Around one in seven couples may have trouble conceiving in the UK, however many won't know they are infertile until after a year or more of trying. Chrissy Teigen, Nicole Kidman and Courteney Cox are among the celebrities who have opened up about their own experiences with fertility issues, with each of them going on to successfully have families of their own.
Some of the factors that may affect fertility can include age, blocked or damaged fallopian tubes and lack of regular ovulation, which can be caused by common conditions like polycystic ovaries (PCOS). However, it is possible to learn about these risk factors in advance and find out how to optimise fertility before you start trying thanks to tests at specialist clinics such as London's Lister Fertility Clinic. Dr James Nicopoullos, Consultant Gynaecologist at the Lister Fertility Clinic, part of HCA UK, recommends couples who are concerned about their fertility health to come in for their Fit for Fertility package, which will often provide reassurance or identify any potential cause for concern that they may need to be aware of.
There are a number of ways women can optimise fertility
"A fertility assessment is a worthwhile investment for individuals and couples who are either looking to start a family in the short-term, or want to explore their fertility health and gain advice about what time frames they should consider when making the decision to start a family in the future," he explained. "The service is suitable for a wide age range – and gives an accurate indication of fertility status and can help to identify/pinpoint any potential issues."
The package includes a number of different tests, many of which would not normally be offered until after years of trying to conceive. As well as taking a full medical history and BMI reading, the qualified team will assess a number of lifestyle factors and offer advice on any changes that may benefit your fertility. A blood test will assess both thyroid function and AMH levels, which can provide a detailed overview of ovarian reserve when combined with a follicle count from a scan. This can identify conditions such as PCOS (which is typically associated with abnormally high AMH levels), as well as give an indication of whether you're at risk of an early menopause.
How to optimise fertility:
Dr James Nicopoullous says that making simple diet and lifestyle changes can help many women to optimise their fertility. "It's no secret that leading an unhealthy lifestyle by being overweight, smoking, regularly drinking alcohol, or taking drugs can have a negative effect on mental and/or physical wellbeing," he said. "However, many women are surprised to learn just how much these factors can put their fertility at risk."
Manage your weight:
"Being overweight/underweight can have a significant impact on fertility by causing hormone imbalances and problems with ovulation, and can also increase the risk of miscarriage, complications during pregnancy and at delivery. Ideally women should aim for a BMI that is between 18.5 and 30. Everyone can check their BMI online for free using specialised calculator tools, or by booking a health check-up with a local GP service. A high BMI can also be a sign of polycystic ovary syndrome (PCOS), which is a common cause of infertility, affecting up to one in five women of reproductive age. This is because women with PCOS find it more difficult to release eggs from their ovaries, caused by irregular ovulation or a failure to ovulate completely."
Reduce alcohol consumption:
"Although there is limited evidence to suggest that moderate alcohol consumption has a negative effect on fertility, women who consume large amounts of alcohol on a frequent basis are more likely to have unusual menstrual cycles, meaning it can take longer to get pregnant."
"Smoking can present serious fertility challenges, such as abnormalities to the cervix and damage to eggs as they develop in the ovaries. This is because chemicals found in cigarette smoke can accelerate aging of the female reproductive system, which in turn will shorten the biological clock and can lead to an early menopause."
Avoid extreme lifestyles:
"Additionally, nowadays we're all encouraged to be as fit as possible - gain muscle, eat 'clean' and limit our body fat percentage. While there are plenty of health benefits associated with leading an active lifestyle and undertaking a healthy diet, there is now evidence to suggest that excessive exercise and extreme dieting can impair fertility.
"Extreme lifestyles can also cause hormone imbalances which are detrimental to fertility and can cause a low body fat percentage, which plays a significant role in female reproduction. Low progesterone levels, often caused by dangerous dieting and exercise, can also pose challenges for egg implantation and to the menstrual cycle. Therefore, it's critical that you keep your progesterone and oestrogen levels balanced and healthy."