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For couples who conceived easily and naturally and had a healthy birth for their first, or even second and third, children, secondary infertility (SI) can be a huge shock. But the truth is that secondary infertility occurs approximately as often as primary infertility.
Secondary infertility means that a couple was unable to conceive after 12 months of unprotected sex, after having previously had one or more healthy pregnancies and births. Some couples with secondary infertility are able to conceive, but experience miscarriages and/or stillbirth that prevents them from reaching a live birth.
Some couples have secondary infertility after multiple previous healthy births.
Note that it’s only called secondary infertility if your first birth occurred naturally. If you used fertility treatment like IVF to get pregnant the first time round, then any struggles to get pregnant a second time are considered part of your primary infertility.
It’s generally thought that secondary infertility affects about as many couples as primary infertility. One study from 2006 reported that 3.3 million women suffered from secondary infertility, and that secondary infertility now accounts for 60% of all cases of infertility.
Another study revealed that among women aged 20-44, 10.5% experienced secondary infertility, while a report from the CDC calculated that 39% of women with fertility issues were suffering from secondary infertility.
It’s clear from these figures that a significant number of couples experience secondary infertility, but it goes under the radar of society far more than primary infertility.
Secondary infertility can originate in either the woman or the man.. It’s estimated that SI cases are divided roughly equally between male-caused infertility, female-caused infertility, and secondary infertility due to unknown causes.
When secondary infertility originates in the woman, it can be caused by:
Secondary infertility that originates in men can be caused by:
The good news is that treatment for secondary infertility can have higher success rates than those for primary infertility. That’s because it’s usually possible to identify a specific cause for SI, and once the cause has been dealt with, fertility levels return.
In general, treatments for secondary infertility are similar to those for primary infertility.
When secondary infertility is caused by adhesions in the uterus or testicular varicocele, surgery to remove the scar tissue, fibroids, or other blockages, and to fix enlarged veins in men, can be very successful.
When secondary infertility originates in the woman, they are often given medications such as clomiphene and letrozole to increase and speed up ovulation and overcome ovulatory disorders.
When SI originates in men, they may be given antioxidants and anti-aging medication to improve sperm quality.
Depending on the cause of the SI, couples might be counselled about changing their diet to lose weight, reducing their caffeine and/or alcohol intake, and/or avoiding certain pollutants.
Timed intercourse together with ovulation monitoring can also help couples with secondary infertility to conceive.
Intrauterine insemination, or IUI, is when sperm is surgically placed within the fallopian tubes to increase the chances of fertilization. It’s been found to be very successful among couples with unexplained secondary infertility, with one study reporting IUI success rates of 47.4% among couples with SI, in contrast with 8.4% among those with primary infertility.
If other approaches don’t result in a healthy pregnancy, couples with secondary infertility are often advised to try IVF. IVF can be more successful among couples with SI than those with primary infertility.
Secondary infertility might be less talked about than primary infertility, but it can be just as upsetting for couples trying for another baby. If you’re struggling to conceive after one or more healthy births, take heart from knowing there are many successful treatment options which can help you build the family you dream of. Whatever path you take to adding to your family, we hope it’s as smooth as possible.
If it’s taking you a long time to conceive your first baby, or you had your first child using IVF, this child could be your one and only.
Perhaps you may not be able to give birth a second time; your local regulations won’t allow you to undergo IVF for a second child or the cost is too high; or you simply don’t have the emotional bandwidth to cope with the stress and challenges of trying to conceive all over again.
Whatever the reason, you might find yourself raising an only child when you had always expected to give your child a sibling. Perhaps you even dreamed of having a big family. As well as having to cope with the loss of a dream, you might also be worrying about how it will affect your child to be an “only.”
There’s a persistent belief in “only child syndrome,” which holds that only children are negatively impacted by growing up without siblings. But at a time when more and more people grow up as “onlies,” does that belief still hold water?
Since research into the topic began over 120 years ago, a lot has changed about society. Today, it’s widely believed that “only child syndrome” is a myth, and there’s no “perfect” size for a family.
The idea that there’s something negative about being an only child began in the 1890s. In 1898, child psychologists G. Stanley Hall and E. W. Bohannon carried out a survey researching only children. They reported that only children are spoiled, selfish, maladjusted, lonely, antisocial, and bossy, to list just a few of the bad traits.
That study led to decades of damning only children. Psychologists claimed that because only children got the full attention of their parents and grandparents, they didn’t learn how to share, acquired an inflated sense of their own importance, and believed that they were fragile beings in a dangerous world. Without other children around them, psychologists argued, they never had to learn interpersonal skills.
In 1928, psychologist Norman Fenton claimed “Being an only child is a disease in itself.”
There is research showing that it can be tough to be an only child. Only children tend to be less tolerant and less resilient than those who grew up with siblings, and more likely to experience stress later in life when caring for their parents.
One study of college students in China found that only children had higher rates of anxiety, depression, and/or a combination of the two than children with siblings. 33.4% of only children in the study had anxiety syndrome, compared with 17.4% of people with siblings; 30.7% had depression, vs. 12.9% of non-only children; and 24.8% experienced both anxiety and depression, compared with 11.3% of non-only children.
But another study just a year later examined the psychological impact of COVID-19 on adolescent mental health. It reported that teenagers with siblings showed higher rates of depression and anxiety than those who are only children, with 35.2% of only children and 38.8% of non-only children showing symptoms of depression, and 20.5% of only children and 24.7% of non-only children showing anxiety symptoms. So like many things, the evidence is mixed.
Most research over the last few decades pointed to the same conclusion: there is no serious handicap in being an only child. In fact, it even brings a lot of positives.
Study after study reported that only children manage as well as or better than most children with siblings. Psychologist Toni Falbo, who is an expert on only children, conducted a meta analysis of over 100 studies and concluded that when it comes to academic achievement and intelligence, only children out-perform everyone except for firstborns and children from 2-child families. They also have a more positive parent-child relationship and better character traits than people who grew up with siblings, and are develop mentally on a level with firstborns and people from 2-child families.
Recent original research concluded that only firstborns and people from 2-child families perform as well as only children in an academic context, and that onlies are on an equal footing with people who grew up with siblings when it comes to interpersonal relationships and character traits.
Much of the research that found that only children are selfish, spoiled, and/or antisocial came from studies in China in the wake of China’s One Child Policy (OCP), which created a generation of children referred to as “Little Emperors.” But deeper studies showed that this was not because they didn’t have any siblings, but because they grew up in a cultural context that lavished praise and admiration on the only child.
In the last few decades, psychologists have agreed that what matters isn’t whether or not you have brothers and sisters, but what your relationship is like with your parents. Falbo pointed out that the reason why only children, firstborns, and people from 2-child families all have high levels of academic attainment and intelligence is because of their parent-child relationships.
According to a recent report, “different developmental outcomes between only children and non-only children is because the former group have a special parent–child relationship characterized by increased parental anxiety and attention.”
That means that parents of only children are more inexperienced as parents, so they can be more anxious and overprotective. But they are also more careful and responsive, which raises children who feel safe and supported, produces positive parent-child relationships, and creates a more stimulating home environment.
