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The World Health Organization reports that almost half of all pregnancies each year are unintended and that 61% of these pregnancies end in induced abortion. The decision to have an abortion is a very personal one, but statistics show it is very common and nothing to be ashamed of.
Even if women know they want to have children at some point in their lives, they may become pregnant without intending to before they are ready. Fearing that having an abortion will affect their future fertility may be a factor in whether or not they decide to go through with the procedure.
Women should be free to choose if and when they want to have children. Unfortunately, the negative stigma around abortion often prevents people from gaining accurate information, making it difficult for women to make informed decisions about their course of treatment.
Whether you have had an abortion in the past or are considering an abortion, worrying about how it might affect your future fertility is completely normal and we aim to address these concerns in this article.
There are two types of abortions available, the procedure a woman can have depends on how many weeks pregnant she is.
To start, data shows that an abortion carried out with no complications has virtually no chance of causing future fertility issues. The chance of experiencing any complications that could lead to infertility (assuming the abortion is safely carried out) are 0.23%.
Making a decision about having an abortion shouldn’t be rushed. However, the earlier in pregnancy the abortion takes place, the lower the likelihood of complications is. While major complications are rare, as with any medical procedure, there are potential risks.
It should be noted that according to multiple studies, legally performed abortions have a lower chance of negative outcomes than vaginal childbirth or C-section. In fact, the risk of death from childbirth is 14 times more likely than from abortion.
As previously stated, there is no evidence to support that having had a complication-less abortion in the past will lead to an increased risk of spontaneous abortion, ectopic pregnancy, preterm birth, or low birth weight in future pregnancies.
There is also no evidence to show decreased fertility or difficulty conceiving postabortion. However, in a small number of women who developed an infection and did not treat it right away, there is some risk.
Asherman’s Syndrome is a disorder in which scar tissue lines the walls of the uterus, and can sometimes occur after a surgical procedure such as C and D surgical abortion. One study found that out of 844 women only 0.7% were found to have Asherman’s Syndrome following sharp curettage and repeat curettage procedures.
Unfortunately, most women who have Asherman’s Syndrome do experience menstrual and fertility problems. In a study of 16 women with Asherman’s Syndrome who had not undergone treatment, only three patients achieved term deliveries.
The good news, however, is that hysteroscopic treatment of Asherman’s Syndrome has shown promising results, with a pregnancy rate of 62.5% in women under 35 years of age.
Thankfully, legal and safe abortions have a very low percentage of risk to women’s health and fertility. However, while women in parts of North America and Europe generally have access to abortions, there are many women around the world who do not.
The rate of serious abortion-related complications is much more likely in parts of the world in which the procedure is illegal or difficult to obtain. Many of these cases go unreported, but it is estimated that 8-11% of maternal death worldwide is the result of unsafe abortions.
Restricting the availability of the procedure is the most dangerous risk involved in abortions We must remove the stigma that surrounds abortion in order to give women the right to choose the course of care that is safest for them.
If you’ve decided that you’re ready to get pregnant, you probably already know that certain things like alcohol and smoking can have a negative effect on your fertility. While these substances are never good for your health, you might be wondering how less obviously harmful parts of your lifestyle might play a part in your fertility.
Information about what medications to avoid when pregnant is generally more accessible, but what about when you are trying to conceive? Is it possible that everyday medications could cause fertility loss?
The most common kind of painkillers are Ibuprofen, Aspirin, and Aleve, which are nonsteroidal inflammatory drugs (NSAIDs). The research on the effects that these drugs have on fertility is somewhat conflicted. While the general consensus seems to be that taking NSAIDs in small doses is unlikely to affect fertility, if taken over a long period of time, they could potentially impair ovulation.
Healthy ovulation occurs when an egg reaches maturity and breaks through the ovarian sack as the egg is released. Because this is an inflammatory function of the body, excessive use of anti inflammatory drugs like NSAIDs could, in theory, significantly delay ovulation.
