Women’s health – particularly uterine and fertility health – has been shrouded in mystery for too long. Our mission is to shine a light on this and help all women better understand their bodies to improve fertility outcomes. There are some questions we get asked quite regularly, as such, we’ve compiled the answers to some of those common questions here.
- At what age does a woman stop being fertile?
- What are the biggest misconceptions when it comes to fertility / trying to conceive?
- How long should it take for someone to conceive?
- What is the usual timeframe for IVF?
- Can a previous abortion affect my fertility?
- How does endometriosis affect my fertility?
- Can the length of my cycle affect my fertility?
- How can I boost my fertility?
- Why is it important to monitor oxygen and temperature levels?
- Are fertility rates dropping?
- How is your fertility rate calculated?
- How does your fertility change with age?
- When is your fertility at its highest? (change rate)
- What fertility treatment is best for PCOS sufferers?
- Why does IVF fail?
- What fertility treatments are there?
1. At what age does a woman stop being fertile?
It’s important to note that every woman is individual, and as such there’s no collective answer to this question. What we do know is that the mean age most people go through the menopause is 51, however they will be perimenopausal for a number of years prior to this.
Your fertility is most optimum in your twenties, and by 35 you are potentially looking at less ovarian reserve. This doesn’t mean that you can’t conceive naturally after this, but it might be more difficult. If you’re looking to have a baby around or after 35, it’s a good idea to arm yourself with as much information about the various tools or tests you might want to undertake to make your chances of conceiving as high as possible.
2. What are the biggest misconceptions when it comes to fertility / trying to conceive?
A couple of misconceptions I see is that IVF will fix it and it’s a one-stop shop to conceive. It’s amazing that we have this tool to support people who are struggling to conceive naturally, however it shouldn’t be viewed as a fail-safe one-time option.
The first IVF baby was born less than 44 years ago, and we’re still learning so much about how we can increase the success rates, but one lesser known fact is that IVF gets more effective the more rounds you go through. On the first round, the success rate is approximately 33%. As your doctors fine-tune and your body appears to learn too, this chance continues to increase with every round. Whilst we all hope that it’ll work first time, preparing yourself for the idea that it might take two to three rounds will help alleviate some anxiety and disappointment if you don’t have success straight away.
3. How long should it take for someone to conceive?
Out of the general group of people who are looking to conceive, approximately 80% of those will have done so naturally within 12 months. After this, out of the remaining 20%, half will have conceived within another six months. For the final group of people who have had no success conceiving naturally after this 18 month period, they may need medical intervention to help them conceive.
4. What is the usual timeframe for IVF?
Once you’ve been referred to an IVF specialist the timeline from that initial referral to your first cycle can differ enormously. If you’ve gone through the NHS, the average wait time is approximately nine months, however this does vary depending on where you live.
Once you’ve had your referral and you have your appointment booked, your first cycle of IVF will take around six weeks. For those who are on a short protocol, this could be as little as three weeks, but your doctor will be able to advise on which is most appropriate for you following initial tests.
You can run IVF cycles back to back, but it is generally recommended that you take a small break. Again this is very much down to the individual and how they’re feeling physically and emotionally as to whether they’re ready to start again and also on the recommendations of your doctor. There’s no right or wrong timeline to follow as everybody is different. What matters is that you go at a pace you feel comfortable and ensure you’re taking care of yourself both physically and mentally.
5. Can a previous abortion affect my fertility?
Having an abortion has no impact on your fertility later down the line if there were no previous complications as a result. If you did contract an infection, as long as this was treated at the time there should be no future impact.
6. How does endometriosis affect my fertility?
Endometriosis is graded from levels 1 to 4 depending on the severity, and struggling to conceive is one of the potential impacts for sufferers. This does not mean however, that everyone who suffers with endometriosis won’t be able to conceive. Whilst it might take a bit more time, the majority of endometriosis sufferers who would like to have children will go on to do so.
Things might be a bit harder if you have grade 4 endometriosis, however this is where it’s important to consult with your doctors to work out a bespoke plan of action for your circumstance, which might include IVF.
7. Can the length of my cycle affect my fertility?
Normal cycles can range from 25-35 days. If you’re having short cycles, as long as the luteal phase (which is the phase in which your uterine lining gets thicker in preparation for pregnancy) is long enough to support an implanted pregnancy, this shouldn’t have any impact on your fertility.
If you’re having long and lengthy cycles, for example sufferers of PCOS might only have two to three menstrual cycles per year, the amount of time in which you can conceive in a year is reduced.
8. How can I boost my fertility?
Unfortunately there’s no tick list to look at when it comes to ways of boosting your fertility, however there are some simple lifestyle changes that can have a positive impact. I’ve chosen my top three to follow below:
Balanced Nutrition – There are no specific studies which highlight that one diet is better than another when it comes to boosting or improving fertility, but my advice would be to ‘eat the rainbow’. Make sure you have plenty of variety when it comes to fruit & veg, choose whole grains where possible and ensure you have a good source of omega 3 too. If you are looking to follow a specific diet, the mediterranean includes all of these factors. Whilst we might not be able to jet over to enjoy the sunshine, we can certainly dish it up.
