Let’s Talk About Fertility is a series sponsored by Vhi Healthcare that deconstructs the stigma around infertility, inspired by the stories of couples who have experienced it and the doctors and counsellors who help them every day.
PLANNING A BABY but not entirely sure how long ovulation lasts, whether you should be taking supplements, or at what stage you should see a doctor?
We wracked the brains of Declan Keane, Senior Clinical Embryologist and founder of ReproMed, to separate fact from fiction when it comes to conceiving.
It’s no secret that fertility, and consequently your chances of conceiving, decreases for most of us as our age increases. But does it take a sharp turn?
Unfortunately, as women approach their late thirties, their anti-mullerian hormone (AMH, an indicator of your egg reserve in your ovaries) does tend to decrease significantly. However, this isn’t true for every woman trying to conceive. Declan says:
Thirty-six is this barometer where you should be assessing your own fertility. However, I see people at 42 with the AMH of a 32 year old and vice versa so it really depends on you as an individual.
Regular exercise is advised for anyone trying for a baby, and Keane suggests that women try to avoid a BMI of 30 or over. However, he says too much intense exercise can actually be damaging.
“Women should be careful not to exercise excessively. Fat deposition on females is important for fertility,” he says. Similarly, Keane warns that men over-consuming protein shakes to complement their workouts can lower sperm count.
In terms of weight, both being underweight and overweight can be an issue, so although a healthy level of exercise can play a role here, it’s important not to overdo it while working out if you’re trying to conceive.
The role of diet in producing high quality sperm and eggs is actually so important that Keane has seen an increase in involvement of nutritionists in the fertility process: “Looking at your diet and ‘fixing’ your body can really improve your chances of conceiving.”
Keane recommends that along with complex carbohydrates and a varied diet, to consider taking Omega-3 fatty acids, CoQ10 and antioxidants, which improve cell health.
Additionally, drinking and smoking have long been heralded as a threat to fertility (the latter damaging ‘genetic cell integrity’ in both sperm and eggs). These two habits can be some of the most damaging of all lifestyle choices on your fertility – in fact, says Keane, “you should significantly reduce or eliminate alcohol if you’re trying to conceive.”
The rule of thumb currently when it comes to seeking medical help is that if both partners have no health issues, you should wait for a year of trying. However, if you’re within a particular age bracket, that time period shortens, says Keane:
If you’re over 36, you should be trying for six months. If you’re not getting any success, see a family GP. It’s about educating yourself about your natural fertility and conceiving naturally. People get caught up in old wives’ tales so education is very important.
It can be easy to assume that you won’t have an issue conceiving until the time comes when you want children. But Keane urges that it’s worth assessing that by the time you are thirty:
I would definitely call on men and women to assess their fertility at a younger age – a sperm test for men and an anti-mullerian hormone (AMH) test for women, which indicates how many eggs you have left in your ovaries.
These simple tests can be done way ahead of planning a family or your first child, says Keane:
Younger women should really assess their fertility at thirty. Why wait for the problem to arise? Assess your fertility ahead of time and understand it. Then you’re forewarned before the quality and quantity of eggs decreases.
As it can often be difficult to time exactly when a woman is ovulating, it can be tempting to use ovulation kits, which Keane warns aren’t always the best option, especially in relation to reducing stress between couples:
They often give false positives and therefore you are taking a little bit of the control away from the couple. They can be relying too heavily on it – which induces a lot of stress for the couple and the result is that they are no longer making love, they are now just making a baby.
Instead, Keane says that “regular timed intercourse during the middle of the woman’s cycle is the best way of covering the fertile period”. The good news is that sperm will last within a woman’s body for two days, so by covering day 12, 14 and 16 of a cycle particularly, you shouldn’t miss ovulation.
If you do decide to go down the road of In Vitro Fertilisation (IVF), there are a few warnings you should abide by to ensure the highest possible level of success. While Keane says that chinese medicine can be useful as a method, it’s important not to mix therapies during the actual treatment.
We do ask people not to use complementary therapies while going through the IVF process. For example, Chinese herbal medicines should be avoided during that particular time as we want to control and mimic your natural fertility without any other unknowns.
Keane also warns that as there will be a number of scans involved, it is advised that just during your treatment that you don’t travel too far. Equally a healthy lifestyle will make for the highest quality sperm and eggs – but “IVF should not take over your lives either”.
Not only does Keane advise that counselling is recommended, he predicts that it will be made “part and parcel of IVF treatment under draft legislation from the government”. Counselling, he says, “gives people the tools for ups and downs of emotional rollercoaster of treatment or taking longer to get pregnant”, and managing stress can be an important issue for couples struggling to conceive.
Learning and using these tools from counselling is especially crucial in the case of using donors, says Keane:
If you’re using donors for either sperm or eggs, you must have counselling – it’s absolutely essential. There are longer term implications for this treatment like should we tell the child, how do we tell them and at what age. Counselling can give you tools to handle these questions.
Let’s talk about fertility and plan ahead with Vhi Healthcare’s new range of fertility benefits. Vhi Healthcare’s fertility benefits are designed to help you at every stage of your journey, from initial investigations and advice, to counselling and fertility treatment including IVF. For more information, visit vhi.ie/fertility.
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