Fertility is considered a natural part of the human life cycle. It’s often the case that infertility is not talked about enough in our youth, nor is it seen as an essential part of sex and reproductive education.
Many women find themselves in their late thirties, early forties or even later in life, thinking that starting a family will be easy enough if they have a good lifestyle, or still have regular periods.
But the biological issues surrounding fertility, or the lack of it, are more complicated than we think. Although we instinctively reproduce, reproduction does not always come instinctively to our body.
We speak to Dr Janet Evans, Consultant Gynaecologist and Fertility Specialist from LWC Cardiff, about some common fertility myths that may be puzzling you.
“My fertility window is only 2 days long every 28-day cycle, so I have to do an ovulation kit and have sex on Day 14, no matter what!”
You don’t need to have perfect timing! Menstrual cycles can vary in length, normally one is 28 days, but it does depend on how promptly the hormonal signal (known as FSH) arrives at the ovary. If it’s late, the length of the first half of your cycle can fluctuate.
First a few crucial, need-to-know elements of the process: the eggs grow in follicles, little cystic structures, just under the surface of the ovary, and these follicles will gradually swell until around Day 14. This is when they rupture and release the egg. This event occurs in response to a second hormone (known as a ‘lutenising hormone’ called LH). This is the hormone that you can track with your ovulation kit.
“The egg needs to be fertilised within about 12 hours, so there need to be some sperms waiting for the egg. Ideally, intercourse the night before ovulation or the day before, will ensure sperms are available, but as sperm can survive for up to 5 days, perfect timing is not vital. You have to leave room for spontaneity!”
The fallopian tube extends from the ovary to the womb – this is where fertilization occurs. When the egg is collected into the tube, the sperm must swim through the cervical mucous, and then through the uterus. In response to the high oestrogen levels that the follicle is producing, the cervical mucous becomes very watery, to allow the sperm to pass through, and this can be a good sign of ovulation and can save you money on ovulation kits.
As ovulation occurs, the stretching and rupture of the follicle may cause some twinges of discomfort or pain, although as this occurs later in the process so isn’t a good indicator of when ovulation begins.
“My siblings/cousins/parents all had lots of kids. That means good fertility runs in my family.”
Family history is always an important factor to consider and genetics can play a big role in health and lifestyle; but does not always predict the future.
Infertility is very common. And your individual lifestyle can affect your fertility as much as the genetic lottery.
“1 in 8 couples will have problems conceiving and the cause of this can be an ovulation problem, it can be a tubal blockage, or it can be a problem from the male partner’s sperms,– so it’s best not to assume a certain outcome based on your family history, only to find later that you were incorrect.”
So – what’s causing your infertility?
- Ovulation problems, often due to Polycystic ovary syndrome (PCOS), associated with small cysts on the ovaries, affects 15% - 20% of women and can lead to irregular periods, weight gain and can even suppress fertility.
- Tubal infertility is usually caused by pelvic infections such as chlamydia, but can also result from surgery around the pelvis, causing scar tissue.
- Male infertility can have hormonal causes, such as the taking of androgenic steroids that will suppress sperm production. There can also be genetic issues at play, but with most men, it’s common for no obvious cause to be found.
- As it’s been said, certain lifestyle choices can have a big impact. Your diet, for example, is important because eating a lot of fruits and vegetables mean that your body is ingesting antioxidants, which clear harmful free radicals in your system, helping to improve egg and sperm quality.
- Smoking can also be an issue when it comes to fertility. Smoking can result in sperms being unable to fertilise eggs, and embryos produced in couples where the man smokes, not being able to implant. Male babies exposed to smoking tend to have lower sperm counts later in life. For women, smoking can affect egg quality and the thickness of the womb lining, and, if you do choose to go through with IVF, can reduce the chance of pregnancy.
- Being overweight can also affect a woman’s periods, which impacts fertility, however, even overweight women with regular periods are 43% less likely to conceive. Not only that but pregnancy in women who are overweight is riskier than women of an average BMI. From diabetes to difficult deliveries and operative deliveries – it is always advisable to consult your doctor to learn what you can do to decrease this risk.
“My father-in-law says infertility is always the woman’s fault.”
Modern research and understanding of infertility has long since debunked any claim that infertility is always solely down to the woman. Unfortunately, it remains a common perception in certain communities and parts of the world where treatment and advice is difficult to come by that, if a couple is struggling to have a child, it’s the woman that needs to somehow alter her lifestyle rather than the male partner. This can be an extremely difficult burden to place on the woman, who is already under pressure in trying for a baby.
From the male side, erection issues will be obvious to the couple but, unless a semen analysis is done, male factor infertility cannot be seen.
“Around 25% of causes of infertility are due to male factors, 25% due to ovulation problems with infrequent periods, 25% due to blocked tubes, sometimes due to infection associated with sexually transmitted disease, or infection from miscarriage, operative delivery or termination of pregnancy, and 25% where no cause has been found.”
Stay updated to read Part Two where you can learn more about the time constraints of your fertility. If you have any questions in the meantime, please get in touch with London Women’s Clinic.