Avoid Alcohol – Whilst we’re all aware not to drink alcohol whilst pregnant, there are studies to suggest that avoiding it completely whilst trying to conceive can improve your chances of a successful pregnancy.
Supplements – Make sure you’re taking the right supplements for you. Folic acid and Vitamin D are some of the most commonly associated with pregnancy care and for good reason. Folic acid helps to prevent some birth defects and whilst green leafy vegetables do contain folate, it’s difficult to get the right amount through food alone. Vitamin D is important for everyone, not just when you’re pregnant, but it’s especially important during the dark winter months. You should be having 10 micrograms of vitamin D every day to keep the calcium and phosphate levels within our bodies regulated. Another supplement you might want to investigate is CoQ10, which may improve the mitochondri of the cell, but it’s always advisable to consult with your doctor to make sure you’re on the right combination of supplements for you.
9. Why is it important to monitor oxygen and temperature levels?
There have been several studies monitoring whether fluctuations in both temperature and oxygen levels during the early development stages of the embryo whilst in the lab has an effect on the quality. Current evidence suggests that fluctuations in both of these measurements can indeed impact the quality of the embryo and its development.
Whilst conditions in the lab are continuously monitored and can be adjusted, we haven’t been able to take these measurements from the uterus until now.
IRIS measures both the oxygen concentration and temperature of the uterus to determine a baseline level for each. Your doctor can then use this information to gauge whether the conditions the embryo is kept at in the lab is of similar levels or if there might need to be some adjustments made to increase the chances of a higher quality embryo.
10. Are fertility rates dropping?
You might have seen on the news that fertility rates have been declining, and this could be down to a whole array of factors including increased availability of education and contraception, societal expectations shifting and people are on a whole leaving it later in life before they make the decision to have a child.
11. How is your fertility rate calculated?
There’s no scientific way to calculate a “fertility rate” as there are so many different factors at play throughout each fertility journey. If you’re undertaking IVF, you will likely have an AMH (Anti Mullerian Hormone) which is used to gauge your ovarian reserve or how many eggs you’re likely to have in your ovaries. This is useful as part of a wider fertility MOT and shouldn’t be the only test you use to gauge your fertility rate, as other blood tests and your medical history will be able to provide a clearer picture of your overall fertility health.
12. How does your fertility change with age?
As a female, you’re born with all of the eggs you’ll ever have in your ovaries. As we go through puberty into adulthood and through all the way to the menopause, we will lose one or more eggs during each cycle. As we get older the quality of the eggs can also be diminished, which can have a direct impact on our fertility if we choose to have children later in life.
13. When is your fertility at its highest? (change rate)
Your optimum fertility years are from your late teens through to your early thirties. From the age of 35 onwards is when we typically see fertility levels start to decline, in part due to both a reduced reserve and lower quality eggs remaining.
14. What fertility treatment is best for PCOS sufferers?
It’s important to say up front that the majority of women with PCOS won’t necessarily need IVF as long as they are ovulating regularly, but if you do suffer from it and are struggling to conceive, the first line of management is lifestyle. Eating a balanced diet, exercising regularly and managing stress levels can all have positive effects on your hormone levels and insulin sensitivity.
The second line of treatment if you’re still struggling to conceive often involves ovulation induction medication such as clomiphene or letrozole. These medications help induce ovulation by regulating hormone levels to promote the growth and release of eggs from the ovaries.
If this is unsuccessful, further investigation might be required, with IVF as a potential next step.
15. Why does IVF fail?
The answer to this is as unique as every person undergoing fertility treatment, but the three most common reasons why IVF can fail are egg health, sperm health and issues with the implantation within the uterus.
You should never view IVF as a one-stop shop, instead look at it as a course of treatment which might include 2-3 rounds or more. During every round you and your doctor will learn more about your body and how it’s responding and be able to adjust and finetune your IVF plan to give you the absolute best chance of success.
16. What fertility treatments are there?
Your doctor will be able to advise on the best fertility route for you, but the most common are as follows:
Ovulation induction – This uses hormonal therapy to stimulate ovulation. This is less commonly used now, but is a good option for people who suffer from irregular menstrual cycles or conditions such as PCOS.
IUI – Intrauterine Insemination (IUI) is most commonly used by same-sex female couples or those who have arranged for a sperm donor. The sperm is placed directly into the uterus without any previous contact with the egg so fertilisation will occur in the body.
IVF – In Vitro Fertilisation (IVF) is where fertilisation will take place outside of the body. Eggs are removed from the ovary and combined with sperm to create an embryo. This embryo is then transferred back to the uterus to continue growing.
ICSI – Intracytoplasmic Sperm Injection (ICSI) is typically used for males with fertility issues. The sperm is collected and is injected directly into the centre of the egg before being placed back into the uterus.
If you’re struggling to conceive naturally and have been referred to a fertility expert, please get in touch with us to see how IRIS can support you on your journey.
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