Is There a ‘Right’ Time To Get Pregnant?

Guest Blog By Bourn Hall Clinic

Many women deeply passionate and committed to their careers choose to delay thinking about pregnancy. “For me, this was driven by concerns about how it might affect my career path and how my dedication to work might be perceived,” remembers Dr Shreeya Tewary, who knows first-hand the real conflict that exists between the biological clock and the career clock.

Dr Tewary is a Consultant Gynaecologist and IVF Specialist at Bourn Hall in Cambridge and will be speaking at the Rising Festival about common causes of infertility, how to know if you may need support to conceive, and steps you can take towards this.

How age impacts fertility

A woman's body is most fertile from the late teens through the 20s. Although women in their 30s and older can conceive naturally, as time passes the quantity and quality of eggs in the ovaries begin to decline and the risk of miscarriage also increases.

Things to consider when trying to conceive

 About 1 in 6 people can experience some type of subfertility. This can be caused by irregular ovulation (release of an egg), blocked fallopian tubes (the tubes that take the egg to the womb), or conditions such as endometriosis, a painful condition where tissue that would normally line the womb starts to grow in other areas of the body. Men might experience low sperm count or poor sperm quality. 

1.  Timing and frequency of intercourse

In a regular 28-day cycle, ovulation typically occurs about 14 days before the next period. Tracking your cycle may help identify irregularities, which may have an impact on chances of conception.

Aim for regular intercourse (every 2-3 days), especially during the fertile window, which is a few days before and after ovulation. 

2.  Healthy lifestyle 

Being overweight or underweight can affect hormone levels and fertility. For patients with PCOS, even a 5% change in body weight can have an impact on how the syndrome affects ovulation. 

A diet rich in fruits, vegetables, whole grains, and lean proteins can support reproductive health in both men and women. 

A daily supplement of folic acid (400mcg or 5mg) for women is recommended to reduce the risk of birth defects. 

Regular, moderate exercise is beneficial, but excessive exercise can negatively impact fertility. 

Sperm quality is also affected by heat so men should avoid hot tubs and wear looser underwear. 

3.  Manage stress 

High stress levels can affect your sex hormones and interfere with ovulation and sperm production. Consider relaxation techniques like yoga, meditation, or counselling. 

4.  Avoid harmful substances 

Smoking, high alcohol intake, excess caffeine and recreational drugs can significantly affect fertility in men and women.

Some prescribed medicines can also have an impact so check this with your doctor. 

5.  Consult your doctor 

If you have a chronic condition like diabetes or hypertension, talk to your doctor about conception and pregnancy as it is important to manage it well to optimize fertility. 

Any infections should also be treated as these can reduce fertility.

When to seek advice 

Fertility naturally declines with age, particularly after age 35 in women. If you are under 35 and haven’t conceived after 12 months of trying, or over 35 and haven’t conceived after 6 months of trying, consider seeking help from a fertility specialist.

There are a number of fertility health checks that can help to detect any potential contributors to subfertility: hormone tests, an ultrasound scan, testing the patency of the fallopian tubes, and performing a semen analysis.

These can be available through the NHS if you have been trying to conceive for over a year or two, but can also be self-funded without waiting.

Can you predict fertility? 

Ovarian reserve declines with age for all women. This decline is steeper after the age of 35. The rate of decline in any one individual is impossible to predict. An anti-mullerian hormone level is a simple blood test (AMH test) which can assess ovarian reserve. It reflects the number rather the quality of eggs within the ovary. This test does not predict the chances of getting pregnant naturally but does provide information about how someone would be expected to respond to ovarian stimulation as part of fertility treatment.

Balancing infertility and work pressures

Infertility is a type of grief and can have a major impact on mental wellbeing. Dr Tewary is concerned about the levels of stress in the workplace, which can be intensified when trying to juggle a career with fertility testing and treatment.

“We need to foster a workplace culture where women feel fully supported in their decisions regarding family planning,” she says. “It is important for employers to recognise the benefits to women of having children earlier in their careers and ensure that robust processes are in place to support them throughout their journey, including a smooth transition back to work.”

Work culture also needs to become more fertility-friendly, and Bourn Hall has teamed up with Fertility Network UK to facilitate its ‘Fertility in the Workplace’ initiative.

 This programme aims to inform employers about the ways they can support their staff experiencing fertility issues and manage the impacts in the workplace. It also provides resources and practical support to employees.

More information about this is available here:

bournhall.co.uk/fertilityblog/fertility-in-the-workplace-creating-greater-understanding/