Infertility

Sixty percent of couples conceive in six months, 80% in 12 months, and 90% in 18 months. In Canada, infertility ranges from 11.5% to 15.7 % of couples. Your family physician can tell you if any tests are needed and help guide treatment options.

AGE AND CONCEPTION
Unfortunately, the ability to get pregnant declines as women age. This means that women over age 35 have more difficulty getting pregnant and, if they do, experience more complications like miscarriage. The effects of aging in men are not as well understood, although studies suggest that older men have lower fertility, and their children have a greater risk of genetic and health disorders.

ASSISTED REPRODUCTIVE TECHNOLOGIES (ARTS)
There are many ARTs available to treat infertility including medication, intrauterine insemination and in-vitro fertilization (IVF). However, it’s important to realize that, while ARTs can make conception happen sooner, these treatments do not make up for the natural decline of fertility due to age. For example, the live birth rate (the chance of a successful pregnancy leading to birth) per IVF cycle drops from about 31% at age 35 to less than 5% at age 42. What’s more, there are more risks involved at an older age, particularly multiple births.

IMPROVING NATURAL FERTILITY AND PLANNING FOR A HEALTHY PREGNANCY
There are several lifestyle changes you and your partner can make to improve your natural fertility.

• Maintain a healthy body weight. A healthy BMI ranges between 18.5 and 25.

• Stop smoking if you currently smoke.

• Consider abstaining from alcohol.

• Avoid recreational drugs and substances.

• Women should take a folic acid supplement. Your family physician can advise you of the best dose for you.

• Women should find out if they are immune to German Measles (rubella).

ONLINE RESOURCE: Get the facts on fertility, including treatment options, risks, and counselling. http://healthycanadians.gc.ca/healthy-living-vie-saine/pregnancy-grossesse/fertility-fertilite/index-eng.php

SOURCES:

1) Case AM. Infertility evaluation and management. Strategies for family physicians. CFP 2003; 49: 1465-72.

2) Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J. Estimating the prevalence of infertility in Canada. Human reproduction 2012; 27(3): 738-46.