A Fertile Imagination?

Why  (almost) everything the tabloids say about fertility is wrong!

Dr Gill Lockwood, Medical Director, Midland Fertility, Tamworth

Dr Gillian Lockwood, medical director

50% of all babies are made by accident (their parents weren’t even ‘trying’ to become parents) and 50% of most couples who ‘try’ to conceive, will succeed during the first three months of ‘trying’, so why are the tabloids so full of ‘infertility’ stories?  Why are we constantly being told that , just to list a few recent ‘breakthrough’ stories, Vitamin D deficiency, mobile phones, leaving the bedroom lights on, processed foods, Jacuzzis, working shifts and drinking bottled water are all responsible for the ‘epidemic’ of infertility we are currently experiencing?

Approximately 1 in 6 couples will contact a doctor (usually their GP) because of difficulty or delay in achieving a first or subsequent pregnancy . Unfortunately, relatively few of these will seek fertility treatment (either NHS or private) because they believe (or are told) that their chances are too low or the cost is too high.  This is such a shame as modern fertility treatment can be very effective and we believe that everyone deserves a chance to become a parent.

Let’s look further at the current picture in the UK. Mother Nature probably intended women to have babies about the time they are in their late teens. Where the woman is 35 (a perfectly reasonable age nowadays for a woman to have completed her education, trained for a career, found a job, a home and a man prepared to commit to fatherhood), it takes on average, twice as long to conceive as under 35. A major ‘design fault’ in human reproduction is that a baby girl is born with all the eggs she is ever going to have and, by the age of 35 a significant proportion will be past their ‘use by’ date. Men go on producing reasonably functional sperm into their 60s. It is a source of understandable relationship friction that at the age of 38 most women have, at best, two years to become a genetic parent, whereas men have two decades.

Granny always said ‘We are what we eat’ and there is good evidence that a high carbohydrate diet, even for a ‘normal weight’ woman can delay conception and increase the risk of miscarriage. So if you have cereal for breakfast, a sandwich for lunch and pasta for supper you may be getting 75% of your day’s calories from carbs and that may impact on your fertility. But switching to macro-biotic mung beans will not necessarily help! Lean protein and leafy vegetables are what the doctor ordered, but do remember that in Bangladesh, where the average woman has 7 children, her diet is significantly vitamin and protein deficient.

Another fertility myth that needs de-bunking is that vigorous exercise will boost fertility. On the contrary, elite male athletes have generally poor sperm because of the high scrotal temperatures generated during training and the high levels of ‘free-radicals’ released by muscle breakdown. It’s the same story for women too, so ‘gym bunnies’ should know that ‘working out’ more than twice a week has the same deleterious effect on fertility as smoking. Positive ‘Body Image’ is closely correlated with frequency of copulation and there is overwhelming evidence that today’s ‘subfertile’ couples are simply not having enough sex. Sex is the glue that sticks couples together and not just the ‘thing’ that might make a baby!

BMI or Body Mass Index (a ratio of height to weight where ‘healthy’ is 19-25 and ‘obese’ is over 30) is widely used by CCGs (Care Commissioning Groups) to ration access to medical treatment and especially IVF. The evidence that a ‘raised’ BMI significantly impacts on pregnancy outcome is weak and some fertility problems, notably Polycystic Ovarian Syndrome (PCOS) are associated with weight problems, so for those patients, it represents a double-whammy. Cholesterol is the basic building block for all the reproductive hormones, so young women who are very thin (anorexics, athletes, dancers, bulimics) will struggle to conceive as Mother Nature is well aware of how many calories are needed to grow a baby in addition to what that baby’s mother needs too.

So, you’ve just met Mr Right (or maybe Mr Right MK 2) and part of your life plan is being a mum, so what do you do? Early on you ask about his medical/reproductive history (undescended testes as a child, mumps as an adolescent, drug/steroid abuse?). If you’ve been ‘trying’ for more than 6 months and he is keen on the baby plan, send him for a semen analysis. 40% of all fertility problems are either mainly or partly male factor). You need to ask your mum about your family’s reproductive history: How old was she when she had her last baby and when she went through the menopause? Girls follow their mother’s reproductive potential very closely so a family history of early (<48 years) menopause should ring alarm bells. If your periods have always been horrible you could have endometriosis and if they are irregular you could have PCOS. Either way early diagnosis will help you plan your campaign to have a baby and you’ll have time on your side.

Getting pregnant should be fun and for most couples practice makes perfect, but if you are over 36 and have been ‘trying’ for more than 2 years, please seek our help sooner rather than later.

egg and sperm