Maybe Baby
Will you be able to conceive when the time comes?

Margaret Bream

It’s a sad irony of reproductive biology that women spend decades trying their hardest not to get pregnant, only to find that when the time is right, they can’t conceive. The fertility they took for granted so long is no longer a given. And it’s all about age.

Photo by Photodisc/SuperStock

“Youth is definitely the key to fertility,” says Dr. Peter McComb, a professor of obstetrics and gynecology at the University of British Columbia in Vancouver. “Place your need for fertility early and high in your life options.”

The stats say it all. “Fertility is optimal through the early 20s,” McComb explains. “At age 35, 20% of women will be involuntarily sterile. At 40, the figure rises to 40% and at 44, to 80%.”

“Think about your fertility earlier,” echoes Dr. Roger Pierson, chair of the communications committee for the Canadian Fertility Society and a professor of obstetrics and gynecology at the University of Saskatchewan in Saskatoon. “As an individual, you have to make some very conscious decisions and understand the impact of age on your fertility. It’s the fundamental reality of being a mammal.” While you can’t stop the clock, here are some things you can do to increase your chances of having a baby when the time comes.

1. Deal with menstrual irregularities
   
   Investigate periods that are infrequent, too light, too heavy or excessively painful. Seek medical advice for any unusual growth of facial or body hair or the receding hairline of male-pattern baldness, as these may signal conditions that can interfere with fertility.
   
   
2. Practise safe sex 
   
   Use a condom. Even if you are taking the birth control pill, barrier contraceptives are a must to prevent the spread of sexually transmitted infections (STIs). “STIs are epidemic now,” Pierson says. Since some STIs cause few visible symptoms, they may go undetected. This can lead to infection and scarring of the pelvic organs and, ultimately, to infertility. “Salpingitis, an inflammation that may scar or block the Fallopian tubes, is usually not noticed by a woman,” McComb says. “So protection is the best prevention.”
   
   
3. Don’t smoke
   
   “When you smoke, you are taking up-close-and-personal responsibility for damaging your own fertility,” Pierson says. “Smoking brings environmental toxicants into your body that you can’t get anywhere else.” And these chemicals are preferentially stored in the follicular fluid, the liquid that surrounds the egg. Recent research also suggests that smoking adversely affects the uterus and cervix. The damage is not limited to women. “Smoking reduces fertility in both sexes,” McComb says. Adds Pierson: “Smoking reduces sperm viability and function by at least 50%.”
   
   
4. Maintain a healthy body weight 
   
   Being too fat or too thin can contribute to infertility, as fat cells produce and sequester estrogen and other hormones affecting ovulation. Both overweight and underweight women may have irregular cycles in which ovulation does not occur, or does not occur properly. “Happily,” McComb says, “restoration of a normal weight can assist ovulation.”
   
   
5. Have regular gynecological exams 
   
   Preventive measures such as Pap smears, which look for abnormal cells in the cervix, contribute to optimum health and protect fertility. Any pelvic surgery, such as the removal of ovarian cysts, should be performed carefully to avoid triggering scar tissue, which could interfere with egg retrieval by the fallopian tubes. If you need to have a pelvic surgical procedure, make sure your doctor uses an approach that spares your fertility.
   
   
6. Protect yourself from radiation 
   
   If you require  repeated pelvic X-rays, speak to the radiologist about your desire to preserve your fertility, advises Pierson. The occasional dental X-ray is safe as long as you’re covered with a lead apron.

No one’s saying you should get pregnant before you’re ready and able to be a parent. But if you think you’ll want to have a baby, keep the ticking of your biological clock in mind. The advanced degree, the big promotion, the fancy house can wait: your fertility can’t.