However, studies show that the required dose of NSAIDs that a woman would have to take for this to happen is much higher than normal usage, so taking the occasional Aspirin for a headache should not cause this to happen.
Another study found that taking NSAIDs to delay ovulation could even be useful in preventing the cancellation of IVF cycles, which can happen when a woman ovulates before her scheduled IVF appointment. Planning the exact time of ovulation, though, is tricky, so this might not be as effective in practice.
NSAIDs have been found to have little effect on male reproductivity, again, as long as they are not being abused.
Opioids, such as codeine, hydrocodone and oxycodone are narcotic painkillers prescribed by some doctors for mid level to more serious pain. Taking these drugs during pregnancy can be dangerous for the fetus and should be avoided by pregnant women. In fact, 5.6% of spontaneous miscarriage can be linked to opioid use during pregnancy.
Women trying to conceive should understand that opioids are highly addictive and it may take time to be able to fully stop taking them before becoming pregnant. Also consider how long you’ve been taking the drug.
One study found that out of 47 women taking opioids over an extended period of time, half experienced amenorrhea, also known as abnormal periods and reduced hormone function.
Give yourself some time to adjust once you stop taking opioids. Women who stopped taking opioids less than a month before becoming pregnant were more likely to have babies with birth defects like congenital heart defects and neural tube defects. Though, exact numbers are hard to find.
Around 16.5% of all women worldwide take antidepressants. Depression is extremely common and nothing to be ashamed of, but when thinking about having a baby it is important to consider the possible implications of SSRIs on fertility as well as the potential consequences that could come with stopping these medications.
Data suggests that women who take antidepressants may be less likely to conceive naturally. Unfortunately, there is not enough research to fully back this claim. SSRIs have also been linked to lower sperm count in men.
All antidepressants are found to have some effect on sexual function in both men and women, from decreased libido to erectile disfunction. The dosage on type of SSRIs may be linked to the severity, but not enough research has been done to have definitive answers.
While many doctors may suggest stopping SSRIs when trying to conceive, the decision is not that easy and leaves couples battling depression with a difficult decision to make. Leaving depression untreated has its own implications.
Women with mood disorders who stop taking their medication may not be in the best mental state to worry about prenatal care. In fact, women with untreated depression have a higher chance of giving birth to babies who will develop depression, anxiety and behavioral disorders later in life.
Couples coping with mood disorders, hoping to conceive should talk to a psychiatrist and weigh the risks of stopping their medication. A combination of counseling and varied medication levels may be the solution.
Couples suffering with depression should remember, getting pregnant is only the first step, being healthy parents once the baby is born is crucial and they need to put their mental health first for this to happen.
Studies have found that antibiotics do not have any negative effect on ovulation or menstruation. However, antibiotics such as Penicillin, ampicillin, and tetracycline have been found to decrease sperm production in men.
While the effects seem to improve once medication is stopped, it is not always possible to discontinue the use of antibiotics, especially if your partner is fighting an infection. Consulting a doctor about the pros and cons is advised.
Asthma affects between 5-10% of women all over the world, making it a very common chronic disease that women of reproductive age suffer from.
While many women with diagnosed asthma conceive just as quickly as women without. One study found that women using short acting asthma relief medication were 30% more likely to have taken more than a year to conceive.
While it is unknown exactly the cause of fertility issues in asthmatic women, it is possible that the inflammation in the lungs could be causing inflammation in other parts of the body, such as the uterus.
If you use beta-agonists to treat your asthma, talk to your doctor about a potential alternative before and during your pregnancy.
Immunosuppressive medications are used to treat autoimmune conditions like lupus, psoriasis, Crohn's disease and alopecia. There are many autoimmune conditions, but the main thing that they have in common is that the immune system attacks the body’s own tissues and medication can be used to help reduce the impact.