Ultimately, being an only child has both positives and negatives, just like having brothers and sisters. It’s true that only children often say that they regret not having had a sibling when they were a child, but there are also children who get bullied by their siblings, or who grow up with low self esteem because they felt like the least-loved child.
Before worrying about your only child, it’s worth remembering that being an only child today is very different to being an only child in 1898, or even in 1928. 100 years ago, children without siblings didn’t have a lot of options for socializing outside of the family, especially since far fewer lived in urban areas. But between playdates, preschool, and playing in the park, things are very different for today’s children.
In 2021 it’s also far more normal to be an only child, so onlies don’t feel stigmatized for not having brothers or sisters. Research by the Pew Center found that in 2015, 22% of children didn’t have siblings by the time their mother reached the end of childbearing age, compared with 11% in 1967.
Finally, psychologists agree that many elements combine to create a child’s personality. It’s not just about being an only child or your birth order, it’s also about how much you’re exposed to challenges, how much you can rely on your early relationships, and more.
If you’re worried about your only child, make sure to give them plenty of opportunities to socialize, and think about the extent to which you “bubblewrap” them and prevent them from taking risks.
If you’re starting your family or hoping to enlarge it, whether through fertility treatments, IVF, or conceiving naturally, there’s no need to worry about how an only child might cope. We hope your parenthood experience is smooth and anxiety-free.
If you’re in a toxic relationship with a partner who’s physically, mentally, or emotionally abusive, or is hyper-controlling when it comes to money, sex, or daily life, it’s probably best to delay trying to start a family until your relationship reaches a more healthy place.
But a toxic relationship can spring up in almost any area of your life: at work, with your boss or a colleague; with your siblings or parents; or with someone you think of as a friend.
If you’re in a toxic relationship, you might find it hard to concentrate at work, difficult to enjoy yourself when you’re with your friends, and even struggle to sleep well at night. But have you considered that your bad relationship could also be affecting your ability to conceive?
Having a conversation with a toxic friend or relative can be incredibly stressful, and stress can impact fertility levels. Even seeing them or just thinking about them can raise your levels of alpha-amylase and cortisol, the primary stress hormones, and trigger your brain to release adrenaline which preps your body’s “fight or flight” response.
As well as leaving you feeling jumpy and exhausted, when these hormone levels are elevated, it throws your body’s hormone balance out of whack and that can affect production of vital reproductive hormones.
Gonadotropin releasing hormone (GnRH) is the substance your body produces to trigger the release of sex hormones like estrogen, which controls a woman’s menstrual cycle and ovulation, and testosterone, which governs men’s sperm quality and sperm count. Scientists have suggested that higher stress hormone levels could interfere with GnRH production, and thus affect both male and female fertility.
When men experience high levels of stress, it can also boost the release of glucocorticoids, which are steroid hormones that influence testosterone and thus affect sperm production.
Being in a toxic relationship means that you are frequently attacked, demeaned, undermined, and generally made to feel worthless and like a failure. No matter how much you tell yourself that “it’s them, not me,” or how many times your friends and partner reassure you, this kind of attack can drag down your self-esteem and trigger depression, anxiety, or both.
Both depression and anxiety can affect your fertility. As well as causing stress hormone levels to rise, anxiety disorders can be accompanied by an imbalance in your estrogen or testosterone levels.
Depression can interrupt the regular functioning of the hypothalamic-pituitary-adrenal axis, which is the central system controlling the menstrual cycle, or disrupt the body’s ability to regulate the luteinizing hormone that is responsible for ovulation.
It might not be the relationship itself which affects your fertility, but the way that you cope with its impact on your life.
If you’re in a toxic relationship, there’s a good chance that you’ll use alcohol, cigarettes and tobacco products, and “comfort foods” to help yourself calm down and recover from a painful interaction.
Although moderate drinking hasn’t been found to have much effect on either male or female fertility, drinking too much — defined as 4-6 drinks a week or more — can be harmful. One study found that women who drink more than 4 alcoholic drinks weekly are more than twice as likely to have a miscarriage as woman who don’t drink, and women who are heavy drinkers could experience menopause at an earlier age.
For men, heavy drinking is often associated with erectile and ejaculatory dysfunctions, which make it difficult to conceive, while long term, heavy alcohol use can lower testosterone, cause testicular atrophy which damages sperm production, and trigger liver dysfunction, which in turns leads to hormonal imbalances when the liver can’t metabolize estrogens effectively.
However, if you’re undergoing IVF, even one extra drink a day for women can significantly affect your chances of success. It’s also known that moderate to high alcohol consumption during early pregnancy can damage the unborn fetus and cause alcohol-related birth defects.
If you quit smoking, you’ll know how easy it is to restart when times get stressful, but any amount of cigarette smoke can make it harder to get pregnant. One study found that if one member of the couple smokes, it can take them around twice as long to conceive than for non-smoking couples.
For women, the chemicals in cigarettes can harm the ovaries and produce poor-quality eggs, as well as disrupting your brain’s endocrine function which is responsible for producing and releasing sex hormones.
Men who smoke are affected too. Cigarette toxins can damage the DNA in sperm and reduce sperm quality, affecting their ability to fertilize the egg and increasing miscarriage rate when conception does occur. 120,000 men in the UK aged 20-39 are infertile because of smoking.
When men and women turn to food to soothe their feelings, they are very likely to eat foods that are high in fat, sugar, and chemicals, speeding up weight gain and obesity which in turn affect fertility.
One study found that your chances of getting pregnant naturally within 1 year (the definition of normal fertility) drop by about 5% for every extra BMI point a woman has above 29. Men who have a BMI of over 25 could see sperm counts fall 22% and sperm concentration drop 24%.
Women who become obese, or eat far too little, could experience anovulation, where the ovaries stop producing eggs on a regular basis or quit altogether.
It’s not surprising that people in toxic relationships have trouble sleeping, because their anxiety and stress levels are so high and they struggle to wind down enough to sleep. But the body uses sleep to regulate hormone production, so if you’re not sleeping well, it can throw your sex hormones out of sync.
Finally, toxic relationships have a way of taking over your life. Everything you do revolves around your reaction to the last incident, or your attempts to avoid having another bad interaction, to the extent that you can’t even enjoy sex. Less sex is practically guaranteed to lower your chances of conceiving.
A toxic relationship can even end up poisoning the other, healthy, relationships in your life, causing your stable marriage or partnership to fall apart.
There’s any number of reasons for leaving a toxic relationship, but it seems like you can add fertility to the list. If you’re hoping to start a family, whether through IVF or by conceiving naturally, removing toxic relationships from your life can only be a good move. We hope your path to parenthood will be smooth and stress-free.
It’s common knowledge that smoking cigarettes can reduce a woman’s ability to conceive. But as the e-cigarette craze continues sweeping the globe, the trend raises questions about the impact of consuming tobacco and nicotine in other forms, such as vaping, for women trying to conceive.
So, how does vaping really affect fertility?
