What Ob-Gyns Wish Women Knew About Their Fertility

Fertility 101

When it comes to fertility, there’s a lot of misinformation out there. There are also a lot of questions: Am I too stressed to have a baby? Do ovulation predictor kits work? How old is too old to conceive (looking to you, Janet Jackson). To clear the air, we touched base with top docs in the field. Here, what ob-gyns at some of the country’s leading institutions want you to know about baby making.

Fertility Isn’t a Light Switch—But Your Biological Clock Is Very Real

It should come as no surprise that fertility decreases as we age. “Peak fertility is 24,” says Cynthia Austin, M.D., the medical director of in vitro fertilization at the Cleveland Clinic. But while your chances of having a successful pregnancy decline after that, there’s no need to panic: “Fertility doesn’t decline abruptly,” says Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology at Yale Medical School. Phew. “But about at age 35, you start seeing a subtle decline, and at 40 a more significant decline. The next bump down is about age 43.”

Just remember: “We are born with all the eggs we are going to ever have; and they just get older with us,” Dr. Minkin says. That means no matter how young, fit, active, healthy, and youthful someone may seem at 35 or 40, Dr. Austin reminds: “The impact of age is independent of how healthy you are or how young you seem.”

Quit Smoking Today

If fertility experts could scream one health message to women, it might be, as Dr. Minkin puts it: “Smoking rots the ovaries.” Dr. Austin points to the in vitro success rates of ladies who light up: “The pregnancy rates are half that of nonsmokers.” (Not to mention, science says smoking can actually cause damage to your DNA.) And while Dr. Austin says that some of the damage to the ovaries is irreversible, quitting today can increase your chances of a successful pregnancy.

Stress CAN Impact Fertility

From formal mind-body programs for women going through infertility treatment to preliminary research that points to a stress-fertility connection, calming the mind has become a focus of having a baby. “No one yet knows how exactly stress and anxiety could impact infertility, but there’s a saying that when you stop trying you’ll get pregnant,” says Daniela Carusi, M.D., an ob-gyn at Brigham and Women’s Hospital in Boston. It might sound like the last thing you want to hear if you’re trying but Dr. Carusi adds: “We see it all the time—a woman who finally gives up trying because she’s going in for IVF gets pregnant.”

Weight Matters

Turns out, there’s an ideal weight range for having a baby. “Being significantly overweight or underweight leads to problems with ovulation, independent of age issues,” says Dr. Minkin. “So to maximize fertility, being of an ideal body weight is helpful.” While every body is different, the Centers for Disease Control and Prevention (CDC) has a tool to ID your body mass index (BMI) with your height and weight. You want to aim for the “normal” range, docs say. If you’re struggling with infertility—and are underweight or overweight—touch base with your doc to find out if your weight could be responsible.

When You Go Off the Pill, You’re Good to Go

Dr. Carusi says that many ladies think they need to wash the Pill out of their system for a few months before getting trying to conceive. It’s simply not true. “Generally, we’ll say it’s safe to become pregnant right when you go off the Pill. It’s completely out of your system a few days after you stop taking it.” In fact, taking birth control pills might help enhance long-term fertility by keeping issues like endometriosis at bay, says Dr. Minkin.

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Freezing Your Eggs Isn’t a Guarantee

“The whole field of reproductive endocrinology has helped many women get pregnant,” says Dr. Minkin. But she adds: “Although egg freezing is an exciting new technology, it is hardly guaranteed.” That’s because of simple science: The majority of eggs will never become a baby—even if you’re trying the old-fashioned way, says Dr. Austin.

If you’re considering freezing, sooner is better than later. “The chances of success with pregnancy with frozen eggs is higher the younger a woman is when her eggs are frozen,” says Mindy Christianson, M.D., an assistant professor of reproductive endocrinology and infertility at Johns Hopkins University School of Medicine.

Alternatively? “Using an egg donor is also an option for women who are over the age of 40 years of age who are not able to conceive,” Christianson says. “There are now frozen donor egg banks available, which make this option more available and affordable.”

Pregnancy Isn’t a Perfect Process

The best way to get pregnant is to have sex regularly. Okay, so this one seems super “duh.” But, Dr. Austin says that many ladies don’t do it, instead utilizing tech like ovulation predictor kits to try only on one certain day. The idea that there’s a “best day” to get pregnant simply isn’t true, she says. “There’s a period of five to seven days leading up to ovulation that is the fertile time.” And abstaining from sex or having him “save up” are flawed strategies too. “To maintain a good sperm count, a man should be having an ejaculation three to four times a week,” says Dr. Austin. That’s why her prescription includes regular, frequent intercourse sans the tech. (Hey, sounds fine to us.)

“In general, there’s a movement toward tracking your physiology—it’s almost like your health and body have turned into formulas,” adds Dr. Carusi. “Many women feel they want to have this sense of control over their fertility, and it just can’t be controlled.”

If regular intercourse doesn’t lead to a pregnancy right off the bat? Try not to freak out, Carusi says: “You can be perfectly fertile and he can be perfectly healthy and that can still not result in a pregnancy because the human body is not that perfect. It can take some months until you hit the jackpot.”

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