Fertility and Infertility For Dummies, UK Edition

Dr. Gillian Lockwood, Dr. Jill Anthony-Ackery, Dr. Jackie Meyers-Thompson, Dr. Sharon Perkins, Jill Anthony-Ackery, Jackie Meyers-Thompson, Sharon Perkins, Gillian Lockwood

• Publisher: For Dummies
• Year: 2011
• Print ISBN: 9780470057506
• eBook ISBN: 9781119998068
• Edition: 1
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

This friendly guide combines professional and personal advice on every aspect of fertility and infertility. From deciding when to seek help and what help to seek, to the emotional, fi nancial, and medical considerations of fertility treatments, you'll be reassured every step of the way with all the support and specialist advice you need to increase your chances of a healthy and happy pregnancy.

Part I

Making Babies as Nature Intended

In this part . . .

Y ou may not have given much thought to the difficulties of getting pregnant – more likely you’ve spent many years trying to avoid getting pregnant! However, after you make the decision to have a baby, you need to look at all the factors that go into having a successful pregnancy, from health issues to lifestyle changes. In this part we look at questions you need to ask before trying to get pregnant, and we give you some basic information on how human reproduction works – and how it will hopefully work for you.

Chapter 1

In the Beginning

In This Chapter

Exploring the odds of getting pregnant

Looking at the connection between age and fertility

Examining the health and finances of your partnership

Combining pregnancy and work life

Researching your family tree

Realising why getting pregnant can be hard today

In the beginning of parenthood, there was Adam and Eve – who, after a bit of fun with a snake and an apple, had baby Cain. Another 62 children later and the first family was firmly established. No worries about not conceiving, no pressure to have more children than their brothers and sisters. Easy! Also, no stress of dealing with parents asking them when they were ever going to give them grandchildren. Lucky Adam and Eve.

This state of affairs didn’t last forever. A few generations later, their descendant Abraham wanted a little Abe, but his wife didn’t get pregnant, so his wife Sarah gave him her maid Haggar so he could have a child with her. Infertility had arrived in paradise, along with surrogacy. Now 5,000 or so years later, you’re ready to start a family and probably thinking it’s going to be easy. You want to have a baby – so have one! And that’s exactly what may happen – no problems. But it’s a fact that 10 per cent or more of the childbearing population all over the world, including about 1.75 million British couples, have problems getting pregnant or staying pregnant.

In this chapter, we look at some of the genetic realities you should be aware of as you think about adding to your family tree, and we discuss some personal and financial matters, too.

Making Babies: An Inefficient Process at Best

The path to pregnancy is an inefficient one even under the best of circumstances. For example, out of 100 couples under the age of 35 trying to conceive, only 20 will get pregnant in any given month, and of those 20, 3 will miscarry. In other words, if you’re under 35, every month, you have a 17 per cent chance of walking out of the maternity ward with a baby nine months later. The chance is highest in the first few months of trying . . . babies do get made on honeymoon!

The good news is that for 100 couples under 35 trying to conceive, 85 couples will be pregnant within one year of trying. Of the 15 women not pregnant after a year of trying, 10, who may be subfertile or have mild infertility issues, will be pregnant after two years of trying without medical intervention. That leaves the other 5 per cent, who may never get pregnant without some help from the medicine (wo)man.

In the UK, the National Institute for Clinical Excellence (NICE) defines infertility as failing to get pregnant after two years of regular unprotected sex.

High-tech infertility treatments, such as in vitro fertilisation (IVF), claim a success rate of about 30 per cent for those under age 35 (see Chapter 12).

If you’re over 35, you’re in good company; 12 per cent of all first-time mums in the UK are over 35! Despite this, Mother Nature doesn’t make it easy to become pregnant past age 35. By your late thirties, only 10 per cent of you will get pregnant in any given month and 17 per cent will miscarry. If you’re over 40, the pregnancy rate, per month, slips to 5 per cent, with 34 per cent miscarrying. By age 45, your chance per month of conceiving is less than 2 per cent, and 75 per cent will miscarry.

Why the decrease in pregnancy and rise in miscarriage as you get older? A baby girl is born with all the eggs she will ever produce – approximately 1 to 2 million – and as she matures, the eggs reduce in number and increase in age, developing chromosomal abnormalities. Men make new sperm every day until their 70s and women are stuck with a dwindling supply of no-longer grade ‘A’ eggs, which may seem unfair, but that’s biology!

Each embryo usually has 46 chromosomes arranged in 23 pairs (made up from an equal contribution from the egg and the sperm). The most common abnormalities are trisomy, the inclusion of a third chromosome of one type, instead of the normal two. At age 20, your chance of having a baby with a chromosomal abnormality such as Down syndrome (also called trisomy-21), or trisomy-13 or -18 (these usually result in newborn death shortly after delivery), is 1/526. By age 30, the risk is 1/385; by age 35, 1/192; by age 40, 1/66; and by age 45, 1/21. Over 70 per cent of early miscarriages are the result of chromosomal abnormalities in the egg, sperm, or both. Table 1-1 pulls all the numbers together.

How Aging Affects Fertility

Whether you’re dealing with fertility or fitness, age does play a role. Whether you feel 15 or 50, whether you look your age or not, your body knows how old you are, and your ovaries do too. Although women have more choices and control in their lives than ever before, our fertility age is pre-destined. Lifestyle issues, such as smoking and being overweight, can shorten our fertile years, but nothing can really increase them. It’s all in the genes.

Calculating your fertility odds at different ages

For women, optimum fertility occurs when you’re about 18 years old. It stays pretty constant in the early part of your 20s and then begins a gradual downward turn. By the time you turn 35, the process has accelerated. When you hit 40, the slide becomes even more dramatic; 33 per cent of women over 35 have some difficulty getting pregnant, and 66 per cent of women over 40 have infertility issues.

Men have it a little easier. Their peak fertility generally remains constant throughout their 30s. It does begin to decline over time, but at a slower pace than their female counterparts. Recent studies, however, do show a rise in chromosomal abnormalities in men over 35, and by age 50, most men show a 33 per cent decrease in the number of sperm produced. So although their problems may be less obvious when it comes to conceiving, the effects of age may play a significant role down the road.

You can keep yourself in better baby-making shape (and better overall health) through common sense ‘healthy living’, including nutrition and exercise. We touch on these topics in Chapter 3. But ultimately, you can’t fool Mother Nature.

Now you may respond with the story of your 18-year-old cousin who couldn’t conceive, your 45-year-old sister who did, or the 80-year-old movie star bouncing the newborn on his knee. Anything is possible. However, statistics provide information on the likelihood of conception, a healthy pregnancy, and babies. These numbers are a resource for determining the best plan of when and how you will conceive. But t...

Table of contents

• Title
• Contents
• Introduction
• Part I : Making Babies as Nature Intended
• Part II : Planning a Pregnancy
• Part III : Tests and Investigations
• Part IV : Eureka! Possible Solutions
• Part V : Post-First Cycle: How You May Feel and What You Can Do
• Part VI : Different Strokes for Different Folks: Options for Non-Traditional Families
• Part VII : The Part of Tens
• : Further Reading