Why do some young women have difficulty conceiving while others, even those who are older, need just one night? For starters, every woman is unique. Statistically, though, about 63 per cent of women in their early 30s will get pregnant within a year of trying, and that number goes down with each passing year (see Fertility in your 20s, 30s and beyond). “It never ceases to shock me how many people say, ‘I didn’t know my fertility diminishes with age,'” says Jan Silverman, an infertility counsellor at Sunnybrook and Women’s College Health Sciences Centre in Toronto. The good news is that there’s plenty you can do to improve your chances of conceiving, from eating right to exercising. Plus, even if you have trouble getting pregnant, new innovations can help about 80 per cent of women bear a child.
To aid you, we’ve gathered all the information you need to know about conception rates, infertility and your partner’s health, as well as an expert-based, six-step pregnancy plan.
Step 1: Visit your doctor and get a full checkup
Talk about your desire to get pregnant. Make certain your medications are safe and immunizations are up to date, especially for rubella and chickenpox. Also, find out whether any health conditions, such as endometriosis or a thyroid problem, could interfere with conception, advises Silverman.
Step 2: Eat right
Good food empowers your body to handle conception, pregnancy and delivery. Colourful fruit and vegetables such as oranges and strawberries provide nutrients and vitamin C, which might protect the health of your eggs, says Roger Pierson, professor of obstetrics, gynecology and reproductive sciences at the University of Saskatchewan in Saskatoon. Getting between 0.4 and one milligram of folic acid from a multivitamin or prenatal supplement may also help prevent birth defects during the first month after conception (when you may not even know you’re pregnant). A new study from The Hospital for Sick Children in Toronto suggests folic acid might also prevent some childhood cancers.
Step 3: Weigh in, then get active
Too much or too little body fat affects hormones, destabilizes your menstrual cycle and contributes to fertility problems. Overweight women in particular experience more pregnancy complications such as high blood pressure, diabetes and low-birth-weight infants. But this is no time for severe diets. Instead, start a gentle exercise program in consultation with your doctor and cut back on unhealthy fats and sugar without eliminating entire food groups, such as whole grain products.
Step 4: Kick a bad habit or two
Cigarettes, drugs and alcohol don’t just hurt you—they have an impact on your fertility and possibly your baby once you get pregnant. Smoking, for example, depletes and genetically damages eggs, increasing your risk of miscarriage and birth defects, says Pierson. Smoking marijuana can also upset ovulation. As for alcohol, it has been proven to cause brain damage in fetuses and should be avoided. Talk to your health professional about quitting.
Step 5: Know your cycle
No one ovulates at the exact same time every month and every woman is different, but you can estimate your most fertile days of the month. The prime time is three days before you ovulate and the actual day of ovulation, which is typically the 14th day after the start of your period. To figure out your fertile period, monitor your vaginal secretions. Clear, slippery and often stretchy vaginal secretions indicate ovulation is just days away. Read Taking Charge of Your Fertility (HarperCollins) by Toni Weschler for more guidance. Don’t want to mess around? Try a fertility monitor, such as the Maybe Baby saliva test ($90 to $100) or ClearPlan Easy fertility monitor ($250 to $300), which measure the surge of luteinizing hormone that occurs right before ovulation. Ovulation test kits are cheaper—about $50 for five—but only indicate when you are ovulating, the point when your fertile time is ending.
Step 6: Just do it
Have unprotected intercourse every two to three days whether you’re charting your cycle or not, says Dr. Seang Lin Tan, professor of obstetrics and gynecology and medical director of the McGill Reproductive Centre at McGill University in Montreal. But have fun while you’re at it. Foreplay helps you get lubricated, a key point since studies suggest that certain vaginal lubricants such as K-Y Jelly and Astroglide slow sperm down. A few sperm-friendly lubes, such as Pre-Seed, have been developed and are available online. Also, lying down for half an hour after sex may help sperm swim up your reproductive tract, according to some experts.
Now that you know how to enhance your fertility, it’s time to consider his. Forty per cent of infertility cases can be traced back to men. Still, your partner may be pleasantly surprised to discover that there are lots of things he can do—besides the obvious—to boost your chances of conception:
Researchers at the University of Bern in Switzerland found that men who smoke have less sperm density, a lower sperm count and less active sperm than men who don’t. Similarly, alcohol and marijuana suppress sperm production. And being overweight impacts men’s hormones and sperm, making them less fertile. Encourage him to exercise regularly and eat plenty of whole grains, fruit and vegetables, all of which contain sperm-enhancing nutrients such as vitamin C and folic acid.