Immunosuppressives are also almost always taken after a person receives an organ transplant to reduce the risk of the body rejecting the new organ.
While there is again, not enough research to know the definitive outcomes of immunosuppressants on fertility loss, studies show that they are almost certainly linked to birth defects and fertility issues.
Women on these drugs who wish to get pregnant should alter the dosage if possible and should discuss their options with their doctor.
There is no doubt that there is a link between epilepsy and fertility issues in both men and women. The problem is that it is very difficult to determine if these issues are linked to the epilepsy itself or anti-epileptic medications.
Depending on the severity of the epilepsy, some people may need to take multiple anti-epileptic drugs, the main ones being carbamazepine, oxcarbazepine (OXC) and valproate.
Women taking three or more drugs to treat their epilepsy were 18 times more likely to experience fertility problems than women not taking any epilepsy medications. Studies have also found that men taking epilepsy medication experienced sperm abnormalities.
While the exact causation is unknown, epileptic people are more likely to experience fertility issues. Those with epilepsy who want to get pregnant should consult with fertility specialists and neurologists about their options when it comes to changing or stopping their medication.
There has been a lot of talk about the COVID-19 vaccination affecting fertility. According to the CDC, there is no evidence that the COVID vaccine has any negative effect on women planning to get pregnant. If you plan to get pregnant, vaccinating against COVID is recommended for your health and the health of your future baby.
If you are planning to travel overseas and need certain vaccinations beforehand, speak to your doctor about whether or not you should wait a recommended amount of time before trying to conceive. While there shouldn’t be any issues, it is best to be on the safe side.
If you think there is a chance you may already be pregnant, check with your doctor before getting any vaccinations to make sure that they are safe.
There are a few chemicals found in beauty products that have been blamed for fertility issues over the past few years. Ingredients like parabens, triclosan, and phthalates are commonly recommended to avoid. While not enough research has been done to draw a clear conclusion about their effects, it might be best not to use products containing these or other unnatural ingredients when trying to conceive.
Certain over the counter medications may be just fine, while others might be directly linked to fertility loss. If you are trying to get pregnant and take medication or have concerns about how your lifestyle might have an effect on your fertility, it is best to discuss it with your doctor.
Celiac disease, an immune reaction to eating gluten, has been connected to a wide array of symptoms from gastronomical to mental. In some cases people with celiac disease have no obvious symptoms at all, making it difficult to diagnose at times.
While going gluten free might seem like just another diet trend, research shows that this is not entirely true. More and more people seem to be developing celiac disease over time and while the cause is not entirely clear, the consequences cannot be ignored.
Those suffering from undiagnosed celiac disorder may experience a number of health issues but could otherwise unexplained fertility loss be one of them?
While most of us have probably heard the terms celiac disease or gluten intolerance being thrown around in the last few years, we might not know what they mean. In short, celiac disease is an autoimmune disorder in which a person has a negative reaction to gluten, a protein that is found in barley, wheat, and rye.
When a person with celiac disease (CD) consumes gluten, their immune system becomes inflamed and overactive, which when left untreated over time can damage the body’s internal organs, such as the intestines. However, celiac disease can cause a number of symptoms that are not only stomach related.
Some of the main physical symptoms connected to celiac disease are:
Celiac disease has also been linked to some neurological symptoms, with as much as 36% of adult patients presenting with neurological changes such as depression, ADHD and even epilepsy.
People can develop CD at any age and the exact causes of the disease are still unknown. Studies show that while a susceptibility for the disease is inherited, the disease itself is not.
Numbers currently stand at about 1 in 133 people with gluten intolerance. However, it is believed that the numbers are actually higher with many people left undiagnosed.
People experiencing obvious symptoms are more likely to seek treatment. However, it is important to note that people with CD who do not present symptoms will still experience health complications over time.
