births.
Additionally, 82% of the babies were born to those who froze their eggs between the ages of 36 and 39, and none were over 40.
Look at the stats for your age band and the fertility clinic you choose.
IF YOU’RE ALREADY A PARENT, YOU CAN STILL BE AFFECTED
Just because you’ve had a baby, it doesn’t mean you won’t have issues the next time.
Secondary infertility affects roughly 5% of the UK’s population, and can be caused by age, previous pregnancy complications or medical treatment.***
If you and your partner have been trying to conceive for some time, try seeking help.
For free advice and a support line, check out Fertility Network (Fertilitynetworkuk.org) or speak to an expert via Hertilityhealth.com.
Fertility SOS – Fabulous’ pick of the best tests
Hertility Health Hormone & Fertility Test, £149
This at-home kit tests hormone and overall reproductive health, while taking into account your medical history, menstrual patterns and any symptoms.
Superdrug Progesterone and AMH Combo Test, £97.99
One of Superdrug’s five at-home fertility tests, these two tests check levels of AMH and progesterone, indicating ovarian reserve and your ability to ovulate.
Boots Ovulation Test Strips, £4.99 for five
Ovulation strips are used to allow you to identify the most fertile days in your cycle, and thereby increase your chances of becoming pregnant.
Fertility MOT, from £300
Packages at fertility clinics can include X-rays, ultrasounds and blood tests to estimate ovarian reserve and identify potential issues.
Though available on the NHS, the waiting lists are long.