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:

• Your lifestyle and any major changes that could be coming up
• Your physical, emotional, and mental health
• Your fertility levels

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.

Lifestyle and relationship status

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.

Mental and emotional health issues

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.

Physical health and illness

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.

Chronic illness

Some chronic illnesses can reduce male and/or female fertility, including:

• Thyroid disorders, since the thyroid affects sex hormone production
• Cystic fibrosis, which can cause the fallopian tubes to be blocked
• Diabetes can cause erectile dysfunction and low sperm counts in men, and could reduce female fertility if it’s not properly managed
• Obesity can reduce sperm production in men and affect ovulation in women

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.

Medication

If you’re taking certain medications, they could make it harder for you to conceive. These include:

• NSAIDs like ibuprofen or aspirin, if taken continuously for a long period of time
• Antipsychotic drugs that are used to treat anxiety disorders or psychosis
• Thyroid medication, if the dose is too high or too low for your needs
• Steroids can interfere with the release of sex hormones. Anabolic steroids in particular can cause male infertility
• Spironolactone, which is used to treat fluid retention

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.

Expected fertility levels

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.