As we enter a new year, it’s important to remind ourselves not to panic and to remain proactive when trying to have a baby. Below we discuss some of the changes you can make to optimise your fertility and how a fertility specialist can assist you.
Things you can do to improve your chances
Lifestyle changes
How you live can have a big impact on your fertility, and making some changes to your lifestyle can increase your likelihood of conceiving. For instance, quitting smoking and avoiding the use of recreational drugs benefits the overall reproductive health of both men and women. Other lifestyle changes that we recommend making when trying to fall pregnant (particularly over the silly season) include:
- Consuming caffeine in moderation (1–2 teas/coffees per day)
- Enjoying a safe amount of alcohol (including at least two alcohol-free days per week)
- Exercising regularly but not excessively (30–40 minutes three times per week)
- Maintaining a healthy weight/BMI (there is a lower success with IVF if BMI > 30).
Having a healthy and balanced diet is essential for both your general and reproductive health. Studies have shown that omega-3 fatty acids can improve fertility in women, while diets high in trans fats may reduce fertility. Diet also affects semen quality in male partners – for instance, men who consume fish, shellfish, poultry, wholegrain cereals and fruits and vegetables typically have a better semen analysis than those with diets high in sugar and processed meats and cereals. It’s also important to note that before enjoying your favourite meals, you should avoid reheating food in plastic containers. This reduces your exposure to estrogenic material which can also affect fertility.
Supplements
Folic acid is the main essential supplement we recommend taking while you are trying to conceive. Although folic acid doesn’t directly affect your fertility, it is very important for lowering the risk of spina bifida in the baby. We also recommend taking a good-quality multi-vitamin when you’re trying to fall pregnant.
Stress and anxiety
It’s normal to feel overwhelmed or anxious and to experience lots of uncertainty when embarking on your fertility journey. However, feelings of continual stress can affect your hormones and in turn reduce your chances of falling pregnant. Therefore, we recommend finding a stress management technique that works for you and your lifestyle, which may involve simply stopping and slowing down or calling someone you trust to share how you are feeling. Other ways that you can help lower your stress levels include:
- Incorporating meditation or mindfulness exercises in your daily routine (e.g. with guided apps like Headspace, Smiling Mind, Calm)
- Engaging in a relaxing activity (e.g. cooking, gardening, drawing)
- Trying acupuncture, traditional medicine, naturopathy (seek those with specialist fertility backgrounds).
Online resources specific to fertility and IVF can also help you manage stress and anxiety. Some of these include:
- Apps that provide guided relaxation and mindfulness (e.g. Mindful IVF, IVF relax)
- Podcasts available on Spotify or other streaming services (e.g. IVF warrior playlist by Lisa Dickinson, Fertility meditations imagery and visualisations for IVF by Jackie Brown)
It’s also important to try not to engage in unhealthy coping mechanisms when feeling stressed, such as consuming alcohol or drugs and binge eating.
It’s all in the timing
Timing intercourse significantly increases your chances of successfully falling pregnant. Out of 100 fertile couples who conceived without timed intercourse, 50% fell pregnant within three months. On the other hand, 76% of similar couples who used a method for timed intercourse conceived within the first month of trying.
Women have a fertile window of about five days before until one day after ovulation. While sperm can survive 3–5 days in the uterus and tubes, an egg usually only survives for 12–24 hours in the tubes. This means that in order to have the highest chance of falling pregnant, intercourse should occur during the 2–3 days before ovulation. Cycle lengths vary from woman to woman, so finding the right time to have sex will be based on the individual. Hormone tests that measure LH (a hormone that rises and leads to ovulation) can be used to help work out the best time for intercourse. Other timing techniques include having intercourse when cervical mucus is slippery and clear, or when the basal body temperature of the female partner is lower (it usually rises after ovulation). There are also a number of smartphone apps available to help track your cycle so you can give yourself the best possible chance of conceiving.
Studies have found that pregnancy rates are slightly better in couples who have intercourse daily (37%) than those who have sex every second day (33%). However, couples should decide on the frequency based on their relationship and dynamics, as daily intercourse is also associated with higher stress levels. We normally advise couples to have sex second daily in the lead up to ovulation to boost their chances of falling pregnant.
Becoming fertility aware
Understanding your fertility better (such as when to time intercourse) will help you troubleshoot what may be going wrong. For additional resources on understanding fertility and optimising conception, see this Fertility 101 video series by Two Lines Fertility.
When to seek assistance
Women under 35 years of age are advised to seek help following 12 months of unprotected and frequent intercourse. As fertility declines with age, women between 35 and 40 are advised to seek specialist opinion after 6 months of trying. Some women who may need to seek help despite trying for less than 6 months include:
- Women over 40 years of age
- Women with oligomenorrhoea/amenorrhoea (infrequent or no periods)
- Women with a history of chemotherapy, radiation therapy or advanced endometriosis
- Women with known or suspected uterine/tubal disease.
Male partners with a history of groin or testicular surgery, adult mumps, impotence or any other sexual dysfunction, chemotherapy and/or radiation or a history of subfertility with another partner, are also advised to seek specialist opinion as soon as possible.
Your fertility specialist may ask you to undergo some fertility testing in order to fully understand your fertility needs. Some of these tests are described below.
Male factor evaluation
Semen analysis is the primary test for male fertility. A typical semen analysis involves assessing semen volume, sperm concentration and count, sperm motility (movement) and sperm morphology (shape). If the semen analysis appears abnormal, a second semen analysis will be done six weeks later, followed by consultation with a fertility specialist.
Female factor evaluation
There are a number of different tests that can be used to investigate female fertility, including:
- Basic blood tests to check thyroid function and usual pre-pregnancy screening for infectious diseases
- Ovulation testing
- Uterine examinations (pelvic ultrasound)
- Ovarian reserve tests (AMH testing, ‘Egg-timer test’)
- Laparoscopy and hysteroscopy (especially for women with symptoms of potential endometriosis).
Tubal flushing can also help determine the patency of the fallopian tubes and is sometimes used as a dedicated intervention to increase fertility.
What if all that still doesn’t work?
Couples who have been trying to conceive for a year commonly require assistance with some form of fertility treatment. There are a few different options available depending on your individual fertility needs.
Ovulation induction
Ovulation induction involves taking medications (tablets or injections) to stimulate the production of hormones that grow and release an egg from a woman’s ovary.
IUI (intrauterine insemination)
Intrauterine insemination involves placing a large number of concentrated sperm into the uterus. By doing so, this boosts the chances of sperm meeting an egg and resulting in fertilisation.
IVF (in vitro fertilisation)
In vitro fertilisation is a procedure that involves fertilising the egg with sperm outside of the woman’s uterus, prior to it being transferred back into the womb for the remainder of the pregnancy. There are two steps in an IVF cycle – egg retrieval and embryo transfer. Egg retrieval is performed in hospital under light anaesthetic and typically takes 15–20 minutes. Patients are usually home 90 minutes later and may require paracetamol for the 1–2 day recovery period. Embryo transfer is a short, five-minute procedure guided by ultrasound. Patients do not routinely require an anaesthetic and are able to go back to work afterwards.
IVF with ICSI (intracytoplasmic sperm injection)
Typically, standard insemination is used during the IVF process – the sperm meets the egg and fertilises it within a laboratory dish. However, intracytoplasmic sperm injection (ICSI) is usually recommended when there is suspected or confirmed poor fertilisation results with standard insemination. ICSI involves directly injecting a single sperm into the centre of an egg, bypassing the outer covering of the egg and making fertilisation a bit easier.
In a nutshell
Making your dream of having a baby a reality can take a little time and persistence. There are some things you can do to help improve your chances and some things we can do to help too. Remember, if you are trying to fall pregnant over the silly season, take your multivitamins and don’t party too hard!
To meet with one of our fertility specialists and learn more about how you can improve your fertility or to discuss your fertility treatment options, call Newlife IVF on (03) 8080 8933 or book online via our appointments page.