7 reasons you’re not pregnant yet

Address these seven common culprits that may be sabotaging your fertility to speed up that visit from the stork.

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You’ve watched your wedding video at least 20 times, framed your favourite snaps from the big day, even had time to turn your bouquets into potpourri. But your home pregnancy tests are still drawing a blank…why?

Take heart ― you aren’t alone hitting this frustrating roadblock. “Infertility is defined as the inability to conceive after 12 months of unprotected sexual intercourse,” notes Dr Yeong Cheng Toh, consultant gynaecologist and reproductive endocrinologist with Virtus Fertility Centre Singapore. “It affects about one in six Singaporean couples ― up to a third of them will have difficulties due to a combination of male and female factors.”
Pinpointing the top reasons why a couple may have trouble conceiving, two fertility doctors give SmartParents expert advice on how to tackle these conditions.

1. AGE

How it affects fertility “Age is the single biggest factor affecting a couple’s chance of conception,” Dr Yeong points out. “Both fertility in men and women are affected by age, although the decline is not as dramatic and finite for men.” Women are born with a fixed number of eggs ― this number drops as they age. So, women, especially those over 35 years old, experience increasing difficulty getting pregnant. In addition, the quality of eggs also drops, which increases the risk of miscarriage. Adds gynaecologist and fertility specialist Dr Kelly Loi, who runs The Health and Fertility Centre for Women, “In men, an increasing number of studies also indicate that the sperm quality drops with age.”
What you can do about it Start planning your family early, urges Dr Yeong. A woman’s best reproductive years are in her 20s as her chances of falling pregnant every month is 20 per cent compared to less than 5 per cent when she’s in her 40s. “For men, the odds of fathering a baby is 32 per cent when they are below age 30 and 20 per cent at over 50 years,” he adds. Before age 35, a woman should seek help from a doctor after trying for a baby for a year without any luck. If she’s older than 35, she should do it after six months.

“Both fertility in men and women are affected by age, although the decline is not as dramatic and finite for men.”

2. STRESS

How it affects fertility Although no studies have proven conclusively that stress is a direct cause of infertility, Dr Loi points out that too much pressure can affect ovulation in women and give rise to irregular menstrual periods. Stress may also stem from trying to find the “right” time to conceive, which can affect the libido and also take the joy out of baby making.
What you can do about it Reduce stress ― have sex regularly to maximise your chances for conception, as well as to take the pressure off having intercourse on the day of ovulation. “Having sex 24 to 48 hours prior to ovulation gives a woman the best chance of getting pregnant as she is her most fertile at this time,” Dr Yeong explains.

3.EXISTING HEALTH CONDITIONS

How it affects fertility Pre-existing health conditions affecting a woman’s fertility could range from an ovulation disorder and fallopian tube blockages to complications in the uterine environment. The most common conditions are polycystic ovary syndrome (PCOS), which affects one in five women and endometriosis, which affects one in 10. “In PCOS, the ovaries contain small cysts or follicles which may not produce eggs capable of being fertilised, while endometriosis alters the abdominal environment, making it difficult for a fertilised embryo to be implanted. It may also affect the quality of the egg produced for fertilisation,” explains Dr Yeong. For men, pre-existing health conditions include a low sperm count, poor sperm quality, or both.
What you can do about it Consider getting a preconception health check-up for both you and the hubs prior to trying to conceive. After tests determine that you have gynaecological issues, you’ll be told what necessary treatments can be carried out to correct them. “Problems such as ovarian cysts and uterine fibroids may sometimes require laparoscopic surgery to optimise fertility,” Dr Loi says.

