Fertility Journal

Common sense and having a baby

Much of the information and advice about improving fertility is based upon sound common sense. The odds against conception are fairly high in every cycle. So patients should do all that they can to try and shift the odds in their favour as much as possible. It makes sense to be tingling with health and vitality when trying to conceive.

There have been a lot of recent headlines about older women becoming mothers after IVF. It is not always wise to defer pregnancy because of the perceived demands of a career. Science cannot be relied upon to bail women out if they leave the decision to have a family until into their 40s and beyond. The number of women who first seek medical advice in this age group is significant and increasing; and the majority of these women will sadly fail to conceive.

Being significantly overweight can lead to irregular cycles and interfere with normal ovulation. There may be associated polycystic ovary syndrome (PCOS) which is relatively easy to treat once the weight has been lost. So the message must be to lose weight. Of course every antenatal clinic will have some hugely obese patients but they may not be the happiest women in the clinic and their pregnancies are certainly more hazardous.

Obesity can affect male fertility too. Sperm production may be reduced, both in sperm numbers and sperm quality.

The link between cigarette smoking and infertility is well documented. Smoking will reduce the chance of natural conception and even halve the chances of IVF being successful. Furthermore smoking significantly increases the risk of miscarriage and stillbirth. It is the commonest cause of “sudden infant death”.

All women trying to become pregnant should have a blood test to ensure that they are immune to Rubella. A vague history of having had Rubella as a child or even a history of having had a Rubella vaccination is unreliable. A small proportion of these vaccinations are either ineffective or immunity is lost.

Alcohol for the male partner may not only prevent him from being able to rise to the occasion but is also top of the list of causes for low sub-fertile sperm counts.

Pre-conception folic acid continued until the 13th week of pregnancy will dramatically reduce the incidence of spina bifida and other related conditions affecting the baby.

It can be so demoralising when a pregnancy does not occur within a few months of trying. The majority of GPs are very aware of the stresses that infertility can bring and are able to set in motion initial investigations and if necessary refer you on for specialist advice and investigation.

And finally…

If you are successful in becoming pregnant particularly after a long history of infertility or after complex fertility treatments such as IVF, remember that you are not like other women who may become pregnant without difficulty. This pregnancy may be your only opportunity ever of having a baby. You cannot afford to take chances or risks. Early booking into a consultant unit is essential. An antenatal problem may indicate admission. A potential problem in labour may indicate the need for an operative delivery.

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