The negative impact of smoking on fertility can’t be overstated. Multiple studies and meta-analyses have found that:
With cigarette smoking linked to both troubles in conceiving and negative outcomes for pregnancy, doctors recommend that women who are trying to get pregnant stop smoking. Even a few cigarettes a week can put a roadblock between a woman and a healthy pregnancy.
It’s clear that smoking reduces the chances of becoming pregnant naturally. Can the same be said for women who are trying to conceive via assisted reproduction?
An American study of women undergoing IVF treatments found that smokers experienced lower rates of success. They had a 50% reduction in implantation and ongoing pregnancy rate, compared to women who did not smoke during their treatment cycle.
Strikingly, the study found that women who had stopped smoking shortly before their treatment cycle had the same rates of implantation and full-term pregnancy as non-smokers, illustrating just how damaging smoking is for fertility.
That conclusion was confirmed by a Danish study, which found a direct link between smoking and unsuccessful fertility treatments. Tobacco use before and during pregnancy lead to higher rates of maternal, fetal, and infant morbidity and mortality, the researchers wrote, along with lower rates of pregnancy.
Often touted as a healthier alternative to smoking cigarettes, vaping refers to consuming tobacco via an electronic device. There are a number of vaping devices on the market. Some are visually similar to traditional cigarettes, while others are sleek, futuristic-looking devices.
Unlike cigarettes, these battery-powered devices heat up cartridges filled with liquid, turning them into vapor which is then inhaled by the user.
Because the most damaging chemicals in cigarette smoke -- carbon monoxide and tar -- are not present in vape smoke, the UK’s National Health Service has recommended that smokers try vaping as a tool to wean themselves off cigarettes.
However, vaping is not harmless. Vape liquid contains large amounts of highly addictive nicotine, and initial studies have linked the practice to lung irritation. And because vaping is so new, the long-term effects are still unknown.
While research is ongoing, it appears that yes, vaping can lead to fertility difficulties.
A recent study published in the Journal of the Endocrine Society found a correlation between e-cigarette use and embryo implantation. Researchers found that mice exposed to e-cigarette vapor had major delays in the onset of their first litters, along with difficulties in embryo implantation. In pregnant mice, vaping “caused changes in metabolic, inflammatory, neurological, and pulmonary factors within exposed offspring.”
In other words, there was a strong connection between delayed pregnancy, impaired implantation of embryos, birth defects, and vaping. The negative impact on both fertility and fetal health should serve as a caution for women who vape that are considering becoming pregnant.
Researchers from Oregon State University found in a meta-analysis that “e-cigarette usage during pregnancy will be as harmful to fetal lung development as is conventional cigarette usage.”
But it’s not just women’s fertility that’s impacted by vaping. Men who use e-cigarettes daily were found to have poorer quality sperm and lower sperm counts than non-smokers.
A Polish study noted that vaping liquid contains a range of harmful substances that have the potential to affect fertility, including “endocrine disruptors, which disturb hormonal balance and morphology and the function of the reproductive organs.”
Although e-cigarettes may be safer than traditional cigarettes, nicotine is definitively linked to health risks for both pregnant women and their fetuses.
Some of the dangers for babies exposed to nicotine in utero include:
For women who are trying to conceive, there’s a clear link between smoking and a higher chance of ectopic pregnancy. Nicotine has been found to cause a spike in abnormal sperm morphology among male mice, and it’s likely that also applies to humans.
E-cigarette liquid is largely unregulated, which means that it’s hard to know just how much nicotine one cartridge contains. This lack of standardization adds another risk factor for women who are trying to conceive or who are pregnant.
Absolutely!
If you’re thinking about becoming pregnant, this is an excellent time to put the vape down and embrace a nicotine-free life. While it’s tempting to think that e-cigarettes are a safe alternative to smoking, the truth is that vaping can also seriously hurt your health - not to mention that of your future baby.
There are many resources available to help you kick your tobacco habit before you become pregnant. Nicotine Replacement Therapy (NRT) is one option, but you should consult with your doctor about the best plan of action for you.
Cutting out nicotine doesn’t just raise your chances of becoming pregnant - whether you’re conceiving naturally or using reproductive assistance - it can also increase the likelihood of carrying a baby to term. Not to mention that your baby will have a smaller risk of potential issues upon birth.
Although research is still ongoing into whether or not e-cigarettes are safer than traditional smoking during pregnancy, there’s plenty of evidence that shows any nicotine consumption can negatively affect the health of both mother and baby.
It’s widely known that the toxins and chemicals in cigarette smoke can affect your fertility, and that if you want to become pregnant, it’s best to stop smoking.
But cigarette smoke isn’t the only source of harmful chemicals that can make it hard for couples to conceive and give birth to a healthy baby. As science advances, scientists learn more about the ways that regular products that you use at home every day can interact with your reproductive health.
There are 3 main ways that environmental toxins can harm your fertility, but bear in mind that some products can affect you in more ways than one:
Each one of us is exposed to millions of chemicals every day, and no one is certain just how many of them could impact on fertility. It’s estimated that each pregnant woman in the US is exposed to over 43 different chemicals on a regular basis.
Here are some of the most common products that you’re likely to have at home and could contain chemicals that can make it harder for you to conceive.
Old pipe networks and paint compounds used to contain high levels of lead, which can damage the reproductive system. For example, the headline-grabbing health crisis in Flint, MI, in 2015 was caused by lead leaching out of old pipes and into the water supply.
If you live in an old house which hasn’t had the paint replaced since the 1970s, the chances are high that it’s lead-based. Oil-based paints, paint thinner, and painting supplies can contain lead and mercury, but newer paints aren’t 100% safe, either. Latex-based paints can be made with ethylene glycol ethers and biocides, which can disrupt the menstrual cycle, decrease sperm quality, and increase the risk of miscarriage.
The chemicals in paint don’t have much impact on your health if they are already on the walls, but they can affect you if you start scraping them off or putting on a fresh coat of paint. That’s when you’ll either create fine particles of dried paint or release paint fumes into the air, which can be easily breathed in.
Many household cleaning products and detergents contain:
Heavy metals have been linked to increased incidence of miscarriage, uterine fibroids, and hormonal disorders which affect fertility.
Triclosan is an endocrine disruptor which raises thyroid hormone levels, affecting fertility in men and women, and can also increase breast cancer. It’s found in many antibacterial soaps as well as household cleaners.
Chlorinated hydrocarbons are used in cleaning agents, pesticides, and the manufacture of PVC items. Women with the highest levels of PCBs have a 50% decrease in their ability to get pregnant, and are far more likely to miscarry when they do become pregnant.
If you live in a busy city or close to a main road, you’re likely to be breathing in a lot of traffic fumes which contain heavy metals, particulate matter, and other harmful chemicals. There’s a slight but definite link between the distance a woman lives from a highway, and her fertility levels.
Traffic fumes affect male fertility too, with motor vehicle exhaust emissions found to affect sperm count, motility, and vitality. .