Figure out lifestyle factors that could be affecting your fertility, click…

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4. BEING OVER OR UNDERWEIGHT

How it affects fertility Weight is one of the key considerations for both women and men when they are trying for a baby. “If either individual is significantly over or underweight, it will cause the body to produce more or less of the hormones that regulate ovulation in women and disrupt sperm production in men,” points out Dr Yeong. In fact, studies have suggested that a 10kg weight gain can decrease male fertility by approximately 10 per cent, he adds.
“Obesity can make female fertility treatment more challenging due to requirements of higher doses of medication needed to achieve an ovarian response,” says Dr Loi. There may also be difficulty with ultrasound imaging, as well as increased risks for needed surgical procedures.
Similarly, being underweight means you might be at risk of nutrient deficiency, while insufficient levels of body fat may also affect ovulation. Dr Loi adds that over-exercising can cause anovulation (failure to release an egg for more than three consecutive months).
What you can do about it Maintain a balanced diet and active lifestyle to ensure a healthy body mass index (BMI). “Having a very high BMI ― greater than 35 ― may decrease fertility rates in some circumstances and may also increase the risk of pregnancy-related complications such as miscarriage, gestational diabetes and hypertension,” Dr Yeong warns. A woman with a high BMI may improve her fertility even if she reduce her weight by 5 per cent.

Studies have suggested that a 10kg weight gain can decrease male fertility by approximately 10 per cent.

5. SMOKING AND DRINKING

How it affects fertility “While moderate alcohol consumption is not proven to have any effect on sperm quality, the long-term effects of excessive alcohol consumption could include erectile dysfunction, reduced libido and subnormal sperm production,” Dr Yeong warns. Smoking also has adverse effects on both men and women’s fertility. In women it can affect egg maturation, hormone production, embryo transport and the environment in the uterus. Smoking has also been associated with speeding up menopause, Dr Loi points out. For men, smoking can affect how well and fast the sperm swims and in the long term, damage blood vessels, which increases the risk of erectile problems and sexual dysfunction.
What you can do about it Quit smoking and reduce alcohol consumption! “Sperm is constantly reproduced and takes approximately three months to mature, meaning that in just a few months after quitting, a man’s sperm is ‘smoke free’ and ‘baby ready’,” says Dr Yeong. For women, stubbing out has been shown to enhance both natural fertility and IVF outcomes. Plus, if you’re serious about expanding your family, you really need to practise caution during pregnancy, or even smoking in front of your offspring as this nasty habit presents a host of health problems for them.

Click for two surprising factors that may impact your fertility…

6. THYROID DISORDERS

How it affects fertility Thyroid hormones regulate ovulation, metabolism and weight management, all key to improving your chances of getting pregnant. “An underactive thyroid gland or hypothyroidism, can be linked to infertility in women as they are not producing enough of certain important hormones,” explains Dr Yeong. Low levels of thyroid hormones can interfere with ovulation, which impairs fertility. In addition, some of the underlying causes of hypothyroidism, such as certain autoimmune disorders, may also impair fertility. Autoimmune disorders include diabetes mellitus type 1, inflammatory bowel disease, multiple sclerosis and psoriasis.
What you can do about it If you suspect that you have a thyroid disorder, look out for common symptoms such as unexplained weight loss or gain, swelling in the neck, mood swings, hair loss, vision problems and irregular menstrual periods. Speak to your doctor about getting tested and seek the advice of a fertility specialist once confirmed.

7. POLLUTANTS

How it affects fertility “Environmental pollutants may potentially affect egg and sperm quality,” notes Dr Loi. In fact, according to the Environmental Health Perspectives journal, pollutants such as polychlorinated biphenyls (PCBs), industrial compounds and certain pesticides can decrease a couples’ ability to have children by up to 29 per cent. “A recent study also suggests that women who live close to major highways where the air is polluted by traffic exhaust fumes may have more fertility issues than women who live further away where the air is cleaner,” Dr Yeong says.
What you can do about it The best thing you can do is try to live a chemical-free life. Dr Yeong advises that you limit outdoor activities if you reside in an area with high pollutants and pay close attention to air-quality advisories, especially during the dreaded haze season!

Photos: iStock


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