Everything You Need to Know About Fertility
Everything You Need to Know About Fertility

Most of us assume that when we’re mentally ready to conceive, our body will follow suit. Unfortunately, that’s far from the case. DR GILLIAN LOCKWOOD outlines the facts about fertility, so you can make informed choices.

Whatever a woman’s age, there are three components to maximising the chance of conceiving successfully: information, lifestyle and nutrition.


Today’s women must become ‘fertility aware’. One-third of all fertility problems diagnosed in clinic are male-factor in origin and virility is no guide to fertility in men. If your partner had undescended testes as a baby, mumps as an adolescent or has dabbled with bodybuilding steroids, there may be a male-factor problem.


A quarter of adults in the developed world are obese and a significant proportion of would-be parents are reducing their chances of a successful pregnancy simply because they are overweight. Obese women take longer to conceive, are more likely to miscarry and have problems in pregnancy (such as diabetes and high blood pressure). We must get ‘fit to be pregnant’ and so, when planning a pregnancy, make sure you leave time to get fit and lose any extra weight. 

Modern studies have shown that moderate drinkers take longer to get pregnant and are more likely to miscarry than non-drinkers. There is also good evidence that drinking more than two large cups of strong coffee (or equivalent in tea or cola) per day decreases fertility and increases the risk of miscarriage. In relation to smokers, they are 50 per cent more likely to miscarry, twice as likely to have an ectopic pregnancy and only half as likely to succeed if they have IVF.


Extreme anaemia due to iron deficiency is rare, but can cause sub-fertility and is sometimes seen in women on strict vegetarian and vegan diets. The only source of vital minerals such as iron and calcium for the developing baby come from maternal stores, which, in turn, rely on good nutrition, which can be supplemented by pre-natal vitamins. A healthy diet with plenty of fresh fruit and vegetables and a minimum of high fat and high-sugar processed foods should establish a healthy nutritional environment for pregnancy.

When should you seek help, and where?

If you are in your twenties, the statistics tell us that you have an 85 per cent chance of becoming pregnant during the first year you try, so the best advice is to try not to worry as stress can make ovulation erratic.

If you are in your early thirties, it is also reasonable to wait a year before starting investigations, unless there are clear risk factors for sub-fertility.

If you are in your mid to late thirties, your biological clock is starting to run down quite fast and it is important to ask for referral to a specialist fertility centre when you have been trying for six months and not achieved a positive pregnancy test. Early miscarriages are unfortunately quite common in this age range and, although deeply disappointing, a miscarriage should be interpreted positively – it means that the fallopian tubes are functioning and the sperm has fertilising capacity.

By 40, time is of the essence. As soon as you know you want to get pregnant, ask for a hormone test, an ultrasound pelvic scan and a semen analysis for your partner. The chance of IVF working drops by half every year over the age of 40 so, if this is a route you are prepared to take, don’t delay.