Myths & facts
Fact: Female age is the single most important factor affecting a woman’s fertility.3 Women are born with a finite number of eggs which decline in quality and quantity with age. Celebrities having children in their late forties gives women the impression that it’s easy – "if they did it ....so can I" – not realising many of these women have used donor eggs from younger women to help them conceive.
Fact: This is probably true for 15-to-20 year old women, but not the case for many couples trying to conceive today. In fact, 1-in-6 couples will have difficulty trying to conceive. The chance of conceiving, or the fecundity rate, is about 20 per cent per month, with around 70 per cent of couples becoming pregnant within 12 months of trying, and more than 80 per cent falling pregnant by 18 months.13
A woman’s chance of conceiving reduces with age. The monthly chance of conceiving at 25 years of age is 25 per cent, by 30-to-35 years it is 15-to-20 per cent, at 40 years it is 10 per cent and by 45 years, there’s only a 2 per cent chance of conceiving.13
Fact: There can be a delay of three to 6 months after stopping the contraceptive pill for the menstrual cycle to kick in and become regular. Remember, it takes on average around 8-to-12 months to conceive.14
Fact: All women wanting to conceive need a preconception check up with their family doctor. It is very important for a woman to check their immunity for Rubella (German Measles) and Varicella (Chicken Pox) prior to conceiving. If she has no immunity, then the family doctor will organise an injection. This does mean a delay for one month of not actively conceiving. Also the family doctor will conduct an examination, perhaps perform a pap smear, if needed and ensure she has no other risk factors for pregnancy or infertility.15
If a pregnant woman has no immunity and contracts Rubella after coming into contact with someone who has Rubella, then her baby has a high chance of being affected, with potential consequences of deafness, blindness, or mental retardation.15
Fact: A person's weight can affect their fertility. The ideal body mass is between 20 and 24.3 Studies have shown it is much harder to conceive when the BMI is greater than 25 and significantly more so when greater than 30.16
On a positive note, obesity studies have shown that you only need to shed 5-10 per cent of your body weight to improve your chance of falling pregnant.17
Fact: Large studies have shown that timing of intercourse with ovulation has no influence on the sex of the baby.18
Fact: Every woman's menstrual cycle is different and each cycle can vary. Ovulation occurs 14 days before the first day of menstrual bleed.3 Therefore the ovulation day will depend on the actual length of the cycle from one bleed to the next. Women can determine their fertile day by using ovulation test sticks.
Fact: Women thinking of conceiving need extra supplementation of folic acid, iron and iodine.3 This can be bought in a pre-conception and pregnancy supplement area of a pharmacy.
A recommended folic acid dose of a minimum of 400mcg per day helps to reduce the risk of birth defects like spina bifida. Foods containing folic acid include green vegetables, beans and cereals. However they will not be sufficient alone, so it is vital that a woman takes a daily folic acid supplement from at least a month prior to conception and for a minimum of the first 12 weeks of pregnancy. Iodine is needed for foetal brain development, and iron requirements increase in pregnancy and reduce the risk of anaemia.3
Fact: Many women and men tend to carry on as usual with their partying lifestyle. After all, they have been doing this for years with their friends. Smoking, an unhealthy diet and excess alcohol have been shown to have some effect on fertility and pregnancy. Cigarette smoking of more than 10 a day reduces fertility chances by 25 per cent. Smoking also has a detrimental effect on obstetric outcome, with higher caesarean rates as well as effects on foetal growth, causing low birth weight.17
Alcohol in quantities of more than 10 glasses a week reduces fertility by 10-30 per cent. Couples need to modify their lifestyle by reducing their alcohol and stopping smoking. In other words, get themselves fertility fit!17,19
Fact: You can have sex anytime you like, but your chances of conceiving are on finite days. The right time in your cycle is the three days leading up to, and the day of your ovulation. Once ovulated, the egg has 24 hours to be fertilised by sperm before it dies, given sperm can survive in the fallopian tube for up to 3 days.3
Surprisingly many women get their timing wrong. Yet we know that women who are aware of their fertile days have an increased chance of conceiving.3 When timing is difficult, the next best thing is to have sex at least three times a week.
Fact: This is incorrect. Men's fertility is also important when trying to conceive. Studies reveal that 40 per cent of infertility problems are linked to the male.7
Men need at least 39 million in the ejaculate with at least 35 per cent swimming in a forward progressive movement.20
Fact: This is not so. When there is no ejaculation for a week or more, the sperm stored in the epididymis of the testes deteriorate in quality. The longer sperm wait around in the testes, the more likely they can be attacked by free radicals, leading to sperm damage.21
The Fertility Society of Australia recommends frequent ejaculation. In fact, daily ejaculation will help the quality of the sperm and its function.
Fact: No, this will not make any difference! After sex, the best sperm will quickly swim through the cervix into the uterus, to the fallopian tubes. Any fluid left behind is from the prostate gland.
Fact: Nearly everyone has stress in their life. Stress and lack of sleep could certainly reduce the frequency of sex, and timing of the fertile window, but it’s not yet clear whether stress has any direct effect on eggs and sperm.
If a couple are taking longer than 12 months to conceive, then the recommended guidelines from the Fertility Group of Certificate of Reproductive Endocrinology and Infertility (CREI) specialists is referral to a fertility specialist for review and investigations.
However, if a woman is over 35 years of age, then the recommendation changes to seeing a fertility specialist after 6 months of trying to conceive.
3. Conceiveplease™ Getting pregnant naturally.
13. American Society of Reproductive Medicine (2012) Age and Fertility: A Guide for Patients. Available at: https://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/agefertility.pdf. [last accessed October 2015].
14. Barnhart KT, Schreiber CA. (2009) Return to Fertility following discontinuation of oral contraception. Fertil Steril.;91(3):659-63.
15. Australian Government Department of Health and Ageing. Clinical practice guidelines: Antenatal care – module 1 (2012). Available at: https://www.health.gov.au/internet/main/publishing.nsf/content/015FBFDD266795DBCA257BF0001A0547/$File/ANC_Guidelines_Mod1_v32.pdf. [last accessed October 2015].
16. Balen AH (2007) Impact of obesity on female reproductive health: British Fertility Society, Policy & Practice Guidelines’, Human Fertility.;10(4):195-206.
17. Sharma R, Beidenharn KR et al. (2013) Lifestyle factors and reproductive health: taking control of your fertility. Reproductive Biology and Endocrinology.;11(66).
18. Wilcox AJ, Weinberg CR, Baird DD. (1995)Timing of sexual intercourse in relation to ovulation. Effects on the probability of conception, survival of the pregnancy, and sex of the baby. New England Journal of Medicine.;333: 1517-1521.
19. Jensen TK, Hjollund NH (1998) Does moderate alcohol consumption affect fertility? British Medical Journal. 317;7157.
20. New 2010 WHO Standards (5th edition) for the Evaluation of Human Sperm. Available at: http://www.aab.org/images/aab/pdf/2014/CRBPPT14/NotesMM%20WHO.pdf. [last accessed October 2015].
21. Wogatzky J, Wirleitner B et al. (2012) The combination matters - distinct impact of lifestyle factors on sperm quality: a study on semen analysis of 1683 patients according to MSOME criteria, Reproductive Biology and Endocrinology. 10:115.