Focus On Fertility

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The Style Edit’s, Health Contributor, Dr Doireann O’Leary discusses fertility.

Being a woman in 2018 is a demanding role requiring us to be many things to many people all at once. We’re expected to forge ahead in our career and make the most of the opportunity, education and privilege our generation has been given. It’s almost seen as going against the sisterhood to say you’d rather prioritise family over work life. Career ladder climbing is a juggernaut that’s difficult to jump on and off of. These days starting a family is often delayed to our thirties or even forties by which time our fertility starts to go downhill rapidly. This can be a huge source of stress and even guilt – ‘Mom guilt’ before even being a mother.

We feel pressure to have it all and BE it all – the powerful woman with a killer suit and successful career, up-skilling and pursuing lifelong learning but also the soft, maternal woman wearing a cute apron, raising a family and making homemade cookies for our children… and our men! We need to look the part too; the hair, the clothes, the gym honed physique. Striking a balance between all of these expected roles can be emotionally and physically exhausting. We’re expected to fluidly transition from one to another… sometimes a few times a day. And it’s often women who are toughest on each other.

I speak with women who struggle with this inner turmoil quite frequently. They’re enjoying their work life, making their way to the top and breaking through glass ceilings but when they go home they feel guilt as time moves on and still no children. I’ve met so many women who want their fertility checked ‘just in case’ despite not currently planning for a baby. I always find this an interesting one. “Why do you want to know? What will you do if the results are not so good?” The answer is always that the job will be put on hold. That’s just the reality of it.

Women want to know how they can optimise their fertility. They want to be ready to ‘go!’ when the time does come for career to take a backseat for a while and thankfully there are some things we can do in our everyday life to help optimise our fertility And the good news? The men can do something too – hurrah!

Smoking
Women who smoke are at higher risk of poor fertility, can take longer to become pregnant, and are more prone to problems throughout pregnancy. Smoking causes stress to our DNA, the list of adverse consequences is endless and fertility is very much on the hit list too. It’s not only women who are affected. Men who smoke are also shown to have lower fertility than their non-smoking counterparts. If you or your partner smoke, quit! Your body and your bank account will thank you.

Weight
Being both underweight and overweight can result in fertility issues. One study of 2000 women showed that for every 5kg of weight gain there was a 5% increase in duration of time needed to attempt conception. Having a low BMI can also lead to fertility difficulties. A BMI of 18.5-25 is recommended as the optimum weight for both men and women hoping to conceive.

Exercise
Again either extreme isn’t good. Too much or too little exercise can have harmful effects on a woman’s menstrual cycle and reproductive hormones. Women with a BMI below 25 who regularly vigorously exercise may have trouble conceiving. Cutting back on frequency and intensity of exercise can help. But of course too little exercise resulting in a high BMI is also not good. A healthy balanced approach to exercise is best. If you’re very fond of the gym, like I am, and would find it hard to go less often, try maybe switch to something a little less intense like a light yoga class. Similarly, men who cycle more than five hours a week have been shown to have poorer fertility. 

Alcohol
Women who drink heavily or even moderately are shown to take longer to conceive than women who drink less. Ultimately, the advice is for women not to drink if they are actively trying for a baby. Men get away with more (don’t they always!) as it’s only the ‘heavy drinking’ category that has been shown to have a deleterious effect on male fertility.

Diet and caffeine
There’s no specific diet recommended tohelp fertility but, as always, a healthy balanced diet rich in antioxidants (found abundantly in fruit and vegetables) may have some benefit and caffeine intake should be limited to about 200mg a day. This is about 1-2 cups of coffee a day.

Sexual Health
STIs can silently have a negative impact on our fertility so regular STI screening and good sexual health practices throughout life (i.e. using condoms) are important for future fertility.

Once you do start trying, knowing your menstrual cycle is important. Download an app to find out when you’re ovulating. You’re most fertile from day 1 of your cycle to the day of ovulation. Then the recommendation is to have sex two to three times a week – no wonder working women can have trouble conceiving! If a couple have been meeting this target for one year and haven’t conceived it’s important to meet your GP. For women over 35, it’s recommended to see your doc after six months and both partners should be evaluated.

So all of the above is pretty standard health advice that we all know in the back of our mind but sometimes it’s good for a little reminder. If you’re concerned about your fertility talk to your GP. Don’t stress. You’re doing your best.x

Doireann O'Leary

Dr. Doireann O'Leary. MB BCh BAO

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