Organic solvents like polybrominated diphenyl ethers (PBDEs) and organophosphate flame retardants (PFRs) are used as fire retardants. They can affect thyroid balance and sex hormone production, which in turn damages the menstrual cycle and ovulation in women.
One study of PFRs among 211 women undergoing IVF found that women with the highest concentrations saw their chances of successful fertilization drop by 10%, of embryo implantation falling by 31%, and a 38% drop in live births.
PFRs and PBDEs are used in:
They are very prevalent in the US and are already in most people’s bloodstreams.
Phthalates and parabens, which are serious endocrine disruptors, are used in a massive number of different household and personal products.
You’ll find them in:
Phthalates and parabens are among the most harmful chemicals for reproductive health, and what’s worse is that they are truly everywhere. Over 97% of Americans have a detectable level of phthalates in their bloodstream, even though phthalates are quickly excreted from the body, because they are so prevalent that blood-chemical levels are replenished just as swiftly.
Many studies over the past several years have linked higher phthalate levels to lower chances of successful IVF outcomes, and increased miscarriage risk both for natural pregnancies and those enabled by IVF. In April 2020, researchers warned that pre-conception phthalate exposure could be a risk factor for adverse pregnancy outcomes. Men with high phthalate levels show damage to sperm.
It’s important to read the labels on cosmetics and look for items that are paraben-free and fragrance-free. It's also a good idea to regularly air your house to get rid of any build-up of fumes, and choose nail polish brands that don’t contain acetone. Although nail polish choices will only prove problematic if you paint your nails weekly or more often.
An astonishing number of plastic products contain BPA (Bisphenol A) or the almost equally harmful Bisphenol S (BPS). Like phthalates and parabens, these are endocrine distributors that affect male and female reproductive fertility.
In men, high BPA levels can drag down sperm count, sperm vitality and motility, and sperm concentration, while in women it can damage tissue in the uterus, ovaries, and the hypothalamus and pituitary gland which govern sex hormone production.
BPA is used in many different types of plastics, including:
BPA is also used to coat sales receipts, so it’s best not to handle them with wet hands and to throw them out ASAP. You should avoid heating up food in soft plastic containers or covering it with cling wrap, because BPA chemicals and phthalates too transfer when they are heated. Use glass or ceramic dishes to reheat food, and cover it with a paper towel instead of plastic.
Unless you buy organic food, all your produce, meat, and dairy is likely to contain some pesticides. If an all-organic diet is impossible, it’s still worthwhile to do what you can to cut your exposure to pesticides as much as possible.
Pesticides can damage sperm quality and quantity, act as endocrine disruptors, and affect fetal development leading to miscarriage. A study of women in Ontario, Canada, found that when pesticides use rose, fertility fell. Washing produce before eating it can help, and if you’re involved in gardening or farming you should also stay away from pesticide usage.
You can also help cut the level of phthalates in your food by avoiding processed foods and takeout food that are sold in soft plastic packaging.
You can’t always remove all the multiple factors that have an impact on your fertility, but the more that you can reduce them, the better.
Checking the products you bring into your home to make sure that none of them contain dangerous parabens, phthalates, BPA, or other harmful chemicals, and trying to stay away from thing that would adversely affect you, can help remove obstacles in your path to starting a family, whether you’re using IVF or hoping to get pregnant.
For many couples who are trying to start a family, that 40th birthday can loom up ahead like a fertility cliff. Becoming pregnant between the ages of 20 and 35 may well be the ideal, but we all know that life doesn’t always work according to plan.
Let us give you some positive encouragement, for a change: even though it’s far easier to become a mother for the first time at a younger age, it can be safe to become a mother after 40.
Pregnancy is not always an easy experience even for younger women, and you’re likely to feel the impact even more when you’re past 40. But you can take steps to lower the effects of pregnancy on your health.
Pregnancy hormones like estrogen, progesterone, and relaxin soften the ligaments, which increases the risk that you could strain a muscle. At the same time, your larger stomach changes your posture and balance, which could put an additional strain on your joints.
Pay attention to the way you sit and stand, so that you don’t accidentally strain a muscle or harm your joints. Try to avoid lifting heavy objects past your first trimester.
Exercise plays an important role in a healthy pregnancy. It raises your mood, helps you sleep better, and helps reduce the potential backaches, nausea, and constipation that often accompany pregnancy. According to the Mayo Clinic experts, regular exercise could even help you have a shorter labor, avoid a C-section, and lower the risk of developing gestational diabetes.
In general, healthcare professionals agree that you can continue any exercise program, but should be careful about taking up a new kind of workout during pregnancy. It’s not a good time to try to reach your peak fitness goals, though; just maintain your current level.
Some of the best workouts for a healthy pregnancy include:
No matter how you slice it, you won’t have as much energy during pregnancy as you normally do, nor will you be as energetic as 20-something expectant mothers. Don’t push yourself to do more; it’s not a competition. Instead, allow yourself plenty of time to rest.
It can be difficult to get enough sleep during pregnancy, especially in the third trimester when every position feels uncomfortable, so take naps and rest as much as you can.
The awkward truth is that the older you are, the higher your risks of a pregnancy ending in miscarriage, rising from about 18% for 30-year-olds to 38% when you reach 40 and 70% at age 45.
Chronic conditions like thyroid disease, diabetes, and high blood pressure all add to the risk of pregnancy loss, so if you’re otherwise healthy you’ll be better placed to give birth to a healthy baby. However, it’s not always clear what causes a miscarriage.
The risks of stillbirth, on the other hand, aren’t much higher for women aged 40+ than for those in their 20s — until you reach the 39th week, that is. From week 39 and on, the risks of stillbirth among the over-40s are double those of someone aged 35. For this reason, best practice in the UK is to induce older women once they reach this point in pregnancy.
The statistics show that if you’re giving birth past the age of 40, you’re a lot more likely to need interventions like a C-section, forceps, or vacuum delivery. The chances of needing a c-section double for women aged over 40.
Here are some of the reasons:
But don’t let minor side effects scare you. Assisted birth interventions and C-sections are safe and usually bring favorable birth outcomes. Here’s what you should know regarding the risks of birth interventions.
The risks to your health
When you have an intervention like vacuum or forceps delivery, it can raise the risk that you’ll have a 3rd or 4th degree vaginal tear, which takes longer to heal and can cause temporary incontinence. You’re also at a higher risk for blood clots, so it’s even more important to keep moving, and you ought to consider wearing compression socks. If you follow medical advice postpartum, however, you’re unlikely to experience any long-term effects.
A C-section is a surgical procedure, so like any surgery, there are risks of infection, surgical injury, and having a reaction to the anesthesia. But that said, the risks of serious harm following a c-section are very low. Choose a doctor whom you can trust, and follow all the advice you’re given about post-surgery care.
The risks to your baby’s health
It’s rare for a baby born through a C-section or assisted delivery to suffer any serious or long-term ill effects. After a forceps or vacuum delivery, your baby might have marks on their head and/or face, and/or small cuts on the face and scalp, but these all heal quickly. Some babies develop jaundice after an assisted birth.
