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Frequently asked questions when trying to have a baby

д-р Антон Баев

How does the modern way of life affect people’s reproductive abilities? What are the current trends in human reproduction?

The number of couples who have reproductive problems is increasing in the last years. Currently over 25 million people in Europe suffer from problems with reproduction. The modern way of life is definitely one of the factors impacting this trend. Stress, smoking, alcohol consumption, insufficient physical activity, obesity – all these reduce the chances for a couple to have a healthy child. Modern women are postponing pregnancy and motherhood to a later stage in their life giving priority to their career. The age is the main reason why women have difficulties to conceive a baby. Female fertility decreases extensively after the age of 35. At the age of 37, the woman has already lost 90% of her eggs.

What are the most common reasons for infertility?

The main reason for women’s infertility is their age at the time they try to have a baby. A woman is born with a certain number of eggs, which decrease significantly after the age of 35. Despite the development of science and medicine, currently there are no ways to increase the number of these eggs. Statistics say that women under 30 have about 20% chance of getting pregnant spontaneously each month. At 40, this chance drops to only 5%. Other causes for women’s infertility are abnormalities of the fallopian tubes, fibroids, pelvic diseases, endometriosis, diabetes, thyroid disease, cancer and others.

The reasons for men’s infertility could be poor quality or low sperm count in the semen, infections in the genital system, anabolic steroids and other synthetic analogues of testosterone, which seriously compromise sperm quality, erection problems and others. The quality of men’s sperm also decreases with age. Although men can produce sperm from stem cells in the testicles throughout their lives, they experience andropause, which means the number and quality of sperm decreases with age. People should be aware that male factors are the reason for infertility in about 50 % of the cases.

How do men and women get checked for fertility?

Fertility testing for women starts with physical examination, pelvic ultrasound and blood tests. Testing for men includes semen analysis in order to identify any abnormalities. Additionally, in case of a need specific diagnostic tests can be performed – hysterosalpingogram, hysteroscopy, laparoscopy, thrombophilia tests, genetic tests, thyroid examination, and others. The main goal is to examine the process of ovulation in women and the spermatogenesis in men. Normal function of fallopian tubes is the other important factor which has to be examined.

In case of fertility problem, the couple has to be consulted together in order to be better diagnosed.

When a couple should seek advice from a specialist in reproductive medicine?

  • After one year of unsuccessful attempts to become pregnant (or 6 months if the woman is older than 35) the couple should consult a specialist in reproductive medicine
  • In case of pathological test results – poor sperm quality, low AMH (this is the best marker for ovarian reserve), abnormalities with uterus and ovaries
  • Endometriosis
  • Hormonal disorders – PCOS, high levels of prolactin, thyroid diseases
  • Previous inflammatory diseases such as chlamydia, gonorrhoea, tuberculosis
  • Surgeries like appendicitis, ovary cysts, myomas
  • Mumps infection (mumps) in both men and women
  • Oncological disease (especially with chemotherapy)
  • Proven genetic syndrome that reduces fertility – Turner syndrome, Klinefelter syndrome and others
  • When one partner has unsuccessful attempts to have a baby with another partner
  • Treatment of cryptorchidism (non-descending testicles) or inguinal hernia in boys

Is there a recipe for successful conception and pregnancy?

Healthy living is one of the most important factors not only for a successful pregnancy, but also for baby’s health after birth. Eat healthy food, decrease the alcohol consumption, quit smoking and have a regular physical activity if you want to conceive a healthy baby. High BMI and smoking decrease with 50% the chances of one in vitro procedure and increase twice the time for spontaneous conception. Regular physical examination for both the man and the woman could identify any potential problems on time, which timely treatment could be vital for conception.

Pregnant women should know that the regulate checks during pregnancy with an experienced physician are important for baby’s health. The baby in the uterus is already an individual. Baby’s health and postpartum life depend on their intrauterine development. Different examinations are performed during pregnancy to monitor the health of the mother and the baby. The normal environment in the uterus and the smooth course of pregnancy determine the health and the future development of the baby.

What recommendations would you give to the couples who want a baby?

They should be in a good health when they want to conceive a baby. The healthier people are, the healthier their gametes are, so a baby could be conceived easier.

Do not postpone too much the time to have a baby. Aging of the woman’s body increases the risks of some complications during pregnancy, such as maternal high blood pressure, gestational diabetes, preeclampsia, and others. It should also be noted that despite the advances in medicine, assisted reproductive technologies are not a panacea. The in vitro procedure has a certain success rate – about 30%, and for women over 40-44 it is 10%.

In the presence of a medical problem, I recommend that the couple consults with a specialist in reproductive medicine as soon as possible.

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