13 Sep The Fertility Clinic
By Dr Ellie Rayner
Deciding when’s the right time to have a baby is an incredibly individualised decision that will vary from person to person and from family to family. Women who plan a pregnancy and are healthier at conception have a better chance of becoming pregnant quickly, having a safe and healthy pregnancy and labour, and giving birth to a healthy baby. With this in mind, whatever age you are, it’s never too early to look at your general health and lifestyle and be informed in preparation for a future pregnancy.
Pregnancy and your age In the UK, most couples under the age of 40, having regular vaginal intercourse and not using contraception, will become pregnant within one year of trying, with around one in three becoming pregnant within the first month. Of those couples that don’t conceive in the first year, around half will fall pregnant spontaneously in their second year, meaning that overall, more than 90% of couples aged less than 40 will fall pregnant in their first two years of trying. Unfortunately, your fertility does decline with age, particularly after 35 years, so if you are considering having a baby it is important to keep this in mind when deciding when the right time is for you.
Preparing for future children later in life In the UK, older maternal age is considered to be 40 years and above, whether this is your first or a subsequent pregnancy. Most older women have a healthy pregnancy and baby, however, unfortunately, there is an increased risk to both mother and baby of medical problems or miscarriage and stillbirth and the chance of these occurring does continue to increase with age. If you are an older mother, your pregnancy is likely to be different from the outset compared to a woman who is younger, with your midwife or obstetrician offering you additional appointments and monitoring of you and your baby to help reduce the risk of complications. Pregnancy in older mothers is becoming more common for several reasons, such as women choosing not to start a family until later in life for personal reasons. As being an older mother carries its own risks, it is especially important if you are considering pregnancy later in life to optimise your health and wellbeing before and during pregnancy to increase the chance of having a healthy pregnancy and baby.
Secondary infertility Around 5% of the population may experience difficulties conceiving a second or subsequent baby and it is important to recognise that this can be just as devastating as for a couple who have never been able to conceive. The treatment and approach to this condition is usually the same as if you haven’t had a baby before, however it is important to remember that as your fertility declines with age, the length of time to achieve a pregnancy can increase.
Many health and lifestyle factors in both men and women can influence your fertility for both first and subsequent pregnancies, so if you are having difficulties trying to conceive it is important to adjust your lifestyle as soon as possible as this alone may make a difference. Reducing or stopping smoking and drinking alcohol, and stopping any recreational drugs are all extremely important steps to take towards improving your fertility and chance of a healthy pregnancy. Unfortunately, being overweight affects your fertility and exercising, and being active regularly, can boost your fertility and will help you have a healthier pregnancy and birth. Seeing your GP before stopping contraception if you have any medical problems or take medication can also help ensure you are on the correct treatment before you conceive.
If you are planning a pregnancy, make sure you are taking Folic Acid supplements for ideally at least three months beforehand to reduce your chance of developmental problems with your baby.
Whether it is your first or a subsequent pregnancy you are trying for, if you are less than 35 years old and have not conceived after a year of trying or are aged 35 years and older and have not conceived after six months of trying, you should see your GP to discuss your personal situation. They will talk to you and your partner in detail and you should be offered investigations and referral to a specialist to rule out any underlying cause and consider whether any further treatment is required.
Dr Ellie Rayner is an obstetrician and gynaecologist, she is the founder of www.thematernitycollective.co.uk