After a C-section, a few babies develop transient tachypnea, which is a breathing problem, but it too resolves itself within a few days.
Conceiving a healthy child
The older you are when you conceive, the higher the chances of having a baby with a chromosomal defect. That’s because your eggs are older too, and their quality isn’t as high as for younger eggs. Older eggs are less likely to divide correctly during gestation, and that’s what causes chromosomal defects.
The most common chromosomal defect is Down’s syndrome, also known as trisomy 21. It’s what happens when the 21st chromosome produces three copies of itself in every cell, instead of just two. The risk of giving birth to a baby with Down’s syndrome is 1 in 1,250 if you’re aged 25, but it’s 1 in 100 when you’re 40 years old, and 1 in 60 by age 42.
If you use your own eggs that you froze when you were younger, you can lower this risk. It’s also particularly important to carry out prenatal screening for Down’s syndrome and other chromosomal issues once you’ve passed 40.
Overall, studies have found that babies born to mothers aged over 40 are 35% more likely to spend time in intensive care, more likely to have a low birth weight, and 70% more likely to be born with a medical issue.
There are a number of conditions which women can develop during pregnancy, and your risk of experiencing them does rise when you’re over 40. But much depends on how healthy you are before you get pregnant, and how well you take care of your health during pregnancy.
If you’re otherwise healthy and fit, you don’t have high blood pressure or other chronic health conditions, and you’ve conceived naturally, there’s no reason why your pregnancy should be higher risk than that of the 30-year-old in the next room.
Preeclampsia is a serious condition that’s caused by having high blood pressure, and can develop into organ damage. When you’re pregnant, the strain on your heart goes up massively, plus your body produces more progesterone which also pushes up your blood pressure and cholesterol. For women who already have high blood pressure or heart issues, that’s sometimes enough to cause preeclampsia.
Your blood pressure (hypertension) generally increases as you get older, and a lot of people aren’t even aware that they have borderline hypertension. When you’re aged over 40, the risks of developing preeclampsia shift from 3-4% to 5-10%.
But there are steps you can take to lower the risk:
Women who are over 40 are four times more likely to develop gestational diabetes — a type of diabetes that only affects pregnant women — than younger women. It goes away after you give birth, but it can increase the risks of developing type-II diabetes postpartum.
You can reduce your risk, however, by paying attention to your diet. Cut the amount of sugar, red meat, and high-cholesterol foods you eat, and increase the amount of fiber. One study found that women who ate 10 grams more fiber per day lowered their risk of gestational diabetes by 26%.
Exercise also helps decrease the risks of gestational diabetes. Studies found that women who were the most active before getting pregnant cut their risk of developing gestational diabetes by up to 55%, and exercising in early pregnancy can also help lower your odds. It seems that the exercise you do before getting pregnant has a bigger impact than exercising during pregnancy.
Placenta praevia happens when the placenta doesn’t move up and away from the opening of the uterus. It can cause a rupture, leading to severe bleeding and possibly preterm labor.
Placenta praevia occurs when your blood (vascular) system can’t support the uterus to expand enough to accommodate your baby. Older women have a higher risk of vascular disease, which in turn increases your risk of placenta praevia.
There’s no specific treatment or cure for placenta praevia, although maintaining a healthy lifestyle which protects your heart and vascular system can help. It’s important to consult your doctor if you have any vaginal bleeding, and get regular ultrasounds so that placenta praevia can be spotted before it causes a serious health issue.
If your doctors suspects placenta praevia, they will avoid performing vaginal exams and recommend that you avoid sex and exercise, to reduce the risk of triggering a hemorrage. In some cases, you might be put on bed rest for the remainder of your pregnancy, to help make sure that you reach term and deliver your baby safely.
Although the risks are higher when you become a mother after the age of 40, there’s no reason to give up on starting a family, either through IVF or by conceiving naturally. Take steps to live as healthy and active a lifestyle as possible, both before and during pregnancy, and carry out all the health checks and screenings recommended by your doctor. We hope your pregnancy and birth go as smoothly as possible.
If you’re over age 35 and you don’t yet have children, you’ve probably had at least one interfering person remind you that you’d better hurry up because your fertility will decline. No one ever says that to men, of course. Menopause is like a ticking time bomb for women who want to start a family, but men don’t have the same finish line for their fertility.
Or do they?
Men can produce sperm throughout their lives, so there is no “male menopause” when men can’t have children any longer. But that said, studies have shown that male fertility does decline with age.
If a man is over age 45, it can take five times longer for he and his partner to conceive than if he was aged 25 or under. When the man is over 40, he and his partner are 30% less likely to conceive during a 12-month period than if the man is under 30.
Male age affects IVF success rates too. One study found that when both the man and the woman are aged 35-39, they have a conception rate of 29%, but that drops to 18% if the woman is aged 35-39 but her partner is five or more years older.
Women tend to see their fertility drop off steeply in their late 30s and 40s, but for men, fertility lessens much more gradually, and from a later age. Male fertility generally starts to fall in their 40s and through their 50s.
A French study found that women’s reproductive capability drops from age 35, but for men it’s only from about age 40. Other research concluded that before age 34, there was no noticeable change in sperm concentration, sperm motility, sperm morphology, or sperm volume, but that after 40, sperm concentration and sperm morphology had both declined.
There are two main ways that male fertility can decline over time:
Scientists have also found that as men age, sperm shows increasing DNA fragmentation, which in turn increase the chromosomal defects that trigger miscarriage.
When men struggle to achieve erection, it’s referred to erectile dysfunction. Without an erection, a man can’t naturally ejaculate the sperm which fertilize the egg and achieve conception. ED can have a number of causes, including insufficient testosterone and poor blood circulation. The risks of severe ED rise 300% between the ages of 40 and 70, and those of moderate ED by 200%.
As men get older, their hormonal balance changes and testosterone levels drop. The decline begins at around the age of 40, which is much later than the age when female fertility begins to decline, but it’s still significant.
Testosterone is the hormone that controls men’s libido, ability to ejaculate, and the ability to achieve and hold an erection. Total testosterone declines at around 0.8% per year, and sex hormone-binding globulin (SHBG) increases at 1.6% per year, which scientists speculate further reduces testosterone levels.
By now, scientists agree that sperm quality decreases with age, but there’s less agreement about exactly why and how that takes place. The drop in testosterone certainly plays a role. Leydig cells in the testes generate very high levels of testosterone which produce sperm, but those Leydig cells drop in number with age.
There are a number of factors which affect sperm and semen health. (Sperm is what fertilizes the egg, and semen is the liquid which holds the sperm.) The main issues are:
It’s still unclear whether sperm concentration falls significantly. Some scientists even think that sperm concentration may increase slightly with age.
There are studies that show that sperm morphology can decline by anything up to 0.9% per year, with a total change of up to 18% over 20 years. Sperm shape affects the sperm’s ability to fertilize the egg. The more that it varies from the normal, the harder it will be for conception to take place. However, sperm morphology is difficult to research with confidence, because the data can vary a lot between studies.
