Dr Bohaira El Geyoushi, fertility expert and brand spokesperson for Clearblue, talks about the things you need to know to maximise the chances of getting pregnant, depending on your age.
Whilst it is true that more couples are choosing to have a family later in life and assisted reproduction techniques are helping people delay the decision, there’s no denying that age will always play an important role.
Women are born with a limited number of eggs. By the time a woman reaches her 30th birthday she has an egg reserve of around 72,000 and this gradually decreases to less than 1,000 at the menopause. As we age it is not only the quantity of eggs that can present challenges, but also the quality, making it harder for the sperm to fertilise the eggs and increasing the risk of abnormalities.
20s
20s is the ideal time to get pregnant when fertility is at its peak, but that still does not mean it will happen immediately. Statistics suggest that the average woman between 20 and 24 years old has about a 20% chance of getting pregnant each month. Lifestyle habits should be the main focus at this age and the number one piece of advice is to quit smoking. Nicotine has a toxic effect on cells, which impacts both the sperm and the eggs, and the same is true of passive smoking.
Being overweight or underweight can also take its toll and there is evidence to suggest that too much alcohol and caffeine may be linked with lower fertility. Stress is another big factor and anyone who is trying to get pregnant should take steps to manage their stress levels.
For anyone who may be suffering from fertility problems caused by conditions such as PCOS or premature ovarian failure (early onset menopause), this is an especially important time and we would advise the patient to start trying for a baby as soon as possible.
30s
It is becoming increasingly common for women to have their first child in their 30s and while fertility does decrease at this age, the change begins gradually then accelerates much more quickly as you get closer to your 40th birthday. This is the time to do everything you can to maximise your chances of conceiving naturally. It is important to get to know your body and understand your cycle as it’s estimated that nearly 50% of couples could be trying to conceive at the wrong time. There are a number of home methods for predicting ovulation, such as the calendar method, however your cycle can vary by up to seven days each month, which makes it harder to be exact. Basal Body Temperature involves taking your temperature daily as soon as you wake up, which can prove time consuming and it’s only been shown to predict the most fertile days in one third of cycles. Ovulation kits such as the Clearblue Digital Ovulation Test are proven to be much more accurate and effective. The test can predict ovulation from the first cycle of use and pinpoint your two most fertile days 12 to 24 hours in advance by analyzing the hormone levels in your urine.
40s
The risk of abnormalities rises with age and women over 40 are considered to be at a higher risk of pregnancy complications. Even with IVF the success rate falls to less than 5% for women over 42 years of age, versus 31% for women under 35.The risk of miscarriage in a woman between 35 to 39 years of age is 24%, and doubles to 51% between 40 to 44 and the risk of conditions such as Down’s Syndrome also increases.
It is best to be proactive and visit a fertility specialist immediately where they will do a variety of tests to try and establish any potential problems that may require treatment. Providing there are no obvious issues patients would be advised to try and conceive naturally for three to six months.
Even if a problem is identified the answer may be something simple such as lifestyle changes or drugs to stimulate ovulation. If we believe the best course of action is assisted reproduction your doctor would advise on the next steps, which may include intrauterine insemination (IUI) or IVF. For anyone undergoing IVF in their late 30s and above we would recommend screening the embryos for any abnormalities before embryo transfer. Even if you fall pregnant naturally in your 40s you will be offered additional prenatal screening tests to assess your baby’s chance of developing more common conditions such as Down’s Syndrome.