7 Fertility Lessons from People Who Have Been There

Written by Dr Tal Jacobson
27 Jan

And what they wished they’d known before they started

Pregnant belly

As part of our research for this program, we asked a number of couples what they wish they had known before they starting trying for a baby, and this is what they said:

1. You need to understand your body

When you’re on the pill for a long time, your body has a very predictable cycle. Come off it, and things may be far from what you expect. “It was such a blow to be told, at the age of 39 and having been on the pill for over a decade, that my hormones were all out of whack and coupled with other issues I was potentially infertile. I felt like I was not as close to understanding my body as I thought – I spent months monitoring my cycle and really getting back in tune with it all,” one woman told me. She has since fallen pregnant naturally, after taking medication to get things back on track.

2. Age matters, don’t miss the ‘baby boat’

One of the most common things I hear is “I wish I hadn't left it so late…” Sometimes we spend so much of our twenties trying to avoid falling pregnant that we lose sight of the fact that fertility rates decline in your 30’s and can be quite low in your 40’s. Although you cannot change your age, one thing you can do is take action. If you are concerned that time is running short and you are thinking about seeing your GP or a Fertility Specialist, arrange it sooner rather than later.

3. The man’s age is a factor too

Perhaps we can blame the number of ageing rock stars producing offspring – many couples don’t realise that the age of the man can also have an impact on your chance of conceiving as a couple.

4. It’s not always so easy the second time around

Secondary infertility is more common than you may think. “I was lulled into a false sense of security that ‘it’s only a matter of time, because our first child was conceived and carried to term so easily,” one woman confessed. “I wish we hadn't wasted a few good years postponing treatment for the second time around”.  Although previous fertility can be reassuring, things can change after a previous successful pregnancy.

5. It can be a long road to conception

For some couples, the decision to start a family is quick – but the outcome is anything but. “We never even considered we might have difficulties, we just thought OK it’s time,” one woman said. “Five years later, our doctor had diagnosed ‘unexplained infertility’ and still we had no baby”. Although this woman was in her twenties when they started, she says she wishes they’d sought medical help sooner. Fortunately, assisted conception did eventually prove to be the answer for this couple.

6.  Sometimes you need to take a break

Your head can get in the way of things sometimes – and for whatever reason, some people find taking a break from something that’s causing stress (whether that’s work, or fertility treatment), to re-energise can help. While stress does not cause infertility, studies1 show higher levels of stress are associated with taking longer to conceive. When you’re already on the emotionally challenging fertility rollercoaster it can be hard to imagine getting into a relaxed headspace, but it can make all the difference.

7. Everyone’s journey is different

Every single patient has a unique set of circumstances, and their path to parenthood will take many different forms. It helps to talk about it with others – you may find it comforting to know you’re not alone, or you may get some insights that help you through to conception.

“I appreciated knowing conception is not as easy as it sounds - or as my school sex ed teachers made it out to be,” one woman told me. “And that no matter how our children come to us, we are still parents.”

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1http://humrep.oxfordjournals.org/content/29/5/1067.short
 

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We hope this article was informative and useful to you. If you have any questions or feedback, feel free to get in touch at info@blogivf.com.au.



Related Articles

Conceiving in your 40s, what are the chances?

I was recently asked to comment in a Sun Herald article on 26th August (also published online here: Sydney Morning Herald) on Collette Dinnigan, who pregnant at the age of 46, has called on women not to leave it too long to try for a baby.

It is always news when a high profile personality such as Ms Dinnigan, has a child, particularly when the personality in question is a bit older.  The difficulty is that these occasions, while very happy for the people involved, give a misleading picture of the actual likelihood of conception in these circumstances.  Remember that high profile personalities such as Ms Dinnigan, are human beings who quite rightly value their privacy and so very rarely (quite understandably) talk to the press when things aren’t going so well.  It was therefore, a particularly courageous action of Ms Dinnigan, while celebrating her own happiness, to so publicly, point out the difficulties that may face other women, seeking the same fulfilment.

What then, are the issues for women in their forties who are planning to have a child?

The main difficulty is that conceiving is simply harder at that age and, even once a woman does conceive, the risk of miscarriage is higher.  Surprisingly, although we have very good data about the effects of age on IVF conception (more shortly), we don’t have very good statistics about the effects of age on conceiving naturally. The limited available data about natural conception comes from old population studies or studies of unique populations, such as the Hutterites of North America, who do not use contraception.  Interestingly these data, such as they are, seem to be entirely consistent with the more modern and abundant IVF data.  Generally, in one year of trying, 75% of women under 30 years and 66% of 35-year-old women but only 44% of 40-year-old women will achieve a live baby naturally.

The main explanation for this, is that women are born with a finite number of eggs, and from that moment onwards, the number of eggs is declining all the time, until women go through their menopause at around 50-51.  Nonetheless, women in their 40s do still ovulate each month.  What is it about their eggs that cause all these problems?

