2 April 2018

Your Top Five Fertility Worries Answered

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Dr Renato Bauman, Clinical Director, Rotunda IVF

‘Very often, when a couple comes to me because they are struggling to conceive, they ask if their choices or actions from the past could be causing the delay. I know that couples feel particularly vulnerable at this stage in the process, and that confronting an infertility problem is a difficult challenge. The natural reaction is to question everything from the previous use of contraceptives to so-called ‘bad habits’. Here are the answers to top five common questions I hear.’

Question 1: I’ve been taking ‘The Pill’ - could this be a problem?

Answer: The oral contraceptive pill is the most commonly used used method of contraception in Ireland. If you are concerned this has affected your fertility - relax! A Danish study in 2013 involving 3,727 women showed that there was no evidence that long-term oral contraceptive pill use had any harmful effects on pregnancy rates(1).
It’s true that both short-and long-term pill users were likely to experience a temporary delay in conception, but the study shows this does not affect a woman’s chances of getting pregnant in the long term.

Question 2: What if I’ve been using other forms of contraceptive?

Answer: As they are designed to prevent pregnancy, most contraceptives are associated with a temporary reduction in fertility. For example, following the Depo-Provera injection it takes an average of 9-10 months before ovulation returns and therefore it may take longer before you can get pregnant. Therefore if you think you will want to become pregnant in the next 12 to 18 months, using a different method of contraception may be advisable.
However, none of the other reversible contraceptive forms used in Ireland have any permanent effects on fertility. With the Intrauterine Devices (IUDs), the implant Implanon and the Depo-Provera injection, long-term fertility is maintained.

Question 3: Do STIs have an impact on fertility?

Answer: It is important to realise that even though contraceptive use does not permanently affect fertility, certain sexually transmitted infections (STIs) can. None of the previously mentioned contraceptive options protect you from STIs, and clearly men are just at risk of the effects as women.
One of the most common STI’s in Ireland is chlamydia. This infection can affect both women and men and if left untreated in women it can cause permanent scarring to their fallopian tubes, which can cause problems with fertility. About 70% of women and 50% of men with chlamydia do not have any symptoms and do not know that they have this condition. It is worth having frequent STI checks and use barrier contraceptives.

Question 4: Do factors such as diet really make a difference?

Answer: Your fertility isn’t static, and there are definite lifestyle and dietary changes that can boost it. This is one part of your fertility journey that you can take control of, and optimise your chances of falling pregnant by addressing these ‘bad habits’.
We know that stopping smoking can improve your fertility and this is also beneficial for your baby during pregnancy and throughout your child’s life.
Being overweight, or underweight, can also affect fertility so aim for a healthy weight to improve your chances of conception. A healthy diet and regular exercise can help you with this.
Some people may also need to reduce their caffeine or alcohol intake, and your GP can discuss this with you.

Question 5: Have I left it too late?

Answer: While there may be a number of contributing factors to pregnancy delay, by far the biggest challenge women face is their age. As a woman ages her fertility declines - so we do have a limited timeframe in which to have our own biological children. This decline increases significantly once a woman reaches her mid-30’s.

Share your worries with an expert

If you are trying to get pregnant, it is important to understand the factors that can affect your fertility, as well as those that cannot. But if you are starting to feel stressed or confused about the situation, speak to a fertility specialist, particularly if you are over 35. They can give personal advice to boost your chances of conceiving, and recommend some fertility tests if necessary, too.

(1) Hum Reprod 2013 May;28(5):1398-405. doi: 10.1093/humrep/det023. Epub 2013 Feb 20

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