Recent studies suggest that there is a connection between undiagnosed celiac disorder and reproductive changes in women. Some of these changes include fertility loss, miscarriages, low birth weights, preterm labor and early menopause. One study even found that babies of women with undiagnosed celiac disease who were delivered with a cesarean had a higher chance of developing the disease themselves.
Up to 50% of women with untreated CD have experienced either miscarriage or unfavorable pregnancy outcomes. Pregnancy complications are found to be four times more likely in women with undiagnosed CD than healthy women.
Undiagnosed women also experience a shorter fertility period and have been shown to begin menstruation later and begin menopause two to three years before women who treated the disease.
The numbers speak for themselves, but you may still be wondering how celiac disease causes these reproductive changes.
Celiac disease affects women in two main ways:
While these potential outcomes may be overwhelming, it is important to note that the women who experienced these issues were only diagnosed with CD after their pregnancies. Women with CD who stopped consuming gluten before and during their pregnancies eliminated many of the risks highlighted above.
Experiencing infertility can be extremely stressful, especially when the cause is unknown. Symptoms of celiac disease have also been known to worsen when a person is under an intensified amount of stress. Which when left undiagnosed can increase chances of infertility further.
This information can actually be good news for many women experiencing unexplained infertility. Around 10-15% of women experience unexplained infertility and studies have found that many of these women have dramatic therapeutic effects after cutting gluten from their diets.
Many doctors are becoming more aware that CD may be a cause of unexplained infertility, but if you are trying to get pregnant or are considering it, it may be a good idea to go ahead and get tested for CD even if you do not have any other obvious symptoms.
If you were diagnosed with celiac disease and you still cannot get pregnant, don’t panic. Your body may need some time to recover and adjust to a gluten free lifestyle. One Swedish study of 11,000 women found that fertility was reduced in women for two years after a CD diagnosis, but returned to normal afterwards.
Women with untreated CD are not the one ones who experience fertility loss. Men with undiagnosed celiac disorder may also experience fertility loss, with one study showing up to 19% of undiagnosed celiac men with abnormal hormone and sperm levels.
While there is a lack of information on the subject, there is some evidence that celiac men, like women, who refrain from eating gluten have also been shown to regain normal sperm and hormone levels over time.
Therefore, men who are experiencing unexplained infertility should also be tested for celiac disease even if there are no other clear symptoms pointing to gluten intolerance.
The course of treatment for celiac disease may seem obvious, stop eating gluten.
Thankfully, today, celiac disease is much more widely recognized than it once was and there are many gluten free alternatives available on the market. That being said, a gluten free diet can still be a serious lifestyle change, even for people who don’t necessarily care for bread and pasta. There is gluten hidden in all kinds of less obvious foods that people with CD will need to look out for.
People with celiac disease will need to stick to a gluten free diet for their entire lives if they want to remain healthy. Consuming gluten even in small amounts can cause autoimmune flare ups. Consulting a doctor or dietitian, especially in the beginning of the transition, is highly recommended.
Women with CD planning to get pregnant should also ensure that once they have cut gluten out of their diets, they are not losing nutrients found in glutenous foods such as fiber, folic acid, and vitamin D. There are many options for gluten supplements such as vitamins and other food sources. Again, consulting a doctor is important for determining the right diet for you.
Getting a celiac disease diagnosis may seem discouraging at first. However, the positive results of a gluten free lifestyle for people with CD are extremely encouraging. The long term negative effects of CD decrease to almost zero the earlier treatment begins.
People with celiac disease can expect to live happy, healthy lives as long as they make the necessary changes to their diet. For celiacs, gluten-free means worry free.
When planning for baby number two, women with a history of fertility issues may question how getting pregnant for a second time will be different than the first. The decision to expand the family is an exciting one. However, for couples who have experienced infertility in the past, preparing for a second baby can cause fear, anxiety and uncertainty.
Thankfully, second-time parents have experienced pregnancy before, which can help relieve the stress of the unknown. Taking the time to consider the factors that can affect a second pregnancy can give couples an idea of what to expect this time around.