Scientists are far more concerned about the way that changes to sperm motility affects male fertility. According to the most recent research, sperm motility could drop by 0.8%/year of age for every year of age. In fact, 40% of men aged 40-60 have low motile sperm, in contrast with just 20% of 20-30 year olds and 17% of 30-40 year olds.
Other issues that cause sperm health to decline are a drop in semen volume, and a loss of strength in vesicular function, which means that the semen is ejaculated much more weakly and doesn’t travel as far.
Women are born with a finite number of eggs, but men keep on producing sperm throughout their lives. Every time that sperm is made, it reproduces the male DNA, and with every replication there’s a risk of mutations, or DNA fragmentation. As men get older, DNA fragmentation increases.
A rise in DNA fragmentation also means a rise in chromosomal abnormalities, which can cause health defects, low birth weight, and miscarriage or stillbirth. The risk of miscarriage in the first trimester is 25% higher when the father is over 35, even if the mother is under 30. Another study found that babies born to fathers aged 45 or over were more likely to be born premature and more likely to have a low birth weight and Apgar score than those born to younger fathers. Additionally, babies with fathers aged over 55 were more likely to need assisted ventilation and to be admitted to a NICU.
Bear in mind that the older you are, the more time you’ve had to be exposed to toxins, germs, and to develop conditions that can affect fertility. The authors of one study observe that “the risk of developing a medical condition or of being exposed to environmental toxins increases with age.”
Some of the environmental issues that can affect male fertility include:
Endocrine disruptors are found in many common items both at home and at work. These are materials that disrupt the release of the sex hormones which control sperm production and erectile function. Some serious endocrine disruptors include:
Other chemicals that affect the hormonal balance include pesticides, DDE, diesel fumes, lead, and paint thinners. Traffic fumes can also affect sperm count, motility, and vitality.
Sperm production works best when the testes are a couple of degrees cooler than typical body temperature, but a lot of men work in hot environments like factories, garages, etc. which raise testicular temperature. When the testes are too hot, they are more likely to produce sperm that’s the wrong shape, affecting sperm motility.
Male fertility problems are often linked to other health conditions, like obesity, cancer, hypertension, heart disease, and kidney disease. Heart disease and hypertension, for example, affect vascular health and increase the risks of ED. Obesity can affect the hormonal balance. All of these conditions are more likely to affect older men rather than younger men.
Common medications like spironolactone and calcium channel blockers prescribed for hypertension, H2 blockers prescribed for stomach ulcers, and antiandrogen treatments (flutamide) for the prostate can all have side effects that affect sperm production.
Like with other health issues, maintaining a healthy weight and avoiding known toxins can make a difference to male reproductive health. If you’re having trouble conceiving, it’s also worth considering if there’s something in your workplace or home environment that could be affecting your fertility.
However, no one can (or should try to) avoid getting older, and it’s inevitable that male fertility will decrease somewhat with age. If you’re a man aged over 40 and you and your partner are struggling to conceive, it’s worth it to check if there’s anything that could be affecting your fertility levels as well as investigating female fertility.
Whether you use IVF, donor sperm, or natural conception to build your family, we hope your experience is as smooth as possible.
Maintaining good health is always a concern, but when you’re pregnant or trying to conceive, the world can feel like it’s full of germs and infections.
It’s an understandable feeling. There are some diseases and bacteria which can cause serious problems for you and/or your baby, but that healthy people would ordinarily shrug off.
But most of these health threats can be kept away by following good hygiene practices and getting vaccinations on time. Here are some of the diseases that can be harmful during pregnancy, and what you can do to protect yourself and your baby.
Chickenpox is usually harmless for children, but it can cause serious damage if you catch it while you’re pregnant. If you get infected with chickenpox before your 28th week of pregnancy, there’s a 2% chance that your baby could develop foetal varicella syndrome (FVS), which can harm their skin, eyes, legs, arms, brain, bladder and bowel.
If you catch it between 28 and 36 weeks, your baby will be infected too, but he/she won’t be born with any symptoms. However, it could become active while your child is still a baby or toddler, and cause painful shingles.
If you catch chickenpox after week 36, your baby will be infected and could be born with active chickenpox.
If you didn’t catch and recover from chickenpox yourself as a child, you should get vaccinated before you start trying to conceive.
Whooping cough (pertussis) has been rising in the last few years, with a serious epidemic in 2012 that saw 10 times as many cases as normal in the UK, and more annual cases than any year in the last 60 years in the US.
Whooping cough isn’t dangerous during pregnancy, but it can be fatal for your new baby. Babies under 6 months are too young to be vaccinated against the disease, but they are protected by your antibodies.
You were probably vaccinated against whooping cough when you were a child, but by the time you come to start a family, your antibody levels have dropped. They are usually high enough to protect you from the disease, but don’t provide enough protection for your newborn baby.
That’s why public health authorities in many countries recommend that women get a booster shot some time between 16 and 32 weeks of pregnancy.
It takes 2 weeks for antibody levels to peak and transfer to your baby. Then your baby has whooping cough antibodies in their own system to keep them safe until they can be vaccinated themselves.
CMV, or cytomegalovirus, is a common virus that’s part of the same family of diseases as cold sores and chickenpox. Once you’ve caught CMV, it remains dormant in your system but it can be reactivated if you get exposed to the virus again.
Most people catch CMV and have nothing more than a cold. But if you catch it or get reinfected when you’re pregnant, your baby could be born with congenital CMV, which can cause blindness or visual impairment, hearing loss, epilepsy, learning difficulties, or more serious birth defects. CMV can also cause stillbirth. It’s worst for babies whose mothers hadn’t been infected with CMV before, and catch it for the first time during pregnancy.
CMV is only harmful to your baby if it’s active while you're pregnant. The dormant virus isn’t dangerous.
Around 1 out of 150 babies is born with congenital CMV, and around 20% of those have birth defects or long-term health problems. Disabilities caused by CMV are more common than those caused by Down’s syndrome, spina bifida, or cystic fibrosis, which are all better known than CMV.
CMV is highly infectious, and it’s passed on through bodily fluids like urine, mucus, saliva, and tears. Small children often catch and pass on CMV, so you should be particularly careful if you come into contact with them.
Currently, there’s no effective way to treat CMV in babies or in pregnant women, although giving babies antiviral medication shortly after birth can reduce the severity of their symptoms. To prevent catching it, you should
Wash your hands regularly with soap and hot water, especially after changing diapers or wiping a child’s nose
Avoid sharing food, plates, or silverware with young children while you’re pregnant
Avoid kissing a child on the face
Flu is no fun at any time of life, but it’s particularly serious during pregnancy. Pregnant women are at a higher risk of developing complications from the flu, and it could cause your baby to be born prematurely, with birth defects or low birth weight.
Flu can also cause stillbirth. The best protection is to get the flu vaccine. One study found that stillbirth rates fell by 51% among women who received the flu vaccine
Most women are vaccinated against rubella in childhood, in which case you’re immune for life. But if you haven’t been immunised and you didn’t catch it as a child, you should get vaccinated before trying to conceive. It’s not recommended to get vaccinated during pregnancy.