Stay out of hot water
Men who are exposed to high heat or compounds such as paint fumes, dry-cleaning chemicals or printing ink may have fewer sperm with less swimming power. There’s no cure for these problems except to remove the cause. If fertility is a concern for you and your partner, you might want him to avoid hot tubs, saunas and big painting projects.
After age 35, male fertility takes a downward turn. A study by U.S. and Italian researchers found that men and women who are both 35 years old have a 29 per cent chance of conceiving each month together. That dips to 18 per cent when the man is five years older and sperm doesn’t swim as efficiently.
See a doctor
Some infertile men have anatomical problems, such as a missing duct from the testicles, that affect their ability to transport and release sperm. A doctor may be able to correct these problems or refer you and your partner to a fertility specialist.
For about 10 per cent of couples, youth, good health and lots of good old-fashioned sex still aren’t enough to start a pregnancy. Experts recommend consulting a doctor if you haven’t conceived within one year. If you’re over 35, however, you may want to see a specialist after six unsuccessful months. “At this age, you don’t have the luxury of time,” advises Pamela Madsen, executive director of the American Infertility Association. The Infertility Awareness Association of Canada (1-800-263-2929) can also provide valuable information and coping strategies.
Sometimes treating the cause of the problem, such as endometriosis, a thyroid problem or a sexually transmitted infection such as chlamydia, does the trick. Otherwise, medical treatments for infertility can help about 80 per cent of couples have a baby. Costs and success rates depend on each individual case. Here are some of the main fertility treatments available in Canada:
Ovulatory drugs ($25 to $4,000 per month)
Some women just don’t ovulate: perhaps due to polycystic ovaries, obesity or an unknown reason. Your doctor can prescribe ovulation-prompting pills such as Clomid or Serophene for a few months as a first-line treatment, then more expensive injectible drugs may be used. However, side-effects may include nausea, vomiting and an increased risk of multiple pregnancies.
Intrauterine insemination ($200 to $800)
If your partner’s sperm lacks oomph, your doctor can try inserting it high up in your reproductive tract on a fertile day. This in-office procedure only works 10 per cent of the time. Dr. Tan says he’ll usually try it only three times on a patient before moving on to a more intense treatment.
In vitro fertilization ($4,000 to $5,500)
This is the gold-standard treatment for any woman with blocked Fallopian tubes (usually caused by a pelvic infection in the past), endometriosis or unexplained infertility. In this procedure, ovulatory drugs help a woman produce many eggs, which doctors collect and mix with her partner’s sperm in a lab. Three to five days later, doctors place one or more of the fertilized eggs in her womb and, it’s hoped, a pregnancy develops. For women under 34, there’s a 55 per cent chance this procedure will work. Success rates decline slightly with each year past age 34.
IVF blastocyst transfer ($5,000 to $6,000)
In some clinics, doctors are now developing eggs in the lab for up to seven days in an attempt to avoid multiple pregnancies. These more developed embryos, called blastocysts, are hardier, so doctors can put only one in a woman’s womb and still achieve a 55 per cent pregnancy rate.
In vitro maturation ($4,000 to $5,000)
Unlike standard in vitro fertilization, this version doesn’t use ovulatory drugs, so it’s ideal for women who can’t tolerate them or those with polycystic ovaries. Instead, doctors collect eggs during a regular cycle and, since these eggs are less mature than the drug-induced eggs normally used, mature them in the lab for one to two days before fertilizing them.
Fertility in your 20s, 30s and beyond
In a perfect world—according to medical science—all women would have their babies at a younger age. That’s because the quality of our eggs decreases over the years. The ideal time for women to have children is before age 35, says Dr. Seang Lin Tan, professor of obstetrics and gynecology and medical director of the McGill Reproductive Centre at McGill University in Montreal. Still, the reality is that the average Canadian woman starts her family at age 26, and many babies are born to women in their mid- to late 30s. Here, we’ve mapped out the statistical chance of conception and possible pregnancy risks, depending on your age: