Thinking about having a baby? - ruralhealth.org.au · 2019-01-07 · • Time of ovulation can be...
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Here is what men and women can do to increase their chance of getting pregnant and having a healthy baby. 1. Learn about the top five fertility factors. 2. Complete the ‘Preconception health checklist’ at www.yourfertility.org.au to take to your doctor. 3. Visit your doctor to discuss how to optimise your chance of conceiving and having a healthy baby. 4. Visit www.yourfertility.org.au for more information. Age Fertility declines with age, so if you are thinking about having a baby, consider trying sooner rather than later. On average, women’s fertility starts to decline in their early thirties and declines more rapidly after age 35. The monthly chance of conceiving is about 20% for a woman in her twenties. By age 40 it is only 5%. Men’s fertility starts to decline at about age 45. Men over the age of 40 are 30% less likely than younger men to achieve conception within a year. Consider seeing a fertility specialist if: • the female partner is younger than 35 and you have tried to get pregnant for a year or more • the female partner is older than 35 and you have tried to get pregnant for six months or more. Weight Size matters! Studies show that fertility and the health of a baby at birth and into adulthood are affected by the health of the parents even before conception. • Being overweight can result in hormone imbalances that affect ovulation and sperm quality. • Being very overweight lowers fertility and increases the risk of pregnancy complications. • A healthy diet together with regular exercise can help reduce and maintain weight in the healthy range. • Your doctor can point you in the right direction if you want to lose weight. Top Five Fertility Factors Thinking about having a baby? Talk to your doctor!
Transcript of Thinking about having a baby? - ruralhealth.org.au · 2019-01-07 · • Time of ovulation can be...
Here is what men and women can do to increase their chance of getting pregnant and having a healthy baby.1. Learnaboutthetopfivefertilityfactors.2. Completethe‘Preconceptionhealthchecklist’atwww.yourfertility.org.autotaketoyourdoctor.3. Visityourdoctortodiscusshowtooptimiseyourchanceofconceivingandhavingahealthybaby.4. Visitwww.yourfertility.org.auformoreinformation.
AgeFertilitydeclineswithage,soifyouarethinkingabouthavingababy,considertryingsoonerratherthanlater.
Onaverage,women’sfertilitystartstodeclineintheirearlythirtiesanddeclinesmorerapidlyafterage 35.Themonthlychanceofconceivingisabout20%forawomaninhertwenties.Byage40itisonly5%.
Men’sfertilitystartstodeclineataboutage 45.Menovertheageof40are30%lesslikelythanyoungermentoachieveconceptionwithinayear.
Considerseeingafertilityspecialistif:
• thefemalepartnerisyounger than 35andyouhavetriedtogetpregnantfor a year or more
• thefemalepartnerisolder than 35andyouhavetriedtogetpregnantfor six months or more.
WeightSizematters!Studiesshowthatfertilityandthehealthofababyatbirthandintoadulthoodareaffectedbythehealthoftheparentsevenbeforeconception.
• Beingoverweightcanresultinhormoneimbalancesthataffectovulationandspermquality.
• Beingveryoverweightlowersfertilityandincreasestheriskofpregnancycomplications.
• Ahealthydiettogetherwithregularexercisecanhelpreduceandmaintainweightinthehealthyrange.
• Yourdoctorcanpointyouintherightdirectionifyouwanttoloseweight.
Top Five Fertility Factors
Thinking about having a baby?Talk to your doctor!
Fertile windowMost fertile days
% li
kelih
ood
of c
once
ivin
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OV
ULA
TIO
N D
AY
Day of intercourse relative to ovulation
0%
10%
16%14%
27%
31%33%
0%
-6 -5 -4 -3 -2 -1 0 +1
SmokingSmokinghasdamagingeffectsonthewholebody,includingeggsandsperm.Italsoincreasestherisksofpregnancycomplicationsandhealthproblemsforthebaby.Quittingbeforeconceptionistheonlywaytoreducetheserisks.
AlcoholForwomen,notdrinkingalcoholisthesafestoptionifyouarepregnantortryingtohaveababy.
Formen,avoiddrinkingexcessiveamountsofalcoholtoimproveyourspermquality.
Timing of sexWhenyouwanttohaveababyyoucanimprovetheoddsofthishappeningifyouhavesexduringthe‘fertilewindow’ofthemenstrualcycle.
Ovulationiswhenaneggisreleasedfromtheovary.Thishappenstwoweeksbeforeaperiodstarts.Technically,pregnancyispossibleduringthesixdaysleadinguptoandincludingovulation.But,thelikelihoodofpregnancyisdramaticallyincreasedifyouhaveintercourseduringthethreedaysleadinguptoandincludingthedayofovulation.
Thelengthofawoman’smenstrualcycledetermineswhenovulationoccurs:
• in28daycyclesthemostfertiledaysaredays12to14
• in24daycyclesthemostfertiledaysaredays8to10
• in35daycyclesthemostfertiledaysarebetweendays19and21.
Forwomenwithirregularcycles,yourdoctorcanorderbloodteststocheckifyouareovulating.
Ifallthisseemstoocomplicated,analternativeistohavesexeverytwotothreedays-thatwayyouaresuretocoverallbaseswithoutgettingtootechnicalaboutwhenthechanceofconceivingisgreatest.
Visitwww.yourfertility.org.auformoreinformationaboutthe‘fertilewindow’andanovulationcalculator.
General healthHereareotherfactorsthatcanaffectmaleandfemalefertilityandthehealthofthebaby:
• somemedicalconditionsandmedications,includingherbaloralternativemedicines
• untreatedsexuallytransmittedinfections(STIs)
• ahistoryofgenitalsurgeryorhavingmumpsasanadult
• recreationaldrugsandtheuseofanabolicsteroids
• exposuretopesticides,heavymetals,toxicchemicals,harmfulplasticsorradiation,allofwhichcanaffectfertility.
Talktoyourdoctorifanyofthesefactorsapplytoyou.
Herearesomethingsyoucandotogiveyourbabythebeststartinlife:
• forwomen,takingfolicacidtabletsforthetwomonthsormorebeforeconceptionandinthefirstthreemonthsofpregnancytoreducetheriskofbirthdefects
• forwomen,GermanMeasles(Rubella)inpregnancycancauseseverebirthdefects.YourdoctorwillorderatesttomakesureyouareimmunetoRubellaandifyouarenot,youshouldbevaccinatedbeforeyouconceive
• forwomenandmen,avoidingexposuretochemicalsathomeandatwork.
Questions to ask your doctor
Your Fertility is a national public education campaign funded by the Australian Government Department of Health.
Facts about fertility to share with patients Thisisasummaryofexistingscientificevidenceaboutthe‘Top5FertilityFactors’.Areferencelistisavailableatwww.yourfertility.org.au.Inadditiontothese,manyotherfactorsinfluencefertilityandreproductiveoutcomesincludingsexuallytransmittedinfection(STIs),environmentaltoxins,diet,andexercise.
Age • Women’sfertilitydeclinesgraduallystartingat
about32yearsofage.Itdecreasesmorerapidlyafter35yearsofage.
• Theriskofmiscarriageincreasesasawomangetsolder.
• Thequantityandqualityofspermdeclinesasmengetolder,startingatabout45yearsofage.
• Femalepartnersofmenovertheageof45takefivetimeslongertoconceivecomparedtopartnersofmenaged25orless.
• Asmengetolder,theriskofchromosomalabnormalitiesandbirthdefectsinthechildrentheyfatherincreases.Also,childrenofolderfathershaveanincreasedriskofhavinganautismspectrumdisorder.
• Postponingparenthoodincreasestheriskofinvoluntarychildlessnessandsmallerfamiliesthandesired.
• Assistedreproductivetreatment(ART)cannotovercomeage-relatedinfertility.
• Therisksofpregnancycomplicationssuchasgestationaldiabetes,pre-eclampsia,placentalabruption,intrauterinegrowthrestriction,prematurebirth,stillbirth,andcaesareansectionincreaseaswomengetolder.
Most people want and expect to have children sometime in their life. For some, age and lifestyle factors reduce their chance of having a baby. Health care professionals are in an ideal position to raise awareness about the effects of age and lifestyle on fertility and pregnancy outcomes and the importance of preconception health.
You can help your patients by asking them if they wish to have children and making them aware of the factors that will help or hinder being able to conceive and have a healthy baby. Consultations about reproductive health matters provide an opportunity to begin a conversation about fertility.
The Your Fertility program aims to give women and men who want to become parents the information they need to optimize their chance of achieving this. www.yourfertility.org.au provides clear and accurate information for the general public and health professionals about the factors that influence fertility and pregnancy health.
Fertility facts for health professionals
Weight • Obesityinwomencancausehormonalchangesthat
interferewithovulationandreduceawoman’sfertility.
• Obesewomentakesignificantlylongertoconceivethanwomeninthehealthyweightrange.
• ThechanceofsuccesswithARTtreatmentissignificantlylowerforobesewomenthanforwomeninthehealthyweightrange.
• Inmen,obesityisassociatedwithlowerfertility.Thisislikelyduetoacombinationoffactorsincludinghormoneproblems,sexualdysfunctionand/orotherhealthconditionslinkedtoobesity.
• Obesityinwomenincreasestheriskofmiscarriage,gestationaldiabetes,hypertension,andprematurebirth,congenitalabnormalities,highbirthweight,stillbirthandperinataldeath.
• Childrenborntoobesemothershavepoorerhealthoutcomesatbirthandintoadulthoodthanthosewithmothersinthehealthyweightrange.
Smoking • Smokersaremorelikelytobeinfertile.
• Womenexposedtopassivesmokingtakelongertoconceive.
• Womenwhosmokereachmenopauseearlier.
• Maternalsmokingincreasestheriskoflowbirthweightandbirthdefects.
• SmokingcandamagespermDNA.
Alcohol • Thereisanegativerelationshipbetweenthechance
ofconceptionandtheamountofalcoholconsumed.
• Partnersofmenwhoconsumemorethan20drinksofalcoholperweektakelongertoconceivethanpartnersofmenwhodrinkless.
• TheNationalHealthandMedicalResearchCounciladvisesthatforwomenwhoarepregnantorplanningapregnancy,notdrinkingalcoholisthesafestoption.
Timing of sex • Whileconceptionistheoreticallypossibleduring
the‘fertilewindow’whichisthesixdaysleadinguptoovulation,thechanceofconceptionisdramaticallyincreasedifintercourseoccursduringthethreedaysleadinguptoandthedayofovulation.
• Timeofovulationcanbecalculatedbysubtracting14daysfromtheaveragecyclelength.
• Payingattentiontotheappearanceofcervicalmucuschangescanhelpidentifythefertilewindow.Afewdaysbeforeovulation,thecervicalmucusincreasesandbecomesclear,stretchyandslippery.
• Anovulationcalculatorisavailableatwww.yourfertility.org.au
Fertility facts for health professionals
Your Fertility is a national public education campaign funded by the Australian Government Department of Health.
This list of references reflects current evidence about the impact of parental age and lifestyle factors on: fertility; chance of success with assisted reproductive technology (ART) treatment; pregnancy health; and the health of the baby at birth and into adulthood. The list also includes references relating to the fertile window in the menstrual cycle. In addition to these, many other factors influence fertility and reproductive outcomes including sexually transmitted infection (STIs), environmental toxins, diet, and exercise.
Visitwww.yourfertility.org.auformoreinformationaboutfertilityandpreconceptionhealth.
Age Cooke,Lynne,andScottM.Nelson.ReproductiveAgeingandFertilityinanAgeingPopulation.TheObstetrician&Gynaecologist.2011;13(3):161-68.
deGraaffAA,LandJA,KesselsAGH,EversJLH.Demographicageshifttowardlaterconceptionresultsinanincreasedageinthesubfertilepopulationandanincreaseddemandformedicalcare.FertilityandSterility.2011;95(1):61-7.
D’Onofrio,B.M.,M.E.Rickert,E.Frans,R.Kuja-Halkola,C.Almqvist,A.Sjolander,H.Larsson,andP.Lichtenstein.Paternalageatchildbearingandoffspringpsychiatricandacademicmorbidity.JAMAPsychiatry.2014;71(4);432-8.
Lawson,Gerald,andRichardFletcher.Delayedfatherhood.JournalofFamilyPlanningandReproductiveHealthCare.2014;40(4):283-88.
MazzaD,CannoldL,NagleC,McKayF,BrijnathB.Makingdecisionsaboutfertility:ThreefactsGPsneedtocommunicatetowomen.AustralianFamilyPhysician.2012;41:343-46.
Ramasamy,Ranjith,KojiChiba,PeterButler,andDoloresJ.Lamb.Malebiologicalclock:Acriticalanalysisofadvancedpaternalage.FertilityandSterility.2015;doi:10.1016/j.fertnstert.2015.03.011.
SchmidtL,SobotkaT,BentzenJG,NyboeAndersenA.Demographicandmedicalconsequencesofthepostponementofparenthood.HumanReproductionUpdate.2011;18(1):29-43.
WeightDerbyshire,E.PreparingforPregnancy:Abodyweightperspectiveandupdateoftheliterature.CurrentNutritionandFoodScience.2011;7:216-20.
GesinkLawDC,MaclehoseRF,LongneckerMP.Obesityandtimetopregnancy.HumanReproduction.2007;22(2):414-20.
HammoudA,CarrellD,GibsonM,PetersonC,MeikleA.Updatesontherelationofweightexcessandreproductivefunctioninmen:sleepapneaasanewareaofinterest.AsianJournalofAndrology.2012;14:77-81.
Koepp,UM,LFAndersen,KDahl-Joergensen,HStigum,ONass,andWNystad.Maternalpre-pregnantbodymassindex,maternalweightchangeandoffspringbirthweight.ActaObstetricaetGynecologicaScandinavica.2012;91(2):243-49.
LaneM,RobkerRL,RobertsonSA.Parentingfrombeforeconception.Science.2014;345(6198):756-60.
Fertility factors reference list
Marchi,J.,Berg,M.,Dencker,A.,Olander,E.K.,Begley,C.,Risksassociatedwithobesityinpregnancy,forthemotherandbaby:asystematicreviewofreviews.ObesityReviews2015;DOI:10.1111/obr.12288.
MafteiO,WhitrowMJ,DaviesMJ,GilesLC,OwensJA,MooreVM.Maternalbodysizepriortopregnancy,gestationaldiabetesandweightgain:associationswithinsulinresistanceinchildrenat9-10years.DiabeticMedicine.2014;32(2):174-80.
MoragianniAA,JonesS-ML,RyleyDA.Theeffectofbodymassindexontheoutcomesoffirstassistedreproductivetechnologycycles.FertilityandSterility.2012;98(1):102-8.
TennantPWG,RankinJ,BellR.Maternalbodymassindexandtheriskoffetalandinfantdeath:acohortstudyfromtheNorthofEngland.HumanReproduction.2011;26(6):1501-11.
SmokingAugoodC,DuckittK,TempletonAA.Smokingandfemaleinfertility:asystematicreviewandmeta-analysis.HumanReproduction.1998;13(6):1532-9.
DechanetC,AnahoryT,MathieuDaudeJC,QuantinX,ReyftmannL,HamamahS,etal.Effectsofcigarettesmokingonreproduction.HumanReproductionUpdate.2011;17(1):76-95.
HackshawA,RodeckC,BonifaceS.Maternalsmokinginpregnancyandbirthdefects:asystematicreviewbasedon173687malformedcasesand11.7millioncontrols.HumanReproductionUpdate.2011;17(5):589-604.
HomanGF,DaviesMJ,NormanRJ.Theimpactoflifestylefactorsonreproductiveperformanceinthegeneralpopulationandthoseundergoinginfertilitytreatment:areview.HumanReproductionUpdate.2007;13(3):209-23.
HullMGR,NorthK,Taylor,FarrowA,FordC.Delayedconceptionandactiveandpassivesmoking.FertilityandSterility.2000;74(4):725-33.
AlcoholFloydL,JackB,CefaloR,AtrashH,MahoneyJ,etal.Theclinicalcontentofpreconceptioncare:alcohol,tobacco,andillicitdrugexposures.AmericanJournalofObstetricsandGynecology2008;December:s333-s39.
HassanMAM,KillickSR.Negativelifestyleisassociatedwithsignificantreductioninfecundity.FertilityandSterility.2004;81(2):384-92.
HomanGF,DaviesMJ,NormanRJ.Theimpactoflifestylefactorsonreproductiveperformanceinthegeneralpopulationandthoseundergoinginfertilitytreatment:areview.HumanReproductionUpdate.2007;13(3):209-23.
Klonoff-CohenH,Lam-KruglickP,GonzalezC.Effectsofmaternalandpaternalalcoholconsumptiononthesuccessofinvitrofertilizationandgameteintrafallopiantransfer.FertilityandSterility.2003;79(2):330-9.
Timing of sexBerglundScherwitzlE,LindenHirschbergA,ScherwitzlR.IdentificationandpredictionofthefertilewindowusingNaturalCycles.TheEuropeanJournalofContraceptionandReproductiveHealthCare.2015;Jan16:1-6.
EcochardR,DuterqueO,LeivaR,BouchardT,VigilP.Self-identificationoftheclinicalfertilewindowandtheovulationperiod.FertilityandSterility.2015;103(5):1319-25.e3.
PracticeCommitteeoftheAmericanSocietyforReproductiveMedicineincollaborationwiththeSocietyforReproductiveEndocrinologyandInfertility.Optimizingnaturalfertility.FertilityandSterility.2008;90(Suppl3):S1-S6.
StanfordJB.Revisitingthefertilewindow.FertilityandSterility.2015;103(5):1152-3.
Your Fertility is a national public education campaign funded by the Australian Government Department of Health.
Fertility factors reference list