If you develop rubella during your first 4 months of pregnancy, you could experience a miscarriage or have a baby with serious birth defects like heart damage, brain damage, vision problems, or deafness.
Toxoplasmosis is a disease caused by parasites that are found in cat faeces, so it can be present in cat litter, in the soil, and in children’s sandpits that cats might use as their toilet. It’s usually a mild disease, unless you’re pregnant. Toxoplasmosis during pregnancy can cause blindness, intellectual disabilities, and other birth defects in your unborn baby.
To avoid coming into contact with anything that could transmit toxoplasmosis, you should:
Get someone else to clean the litter tray if you have a cat
Wear gloves if you’re gardening or handling newly-dug vegetables, and/or wash your hands well afterwards
Make sure that all vegetables are washed thoroughly before you eat them.
Group B streptococcus, or group B strep, is a common and usually harmless bacteria that’s present in the bodies of around 30% of people. You wouldn’t know that you have group B strep unless you get tested.
Group B strep doesn’t harm you or your baby during pregnancy, but if you have group B strep, it can infect your baby during birth. This happens in approximately 1 out of every 1,750 pregnancies.
Babies infected with group B strep can develop meningitis, blood infections, and/or pneumonia, causing long-term disabilities in around 1 out of every 14 babies who are infected. Approximately 5% of babies with group B strep die from the disease. But most babies make a full recovery if they are treated early with antibiotics.
Group B strep is effectively treated with IV antibiotics during labor, so it’s recommended that every woman get tested for the bacteria between her 35th and 37th week of pregnancy. The bacteria grow fast, so testing earlier could mean that infections go unnoticed. If you have group B strep when you give birth, there’s a 1 in 400 chance that your baby will be infected, but if you get IV antibiotics, the risk drops to 1 in 4,000.
Listeriosis is a type of food poisoning caused by listeria. Listeria can be found in:
Soft cheese
Raw, unpasteurised milk and dairy products made from raw milk
Pate and deli meats and other chilled ready-to-eat foods
Chilled smoked seafood
so it’s best to avoid these foods. It can also live on the surface of fruits and vegetables, so wash all fruit and vegetables before eating them or handling them without gloves.
Although listeria is rare, even a mild case can cause serious damage to your baby, resulting in miscarriage, stillbirth, and severe illness in your newborn.
A number of sexually transmitted diseases (STDs) can be harmful to your foetus or newborn baby. It’s best to always practice safe sex, including using a condom.
Chlamydia is particularly common, and you might not know that you have it. If you’re concerned that you might have been infected with chlamydia, ask for a test during pregnancy. It can cause premature birth, miscarriage, birth complications, and eye infections or pneumonia in a newborn baby. Chlamydia can be successfully treated with antibiotics before and during pregnancy to prevent you from passing it on to your baby.
Hepatitis B can be caught by contact with infected blood or sexual relations with someone who has the disease. If you have hepatitis B, you’re likely to pass it on to your baby. In that case, your baby will be given a vaccine at birth and at intervals during their first year, and it’s very effective at preventing them from developing long-term infection.
You might not know that hepatitis B is in your bloodstream, so it’s important to get tested for it during pregnancy. Women who are exposed to it during pregnancy can take antibodies that help reduce the risk of transmitting it to their baby. If you’re in a situation that increases your exposure to hepatitis B, you should get vaccinated before you try to start a family.
Hepatitis C is another blood-borne disease that’s transmitted through having sex, sharing needles, or getting a blood transfusion from someone who has the disease. The risk of passing it on to your baby is a lot lower than for hepatitis B, but if it happens there’s no effective cure.
Genital herpes are transmitted through having sex with someone who has genital herpes sores. If you catch genital herpes for the first time during your last 6 weeks of pregnancy, it could infect your baby with neonatal herpes. Neonatal herpes can be fatal if it goes untreated, but antiviral medication is very effective. The risk of transmitting it is a lot lower if you’ve had genital herpes before.
If you have genital herpes sores towards the end of your pregnancy, your doctor might recommend a caesarean section instead of vaginal delivery, to reduce the chances of infection.
The Zika virus is spread by infected mosquitoes, although you can also catch it through having sex with someone who’s infected. Zika disease is usually mild, but if you catch it while pregnant it can cause serious birth defects, like microcephaly, seizures, developmental disabilities, and blindness, as well as stillbirth.
ZIka outbreaks are common in some parts of South and Central America, parts of south and southeast Asia, the Caribbean, Africa, and some Pacific Islands. They’ve also occurred occasionally in some parts of North America, but the risks of catching it there or in the UK or Europe are very low.
It’s best to avoid traveling to areas where Zika is widespread during pregnancy, and to use mosquito repellent and to cover up if you are in an area with an outbreak.
Fifth disease, also called slapped cheek disease, is caused by the type B19 human parvovirus. It’s common among young children and it rarely provokes any serious effects, but it can cause miscarriage if you catch it when you’re pregnant.
Many women are already immune, because they caught it in childhood. There’s no vaccine against Fifth disease, so avoid being around anyone who might have it. You can also reduce the risk of catching it by washing your hands thoroughly.
Although there are a lot of dangers around you when you’re pregnant, the right precautions can help you keep yourself and your baby healthy and safe. Whether you’re hoping to conceive naturally or planning to undergo IVF treatment, we hope your pregnancy and birth go smoothly and without anxieties or health scares.
Most couples discuss when might be the ideal time to start a family. Although everyone would love to be told exactly when is the best time to have a child, the truth is that there’s no single perfect moment when you should try to conceive.
There are always a lot of variables to consider, including:
It’s important to explore these issues. Although there’s no perfect time, there are indeed periods in your life which would be more suitable to raising a child, and times when it would be better to wait. Here are some of the issues to consider before you plan to start a family.
Ideally, it would be best to wait to start a family until your lifestyle is established and there are no major changes expected in the next year or two.
This isn’t just because you want to raise your child in a stable environment, but also because big changes to your life always increase stress and anxiety. That’s true even for positive changes, like moving to the region where you always wished to live or switching careers to pursue your dream job.
It’s still unclear whether stress has a significant effect on your fertility, but scientists do think that increased levels of the stress hormones alpha-amylase and cortisol could interfere with the production of GnRH (gonadotropin releasing hormone), which is responsible for the release of sex hormones. A US-based study found that women who have the highest levels of alpha-amylase took 29% longer to get pregnant than those with the lowest levels, and different research concluded that for men, stress affects sperm shape and speed.
You should also never decide to try for a child as a way of fixing a problematic relationship. Again, not just because you might not have resolved your issues by the time your baby is born, but also because the added stress can affect fertility.
Many people struggle with mental health disorders like anxiety and depression, and worry that these could stop them from starting a family. The good news is that there is no reason why you can’t have a healthy baby and a happy family even while struggling with anxiety or depression.
However, both anxiety and depression can make it take longer for you to conceive naturally.
Anxiety could raise your stress hormone levels, and may be caused by an imbalance in the sex hormones estrogen and testosterone. Depression can disrupt the hypothalamic-pituitary-adrenal axis, which controls the menstrual cycle, or disrupt the luteinizing hormone which regulates ovulation.
