Your fertility questions answered by Dr Lizle Oosthuizen
Falling pregnant isn't as easy as it might seem, and would-be parents often find themselves scratching their heads as they wonder why it just hasn't happened for them yet.
Sometimes they'll even resort to extreme measures to ensure a successful pregnancy, but some of these can, in fact, be quite dangerous.
1. I'm 35. Is it true that I'm too old to conceive naturally?
Every woman is born with a certain number of eggs, and although this may vary from woman to woman, the general trend is a decline in the egg number as well as egg quality as we age.
We know that fertility declines more rapidly after the age of 35 and this process of losing egg number and quality speeds up as we get closer to 40. Egg quality is very important, and we know that the older a woman gets, the higher her risk of miscarriage or conceiving a pregnancy that is genetically abnormal.
This is not absolute - so a pregnancy after 35 does not mean you will have an abnormal pregnancy, it just means the chances are higher, and your monthly chance of achieving pregnancy starts to decrease.
So no, you are not "too old to conceive naturally" but your overall fertility is decreasing. Most couples will conceive within a year of regular (2-3 times per week) unprotected intercourse, however we recommend not delaying for a year before seeking help if you are older than 35 for the reasons outlined above.
ALSO READ | Some tips to up your chances of having a son
2. Is it good for women to drink their early morning urine to increase their fertility to get pregnant?
There is no evidence for this and we definitely would not recommend it.
I imagine this idea may have come from the fact that some hormone treatments were created from the purified products of urine from menopausal women.
3. We've been trying to fall pregnant for six months. When is the right time to approach a fertility expert?
Excellent question. Most couples will conceive within a year of regular unprotected intercourse. We recommend you consider your cycle, your previous risk factors and your age when deciding when to see a specialist.
As I outlined above, after 35 you should consider seeing a specialist after six months rather than one year. If you know your cycle is irregular (less than 21 days or more than 35 days, or there are large variations in cycle length), you should see a doctor sooner as you are likely not ovulating.
If you have heavy or painful periods, you should see us sooner as there may be an underlying problem, such as fibroids or endometriosis, that can reduce your chances of falling pregnant.
Similarly, if you have had any major gynaecological surgery or your partner has any known problems, such as major testicular trauma, surgery, STDs or testosterone use.
There is also no harm in seeing a fertility specialist to see if you should be concerned or if you can continue to try a little longer.
4. I have three boys, what are my chances of having a girl next?
We can't predict this, unfortunately.
Some couples ask about having IVF to choose the gender of the embryo we transfer - termed gender selection for family completion.
This is not allowed in South Africa, unless we are trying to avoid a serious medical condition that we know is only seen in girls or boys.
5. Do I have to be my perfect body weight to fall pregnant? I'm about 10kg overweight and haven't been able to fall pregnant this year.
While you don't need to be your ideal body weight, we recommend having a normal body mass index (BMI), which is calculated as weight for height.
Being 10kg overweight would be very different if you are 155cm tall, or 175cm tall. We know there are complex relationships between your weight, your insulin levels and ovulation.
We also know that fertility treatment over a BMI of 30 (considered obese) is associated with increased doses of medication, lower chances of success, and higher risks of miscarriage.
We would always recommend losing weight. We know that a 5-10% decrease in body weight (when overweight) can improve ovulation.
Furthermore, we know that falling pregnant when overweight is associated with higher chances of serious complications for mom and baby.
ALSO SEE | Parent24 fertility hub
6. I've been told that I have to have sex in one particular position to fall pregnant. Is this true?
This is not true. When sperm enters the cervix (mouth of the womb), it does not rely on gravity to reach the ovulated egg.
The vagina cervix makes secretions to assist the sperm. The sperm has a tail capable of helping it move and the uterus undergoes small contractions to help drive the sperm towards the tubes.
Do you have a question about falling pregnant? Let us know and we'll find an expert answer for you!
Share your stories and questions with us via email at chatback @ parent24.com. Anonymous contributions are welcome.