A common misunderstanding with some women is that the fact she looks and feels young, and leads a healthy lifestyle, means that her eggs will be healthier. I regularly see women who have taken enormous care with their fitness and their health.  The rest of their body is in great shape, completely fit and ready to carry that longed-for pregnancy.  Sadly, despite this, the eggs still can’t do it.  The effects of time are remorseless and, sadly, there is no wonder drug to fix it.

Scientists have shown that eggs from older women are more likely to have an abnormal makeup making pregnancy less likely, miscarriage more common and increasing the risk of Down Syndrome, a condition where a child is born with an extra chromosome number 21.

Nor is IVF a cure for this problem. For women, in their early 40s, IVF is still a good thing to try and gives significantly higher success rates than trying naturally.    However, IVF success rates fall sharply after the age of 40 and by the time a woman is 45 are close to zero.

So, what’s the good news?  Well despite all of the above, many women do conceive in their forties, either by IVF, or naturally, and have very happy healthy families.  It is obviously better to have your family earlier, if you can, but all hope is not lost, just because you’re past 40.  Conception and early miscarriage are the big problems but, if you do conceive and get past the first few weeks, by far the most likely outcome will be a healthy child.  While the risk of Down Syndrome is increased, most of the other problems that affect young children are not increased by being conceived a later maternal age.

Finally, many women worry that by having their children later, their long term health and emotional development may be affected.  On the contrary, we now know that the children of older mums grow up to be as healthy and bright as any other child.

Snapshot of Fertility in Australia

There have been a number of happy and high profile stories in the press recently about older celebrities giving birth to healthy children. Stories like this used to be extraordinary, but they certainly seem to be on the increase. While this trend is supported by data that shows the fertility rate and numbers of births are increasing for women over 30 and especially for women in their early 40s, women and couples should understand the risks associated with having children later in life.  IVF Australia, Melbourne IVF and Queensland Fertility Group, have teamed up to create their latest infographic - “Fertility and Age in Australia” which explores some of these issues.
 Fertility in Australia infographic

Paternity, Maternity, Equality

Conceiving a baby in a same sex relationship

IVFAustralia, and its partner clinics Melbourne IVF, Queensland Fertility Group and TasIVF, are proud supporters of ‘rainbow families’. IVFAustralia were an Official Supporter of Sydney’s Gay and Lesbian Mardi Gras this year, and we’ve seen the number of same sex couples accessing our donor program double in the last year.
 
In 2011, a survey of 3,835 LGBT people found 33% of women and 11% of men had children1 - but close to 40% reported wanting to have children or have more children. This so-called ‘gayby’ boom is thanks to changes in community attitudes and laws, including better access to Assisted Reproductive Treatments for lesbian and single women.
 
So, if you’re hoping to experience the joy of starting a family within a gay or lesbian relationship, what do you need to consider?

How long will it take to conceive?

Generally speaking, we’d expect a healthy woman with no fertility issues to fall pregnant through IVF or Artificial Insemination within six months. You can prepare for pregnancy by improving your diet, doing regular exercise and other lifestyle factors.
 
When you access the donor program there are a few extra decisions you need to make.
 
Do you choose a known donor, or an anonymous donor? In a lesbian relationship, do you want to implant an embryo with eggs from one mother into the other? Should you store some sperm from the same donor for later, in case you’d like a related sibling? For two dads, the process of finding a surrogate can also be complex.

How do we choose a donor?

Our fertility clinics offer access to both Australian and US* donor sperm. The access fee for US donor sperm is higher, but the waiting list is also shorter as there is a shortage of local donors (gay men, we’d love to hear from you!)
 
When you’re using donor sperm or eggs, there are a few legal, emotional and ethical factors to consider and a counsellor will help you work through these concerns so you can make the best decisions for your family’s future.

Are there any legal issues?

Each state has different laws about parental recognition and access, so it’s worth seeking specialist advice before you start.
 
For example, in Victoria, the Victorian Assisted Reproductive Treatment Act (2008) removed discrimination against lesbian and single women with regard to fertility treatment, recognised parenting status for non-birth mothers and also effectively legalised ‘altruistic’ surrogacy. It also recognises lesbian couples as equal parents of their child or children as long as they were in a de facto relationship.

What else should we be prepared for?

30 years of research2 has shown that the children of same-sex parented families do just as well as the children of heterosexual parents socially, educationally, physically and emotionally.

The issues your children will face as they get older are just the same as the issues facing any children conceived using donor sperm or eggs: Where did I come from? Should I contact my donor? You need to be prepared for these questions at some point.
 
In the meantime, we hope we can help you fulfil your dream of having a baby, and that you will experience the joys of pregnancy, birth and parenthood.

What should be my next steps?

If you would like to learn more about the fertility treatments available for same-sex couples in your regions, visit one of our websites. 


 * IVFAustralia and Queensland Fertility Group patients only.

1 Leonard et al. (2012) Private Lives 2: The Second National Survey of the Health and Wellbeing of GLBT Australians, The Australian Research Centre in Sex, Health and Society, Melbourne
2Rainbow Families Council of Victoria (2010) Rainbow Families and the Law, RFC, Melbourne, http://www.rainbowfamilies.org 

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