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Couples unable to conceive after a period of time of regular unprotected intercourse. In women under 35 years old, up to 4 in 5 couples should conceive within the first 6 months. Therefore it is reasonable to seek fertility advice and/or investigations after 6 months of unsuccessful trying for conception. In older women, Dr Huang advises seeking fertility advice and /or investigations after 4 months of trying.
Individuals with a known medical condition affecting fertility, including polycystic ovary syndrome (PCOS), endometriosis, irregular menstrual cycles, or previous cancer treatments.
Anyone interested in their fertility status for future planning. This includes single individuals or those in a relationship not currently trying to conceive but who wish to understand their reproductive health and faciliatate informed fertility planning.
Female Factor – 30%
The most common cause of female factor infertility is advancing age. There may also be an ovulation dysfunction, which may be related to abnormality in hormones released from the brain, or hormones from the ovary such as polycystic ovarian syndrome or ovarian failure. Other causes of female factor subfertility include blockage of fallopian tubes or pathology in the uterus including polyps and fibroids. Pelvic endometriosis is another common cause that may compromise fertility. It is found in approximately 30% of subfertile women who experiences no other symptoms of endometriosis, and in 85% of subfertile women who experiences pelvic pain during their periods or at other times. Other conditions which can also compromise fertility include thyroid dysfunction or cancer chemotherapy treatment.
Male Factor – 30%
Causes can include dysfunction in production of sperm, or the delivery of sperm. Other causes such as overexposure to certain chemicals and toxins can also compromise fertility. These include heat, chemicals, tobacco smoke, alcohol, marijuana, and steroids (including testosterone). Treatment for cancer can also impair sperm production.
Combined Female and Male Factor – 30%
It can be a combination of the above mentioned causes.
Unexplained Subfertility – 10%
Infertility where no cause is found.
If there is sexual dysfunction, further hormonal and imaging studies can be done.
Lifestyle factors such as what you eat, how you move, and even how you manage stress can affect your chances of falling pregnant. Some lifestyle factors, such as smoking and other ilicit drugs have very clear evidence of harm on fertility and pregnancy and should be avoided. Other lifestyle factors are less clear cut.
We all know that what we put into our bodies can influence everything we are and become. Generally, what is good for general health will be good for fertility health.
There is no universally accepted theory about diet and fertility. There are just too many different dietary regimes to date that suggests possible benefits on fertility. The reality is that everyone is different and the individual must be taken into consideration. There is not ONE diet that will suit all.
The general principles of eating for fertility includes a well balanced diet, high in fresh vegetables and fruits, whole grain better than refined carbohydrate, lower in processed sugars, lower in animal derived fats (except fish) and higher in good proteins and fats, like nuts and fish oil.
The general consensus leans towards the Mediterranean diet – high in fresh vegetables and lower in animal fats and higher in good plant and fish fats.
If you have concerns about your diet or wish to look more closely at what can be supplemented in your diet, you can see your GP or a dietician or nutritionist to discuss further.
Coffee has become an integral part of many of our lives, and is a topic of great concerns to many while trying for pregnancy.
There is so much inconclusive and conflicting information that care needs to be taken about drawing definitive conclusions.
The more reliable data so far suggests that excessive caffeine intake can increase time to pregnancy and increase miscarriages and stillbirth. This seems to be a dose relationship, where more coffee drinking can lead to more negative effects.
Caffeine can affect women’s hormone level and men’s sperm health. A study found women who drinks less than 1 cup of coffee a day are twice as likely to fall pregnant each time they try, when compared with women who drank more than 1 cup a day . And the more coffee she drinks, the less likely she is to fall pregnant. So while this study may raise concerns about coffee drinking while you’re trying to fall pregnant, it does also show that women who drink coffee moderately can still fall pregnant in the normal span of time.
Another study found men who drink more than 2 cups of coffee a day are found to have a higher miscarriage rate in their partners.
In summary, the link between coffee drinking and fertility is far from clear, but there may be negative effects. Therefore the safest thing to do is to stop drinking coffee while trying for pregnancy. But if you can’t stop, it is good to limit to no more than 1 cup of coffee a day for women and 2 cups o coffee a day for men.
The current national NHMRC guidelines for safe alcohol intake is no more than 10 standard drinks a week, and no more than 4 at one sitting. When you are trying for pregnancy, an even lower intake is advised. Overconsumption of alcohol can negatively affect your health as well as the development of the baby. It can also affect sperm count in men.
There is no established safe level for alcohol consumption while trying for pregnancy and during pregnancy. What this means is that there is no consumption level above which we know is bad and below which is ok. Therefore, it is best to avoid alcohol while you’re trying for pregnancy or during pregancy, if you can.
If you can’t maintain abstinence from alcohol, then risk minimisation and moderation is the key. If you have any concerns about your alcohol intake and what you can do about it, you can see your GP to discuss this further.
Mental health is very important as part of general health as well as fertility health.
You should see your GP before you are ready to try for pregnancy for a general health check up, including a mental health review.
Many women are concerned that it is their very high stress levels that may be stopping them from getting pregnant. Whilst women under stress can still fall pregnant (if we think of the women in war torn countries where they are under unbelievable amount of stress), stress can still affect fertility. We know that there can be observable and measurable changes in the body when we are under stress.
However, it may not be productive to be told to “Just relax” or “don’t stress”. Sometimes the stress of trying not to stress ends up being worse than the initial stress to being with.
Dr Huang advises all of us should aim to moderate stress in our lives rather than eliminate stress. If we are kind to ourselves and others, it is a good place to start. If you feel you need extra supports, remember there is help out there. You can see your GP or a counsellor, and don’t forget your partner, family and friends.
Starting your fertility assessment is a significant step towards understanding and potentially overcoming any fertility challenges. Understanding your fertility situation can make all the difference. It’s about feeling empowered. The results of your fertility investigations will facilitate the conversation regarding your next steps and development of a personalized treatment plan.
Remember, while fertility challenges can seem overwhelming, there are numerous paths to explore with a range of treatment options available.
She holds a Masters of Reproductive Medicine degree and welcomes both general gynaecological patients, as well as fertility patients.
Dr Huang offers fertility treatment through Genea Melbourne City, which is affiliated with Genea. Genea is an industry leader in the provision of fertility medicine services, and consistently achieve IVF success rates that surpass the national average across all recorded measures.
Contact us today to schedule a consultation and take the first step towards realising your parenthood goals.