If you’re suffering from depression or anxiety, and it’s not yet under control with medication or lifestyle changes, it is better to wait until you have received medical help and balanced your mental health.
In general, if you or your partner are scared about having a baby, wrestle with anger management problems or psychosis, or a mental or emotional health disorder that affects your daily life, it’s not a good time to start a family. Simply trying for a baby can be stressful on its own and could adversely affect your state of mind, while caring for a new baby, and then a toddler, can be the last straw if you’re already depressed, anxious, or experiencing mood swings.
It’s best to consult with your healthcare provider to improve and stabilize your mental and emotional health, before you begin or expand your family.
Most temporary illnesses don’t affect female fertility, so a cold, cough, or flu isn’t a reason to wait to start a family, although you might not feel much like having sex when you’re feeling ill. However, male fertility can be affected by a high fever (38.8°C and up) that continues for three days or more. The high body temperature can depress sperm production for up to six months, but it does recover with time.
Some chronic illnesses can reduce male and/or female fertility, including:
Other conditions don’t affect your fertility but can increase your risk of miscarriage or stillbirth. Women who have heart or kidney conditions, rheumatoid arthritis, high blood pressure and other auto-immune disorders, are generally considered to be high-risk, and are therefore kept under careful observation during their pregnancy. If you fall into any of these categories, it’s wise to consult with your doctor before you start trying to conceive.
If you have lupus, you should plan your pregnancy carefully. The CDC advises that you make sure that your disease is under control or in remission for at least six months before you conceive. Getting pregnant while you have active lupus can cause serious health problems for you and/or your baby or lead to miscarriage or stillbirth.
If you’re taking certain medications, they could make it harder for you to conceive. These include:
Most of these effects are reversed once you stop taking the medication. If you’re on any of these medications, you may prefer to wait to try for a baby until after you finish taking them.
Your age is definitely going to affect your timing. Although you can still get pregnant when you are aged 40+, your fertility declines faster once you reach the age of 32, and drops faster still from age 37.
Additionally, when you’re over 35 your risk of having a miscarriage or stillbirth increases significantly. One study found that for women in their early 20s, 10% of pregnancies end in miscarriage, but that rises to 18% when you’re over 35 and 34% if you’re in your early 40s.
That means that if you’re approaching 35, you might want to consider your options including both trying for a baby soon, or potentially freezing eggs for a later date. The American Society of Reproductive Medicine (ASRM) recommends that if you are aged over 35 and you haven’t become pregnant within six months of unprotected sex, you should begin evaluation for infertility treatment, rather than waiting the standard 12 months.
If you received radiation therapy for cancer or other illness, you have PCOS, fibroids, or endometriosis, or you’ve had an STI in the past, the American College of Gynaecologists suggests seeing a fertility advisor straight away. They can help you plan the best times to get pregnant and give you advice about IVF and egg freezing.
Many doctors advise freezing your eggs before undergoing any kind of treatment which could affect your ability to get pregnant in the future. Egg freezing means that your eggs are collected, frozen and stored securely until you are ready to start a family, when fertility doctors will help you through the IVF process. If you freeze your eggs when you are young and healthy, it greatly increases your chances of success later on when you’re ready to undergo treatment, even if you have conditions like those mentioned above which make it difficult to get pregnant naturally.
Although there’s no perfect time to start a family, there are many good options. What matters most is that you both feel that the time is right. Whenever that may be, we hope that your path to parenthood goes smoothly.
If you’re trying to start or expand your family, you probably want to know whether COVID-19 could affect your fertility.
So far, it’s hard to say for sure. COVID-19 has only been around for a little over a year, so scientists haven’t had time to see if it has any long-term effects on fertility.
There are 3 main areas of concern for COVID-19 and fertility:
However, so far no studies have found that COVID-19 has a significant impact on any of these issues.
There are two reasons why scientists were concerned that COVID-19 could reduce fertility in women:
The coronavirus attacks the body by binding on to the ACE-2 receptors inside the cells, and the female reproductive system has a high concentration of ACE-2 receptors.
In women, ACE-2 receptors are part of the system that produces and matures new oocytes (egg cells) and controls ovulation and the regeneration of the endometrium, which is the lining of the uterus which receives the fertilized egg.
Inflammation is also known to affect egg production.
But no studies have found that COVID-19 has a noticeable effect on female fertility, which is good news.
Just like with female fertility, scientists were worried that inflammation, together with the effect of COVID-19 on ACE-2 receptors, could affect male fertility.
The male reproductive system has a very high concentration of ACE-2 receptors. In men, ACE-2 receptors can play a role in sperm production, so men who’ve had COVID-19 could see a drop in sperm quantity, quality, and motility.
Fever, inflammation, and disruption to the hypothalamic-pituitary-gonadal (HPG) axis, which controls the release of sex hormones, can affect testosterone levels and sperm production. That’s why other viral illnesses which cause fever and inflammation, like mumps and measles, can affect male fertility.
But so far, there’s very little evidence that male fertility is affected by COVID-19.
A recent study from January 2021 found that men who had severe COVID-19 saw both sperm concentration and sperm motility drop, and that sperm cell shape was altered following the illness. However, the same study found that all of these elements improved over time.
Other scientists pointed out that the study doesn’t make a clear link between COVID-19 and the impact on sperm production, because:
Once again, we’ll have to wait for more studies.
One study found that COVID-19 could be associated with erectile dysfunction (ED), causing a condition that’s being called “COVID penis.” The coronavirus attacks the inner walls of small blood vessels called endothelium, which play an important role in penile erection.
But stress and anxiety can cause ED, and the pandemic has increased everyone’s stress levels.
Scientists also point out that men who are generally in poor health are more at risk of ED, and they are also more likely to experience severe COVID-19, so it’s possible that their general ill health is the true cause of ED.
There’s some evidence that pregnant women suffer from more severe COVID-19 than women who aren’t pregnant, but they aren’t more likely to catch it, and so far, there’s no sign that COVID-19 has a significant impact on pregnancy outcomes.
Doctors have seen a slightly higher rate of preterm birth among pregnant women with symptomatic COVID-19, but not among women with asymptomatic COVID-19. This could be caused by comorbidities which make COVID-19 more serious, instead of by the virus itself, especially since women who are asymptomatic aren’t more likely to give birth early.
There’s also no clear evidence that the fetus can be infected by COVID-19 through the placenta. The studies are very small, but they don’t show that the fetus is harmed by maternal COVID-19. Babies born to mothers with COVID-19 aren’t significantly smaller or showing signs of distress, and a study by the CDC found that there’s no greater risk of miscarriage for women with COVID-19.
COVID-19 changed the way we live, and that can have a knock-on effect on your fertility in a number of ways:
If you’re trying to start or add to your family, it’s important to follow COVID-19 guidelines and as always, continue caring for your physical and mental health. Whether you’re using IVF or hoping to conceive naturally, COVID-19 doesn’t need to derail your plans.
