Important factors affecting fertility

Fertility is a growing concern in today’s world. Amidst the modern lifestyle and increased stress, many vital factors affect fertility. Let us look at the critical factors affecting fertility in both men and women, which are as follows.

Age of the couple

A woman’s age is the most important factor affecting fertility. At the time of birth, women have a finite set of eggs, and the number of eggs available decreases each day from birth onwards. At a younger age, the decline is relatively gradual as only a few eggs are ‘lost’ each day, but as women approach their mid to late 30s, the decrease gets much steeper. It’s not just the number of eggs, but the quality of the eggs also declines as women get older. With the reduction in both the quantity and quality of available eggs, older women are less likely to get pregnant, and if they do get pregnant, they may not be able to carry it to full term. It’s not just the fertility of women that gets affected with age but also of males. As they grow older, the sperm quality becomes weak. So, getting pregnant with low-quality sperm causes poor pregnancies, which might lead to a miscarriage or a premature delivery. However, the reduction of male fertility with age is not as rapid as that of women.

Previous successful pregnancies

If a couple had a successful pregnancy and a healthy delivery earlier, subsequent pregnancies would become easy. It means both partners are fertile and can carry it to full term.

Duration of subfertility

If the couple has been trying to achieve pregnancy for a very long time, they are less likely to get pregnant. If the duration of trying is less than three years, they are almost twice as likely to get pregnant than couples who have been trying for more than three years.

Timing and Frequency of Sexual Intercourse

The menstrual cycle is for 28 days, meaning there are 28 days between the start of one period and the start of the next. Ovulation, the process of an egg release from the ovary, occurs on day 14 of a 28-day cycle. So, for successful fertilisation, a sperm must be present while the egg is released. Hence, the timing of intercourse is essential. Conception chances are low at the beginning of the cycle and increase from about day eight onwards. Women are most fertile if they have sex two days before they ovulate, i.e., on day 12 of the 28-day cycle. After ovulation, the chance of getting pregnant decreases dramatically. So, the sperm must be present in the female genital tract before ovulation to maximise the chances of getting pregnant. This is because after ovulation, levels of the hormone progesterone increase, which causes cervical mucus to become thick and sticky, preventing sperm from being able to swim through it to get to the egg to fertilise.

Couples should have regular sex 2-3 times a week to get pregnant since, at this frequency, a good volume of fresh sperm will be present in the female reproductive tract at the time of ovulation. But if they have sex once a week, the chance of getting pregnant is less due to the lack of fresh sperm in the female genital tract at the time of ovulation.

Lifestyle Factors

Weight: If the body is overweight, then women do not have regular periods, which means they are less likely to release an egg each month (ovulate) than women with regular periods. The chances of pregnancy are reduced. Even if the body weight is reduced by 5-10% of the total body weight, it may restore a regular menstrual cycle, thereby increasing the chance of getting pregnant. Being overweight increases the risk of miscarriage, coupled with problems during pregnancy and delivery. A balanced diet coupled with exercise has shown to be better than any other. If you feel less motivated to exercise daily, join a group program. If men are overweight, they have suboptimal sperm and therefore reduced fertility.

Underweight is also an issue, as it leads to ovulation issues. Underweight women also have issues in carrying the pregnancy to full term, so gaining weight is likely to improve fertility.

Habits such as smoking:  Women who smoke have their infertility decreased by three times as compared to non-smokers. Secondhand smoking or passive smoking is also harmful. Hence, smokers should avoid smoking around pregnant women. Smoking reduces a woman’s ovarian reserve, which means her ovaries will have fewer eggs as compared to a non-smoking woman of the same age. Smoking also damages the inside of the fallopian tubes. Fallopian tubes are the transporting mechanism that carries the egg and embryo into the uterus. For men, smoking interferes with sperm quantity and quality.

Alcohol: Women drinking more than five units of alcohol a week may reduce female fertility. After conceiving, alcohol consumption may lead to congenital disabilities and developmental delays. Women who are trying to conceive should avoid alcohol because there is no ‘safe’ limit. For men, excess alcohol consumption leads to difficulty in maintaining an erection, impaired ejaculation and reduced sperm quality.

Over-the-counter and recreational drugs: Non-steroidal anti-inflammatory drugs interfere with ovulation. Regular aspirin use may interfere with implantation. Recreational drugs may interfere with ovulation and the function of the fallopian tube. Anabolic steroids, which are used in excess in bodybuilders, inhibit the production of sperm, and this may be permanent even if the drug is stopped.

Medical Conditions: Some women have medical conditions impairing their fertility. Polycystic ovary syndrome, endometriosis, thyroid, diabetes and obesity are a few of the determinants of fertility. Structural and functional inabilities in the reproductive systems of the couple are significant roadblocks. Hormonal imbalances create a significant hindrance in pregnancy.

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