Fertility

from PAI Diary 2018

VMS

Becoming pregnant is not always straightforward. There are many factors that can impact the fertility of men and women. With couples choosing to have children in later life, patients are seeking information and help more frequently. If a couple have been trying regularly for a period of six months to conceive, they should be referred to their GP so that sperm can be tested, and ovulation can be confirmed.

Factors Affecting Fertility

Age: When women reach 35, the quantity and the quality of their eggs begins to decline as the rate of follicle loss accelerates. This makes conception more challenging as follicle loss results in fewer and poorer quality eggs. Women over 35 are also at a higher risk of having babies with chromosomal abnormalities, or miscarrying. Weight: If the female patient is overweight or significantly underweight, it may prevent normal ovulation. Having a healthy BMI has been proven to increase the frequency of ovulation and result in pregnancy. If the male is overweight, his fertility will be lower than normal. Smoking: Smoking increases the risk of miscarriage and ectopic pregnancy. It can also damage the cervix and fallopian tubes. Smoking cessation is recommended before even trying for a child.

Sexual history: Chlamydia and gonorrhea can cause fallopian tube damage, so patients who have had regular unprotected sex with multiple partners should get an STI check before trying for a baby. Alcohol: Heavy drinking is associated with an increased risk of ovulation disorders and endometriosis.

Positive steps to aid becoming pregnant:

• Eat a healthy balanced diet: If the BMI of both partners is between 20-25, they have a better chance of becoming pregnant. • Avoid alcohol: drinking alcohol in the first three months of pregnancy can increase the risk of miscarriage; the quality of sperm is also affected if a man drinks more than 3-4 unit of alcohol a day. • Take folic acid supplements when trying for a baby and through the pregnancy. These reduce the risk of neural tube defects, such as spina bifida. • Have sex when ovulating: Women are at their most fertile when ovulating, so when trying for a baby, it’s the best time of the month to have sex.

Ovulation Tests

A woman’s body runs on cycles with fertile windows. An ovulation predictor kit can help to identify the two days of the month when she is most likely to conceive. There are changes in the body right before ovulation. An ovulation test works by detecting one of these changes, specifically the increase of luteinizing hormone (LH) levels in urine. The LH surge, as it is commonly called, precedes ovulation by 24 to 36 hours. Predicting the LH surge with an ovulation test, enables her to identify the most fertile time of her cycle — the two days beginning with the surge. Couples can maximize their chances of becoming pregnant if they have intercourse within 24 to 36 hours after detecting the LH surge. Timing is one of the most important factors when trying to get pregnant.

How Pregnancy Tests Work

From the earliest moments of conception, the body is already starting to undergo monumental changes. One of the very first is production of the pregnancy hormone, hCG (human Chorionic Gonadotropin), which can be detected in the blood and urine. hCG increases rapidly, doubling every 36 to 48 hours as the pregnancy progresses, reaching its peak at eight to ten weeks. Pregnancy tests work by detecting hCG levels in urine. When a woman’s urine comes in contact with the specially treated strip on a pregnancy test stick, results appear within minutes, indicating whether or not hCG, the pregnancy hormone, has been detected.

Tips for using pregnancy tests:

• Using a test first thing in the morning is thought to deliver the best results, because urine is the most concentrated at that time.

• Read the instructions carefully, and make sure to follow them, step by step • Use a clock or a timer when taking the test

Advice for after taking the test:

If a woman gets a positive result, they should schedule a GP appointment. If the result is negative, or inconclusive, and her period is not yet late, she should test again a few days later. If a woman has missed her period by a week or more and she is still getting a negative result, she should call her GP.

WWho? Adult, women over the age of 45 are at a greater risk of infertility

WWhat are the symptoms? Being unable to conceive

HHow long have they had the symptoms? Couples trying for longer than 6 months and who do not have risk factors should refer to a GP

AAction already taken? Couples may already be taking