On Board for Baby

Fertility and reproductive health raise a lot of questions. Here’s where you can go to find answers.

Numerous factors contribute to fertility issues in women, but the most powerful one—and perhaps simplest—is age. Beginning around 30, a woman’s chances of getting pregnant naturally diminish somewhat. Since 20 percent of women today now have their first child after 35, age has become increasingly significant in fertility struggles.

“One of the big problems that we encounter is delayed childbearing, and the lack of awareness that people have that that can be detrimental to their fertility,” says Dr. David Olive of the Wisconsin Fertility Institute in Middleton.

Olive says a woman’s ability to conceive a child drops steadily throughout her 30s, with benchmarks at 35 and 37. By age 40, “the decline really has accelerated tremendously,” says Olive.

Interestingly, Olive says one of the unfortunate byproducts of today’s obsession with celebrity is that tabloids give the impression a baby is possible at any age. Example after example of women giving birth in their 40s and even their 50s can create a false sense of security about pregnancy options. Of course some women can still get pregnant at these ages, but it’s likely they’re using someone else’s eggs to do so (yet another truth the tabloids let slide.)

“Donor eggs are a very efficient and excellent method for people to get pregnant once they have reached a certain age, but confidentiality keeps the magazines from printing that,” says Olive. “So when people who are famous become pregnant in their 40s and 50s, it makes it look like it’s easy to get pregnant any age. And it’s not.”

Don’t Wait to Visit Your Doctor

Though delaying pregnancy is a perfectly valid choice, women may not realize just how big a factor age can be—and therefore arrive at the doctor’s office later rather than sooner.

“We see are a lot of people who tried to get pregnant starting at age 33 or 34,” says Olive. “They may have waited a couple years to go see their doctor. Now they’re 36, their doctor says, oh, I think we can try a few little things here, and before you know it they’re 38 years old and coming in to see me. And at that point, although not too late, it would have certainly been more efficient had they come in three years earlier.”

According to Olive, a good rule of thumb is that any woman of any age who has not gotten pregnant after a year of trying should pay a visit to her doctor. If she’s over 35, six months is long enough. Three months is sufficient after the age of 40, or skip the wait entirely.

“You can always come in for a consult at any time,” says Olive. “It never hurts to know your situation a bit clearer.”

But age is not the only factor when it comes to determining a woman’s chances of getting pregnant. Family health history, weight, stress and nutrition all play a role—as do other considerations.

Know Your Risks

At Wisconsin Fertility Institute, doctors conduct an initial consultation that lasts approximately an hour and a half, during which each woman’s unique needs are assessed. After preconception counseling and a general evaluation, there is a determination of whether certain tests are needed. One key benefit of working with a fertility specialist is that women can prepare for pregnancy long before it occurs, as well as maintain optimal health in those early critical weeks.

“Many times a pregnant woman doesn’t see her doctor until she is 10 or 12 weeks along,” says Olive. “But there are several things that are important to pay attention to well before that time.”

Sexual lubricants may be preventing pregnancy from occurring, even if the package states it is safe. “There is not a single lubricant out there that doesn’t kill sperm to some extent,” says Olive. “We have people who have never been told that before, who come here and have been trying for five years to get pregnant.”

Another issue women may be unaware of is the role their own thyroid plays in early pregnancy. A fetus’s brain begins to develop at four weeks, but its thyroid gland doesn’t develop until 12 weeks—and thyroid hormone is crucial to brain development. Therefore, between weeks 4 and 12 of pregnancy, the fetal brain relies on the mother’s thyroid levels. A simple thyroid check before conception will determine if any further action is needed.

Genetic diseases are another key factor. If a woman and her partner are genetically incompatible in any way, there’s a good chance that mother and her baby could be, too. Each ethnic and racial group has a different set of diseases for which it has a particular risk, so genetic testing may be in order.

Many people are aware of the risks of high caffeine intake throughout pregnancy, but recent studies show caffeine may also contribute to miscarriage. “There’s accumulating data now that over 200 mgs a day of caffeine will increase the risk significantly for miscarriage,” says Olive. “A fresh brewed cup of coffee is about 150 mgs, so it doesn’t take that much to put somebody over the top.”

Finally, never underestimate the impact of stress and nutrition on a woman’s chance of getting pregnant, or on maintaining that pregnancy. Olive says from an evolutionary standpoint, decreased fertility when a woman is under stress makes sense. “When the female body detects illness, one of the first things that it tends to shut down is reproduction,” says Olive. “So when people are starving, under a lot of stress or in an unstable situation, that decreases fertility or even causes miscarriage.” Quitting smoking, avoiding alcohol and other drugs, eating a healthy diet and avoiding stressful situations is not only useful advice for pregnancy—it’s sound advice for increasing fertility. 

“The bottom line is we can help you, “ says Olive. “The sooner we can see you, the better we can do that.”


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