It may be important to some couples that their children be close in age, motivating them to expand their families more quickly than others. While the decision is ultimately a personal one, not waiting long enough between pregnancies can be risky for both the mother and baby, especially if the previous pregnancy was strenuous.
Research suggests that ideally, women should wait 18 months between pregnancies. The interpregnancy period for women who have a history of infertility issues is not any longer or shorter than for women without.
Pregnancies less than 12 months apart can put infants at risk of congenital disorders such as preeclampsia and in some cases developmental disorders such as autism. Studies found that short interpregnancy intervals carry a 3% increased risk of preeclampsia and two to three-fold increased autism risk. Babies conceived within six months of a previous birth have an 8.5% risk of being born prematurely and the risk of miscarriage in these pregnancies increases by 230%.
Having a baby is no easy task and while it may be natural for new moms to shift focus from caring for themselves to caring for their new baby, it is important that women dedicate enough time after giving birth to recovering both physically and mentally.
Research shows that mothers need at least 12 months post-birth to fully recover in the following ways:
While not waiting enough time between pregnancies is ill-advised, waiting too long to get pregnant carries its own set of risks. One study found that women waiting 72 months or longer between pregnancies were at a higher risk of stillbirth than women who waited less than 6 months. This can be traced back to physiological changes affecting pregnancy in older women.
Couples on their second pregnancy have naturally aged since the birth of their first baby, which automatically decreases fertility in both partners. Parents who experienced fertility issues with their first baby should also take into consideration the role of aging in infertility.
Women who used ART, such as IVF, for their first baby may be worried about how this might affect their chances of having a second child. While there are no guarantees, a recent study published very positive results for IVF baby number two, reporting 43% of women had another baby after just one frozen embryo transfer. After six cycles of frozen embryo transfer between 61% and 88% of women had a baby.
It is important to note that these results differ when using fresh embryos, with successful birth rates standing at 31% after one IVF cycle. Frozen embryos are advantageous especially for women who are older at the time of the cycle than they were upon freezing the embryos.
IVF technology has advanced immensely, giving women with fertility issues a much greater chance at having children than ever before. That being said, science cannot prevent the aging process altogether and women who know they want to have a second baby should not wait too long before starting the process again. The study showed that success rates decreased with age, with women aged 40 at a 20% chance of getting pregnant with fresh embryos.
Women who experienced fertility issues with their first baby are likely familiar with the potential causes of primary infertility and how these factors might affect a second pregnancy. After giving birth, however, women can sometimes sustain damage to their reproductive organs caused by complications during pregnancy or surgery, posing a different set of infertility risks.
Some of the leading causes of reproductive organ damage are:
For parents that experienced difficulty with conception or pregnancy in the past, the thought of going through a similar process again may bring up more feelings of anxiety than excitement. Fertility problems can be traumatic and isolating, leading some to self-blame.
It may be hard to remember, but millions of couples face fertility issues each year. Some may find comfort in the fact that they are not alone in their struggles and can look to support groups or counselors. Building strong support networks either through therapy, friends, or family, can help cope with feelings of fear and loneliness surrounding the topic.
Some may prefer to keep their fertility treatments private. In this case, strong communication between partners is important to maintaining emotional health in the relationship. Setting realistic expectations before trying for a second child can help prepare for emotions that may arise, no matter the outcome.
Sometimes fertility can take center stage, making it easy to forget the importance of self-care. Mothers need to take care of themselves by exercising, eating right, and getting proper rest. Anxiety can negatively affect fertility, so while it may seem difficult, relaxing can actually make a difference.
Becoming as informed as possible can help empower couples by allowing them to make the right decisions depending on their situation. Consulting a fertility specialist is the best way to determine the best course of action.
Families that take time to do their research can regain a sense of control and calm. No matter the chosen path to becoming a second-time, we hope your experience is as smooth as possible.
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.
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.
