A guide to having kids (or not) on your terms

In short, yes. This is because the changes in the quantity and quality of eggs play the biggest role in why getting pregnant gets more difficult as you get older. An AMH test is one of the most accurate ways to check the size of your ovarian reserve.

A common question we get is, how many eggs does a woman have? Biologically speaking, after around 37 years old, you lose substantially more eggs with each menstrual cycle compared to when you were younger. Your doctor would describe this as your ovarian reserve or fertility decline being faster. At around the same time, the quality of your eggs also declines more rapidly due to chromosomal abnormalities (changes in your eggs’ DNA). This means that your eggs are less likely to get successfully fertilised and/or implant into your uterus and are more likely to end in a miscarriage or a baby with a genetic anomalies (such as Down’s Syndrome). It’s also important to note that chances of success with IVF will also decrease with age.

It’s important to remember that successful conception is just the beginning and a healthy pregnancy and birth requires a healthy mother. The Royal College of Obstetricians and Gynaecologists (RCOG) views you as having an advanced, or older, maternal age as soon as you hit 40 years old and after this age, your pregnancy is considered to be riskier as you are more likely to experience conditions such as high blood pressure and diabetes whilst you are pregnant as well as being more likely to have complications for both you and the baby during childbirth.

Female fertility is only half the equation, and whilst it is less commonly discussed, men also have a peak age of fertility and experience a fertility decline as they get older. Although some men will produce sperm and be fertile their entire life, there is evidence that factors such as sperm count, morphology, motility and DNA integrity significantly declines with age, particularly after 40.

Depending on the type, your use of hormonal contraception may temporarily suppress your ovarian reserve and it can take several months for both your ovarian reserve and periods to return to what is normal for you. So, whilst there is no evidence to suggest that hormonal contraception can impact fertility in the long term, it’s worth knowing your body may need time to get back to normal when planning future pregnancies.

Your STI history may also play a part in your fertility. This is because some STIs such as chlamydia and gonorrhoea can impact your fertility by causing scarring in your reproductive organs. This is particularly true if you have repeated and/or infections were treated late. If you are sexually active (espeically with multiple partners), it’s a good idea to do regular STI checks to keep an eye on it and act fast if you do get any infections.

Cigarette smoking has been associated with infertility in both males and females with the evidence showing that smokers have a smaller ovarian reserve and poorer reproductive function. Both of which lead to taking a longer time to conceive and reaching menopause at an earlier age. Use of cannabis has also been shown to affect reproductive function and could therefore impact your ability to conceive in the future. It is therefore recommended to steer clear of smoking both tobacco and cannabis as part of preparing your body for future pregnancies.

Whilst some of us tend to reach for a glass of wine to relax, regularly drinking alcohol and binge drinking has been shown to impact reproductive function by affecting the hormones that control your egg maturation, ovulation and overall menstrual cycle. As part of preconception care, it’s best to keep your alcohol intake to a minimum or avoid it completely if you want to give yourself the best chance of success of conceiving in the future.

A life full of stress is known to have a negative impact on your mental health and we now know that mental health and reproductive health go hand in hand, with each heavily influencing the other. High levels of stress have been linked to decreased pregnancy rates in women who undergo IVF as well as causing conditions which disrupt ovulation such as hypothalamic amenorrhea. So if you’re wanting to get yourself in the best position to prepare for a successful pregnancy, take a look at your current lifestyle. Are you currently under a lot of stress? Our in-house fertility counsellor is on hand to support you and your mental well being?

We’ve all heard of beauty sleep but how important is sleep for your reproductive health? Well, very important. Sleep is needed to stimulate the release of many of your reproductive hormones, so too little or disrupted sleep can impact your menstrual cycle and therefore fertility. Sleep deprivation has also been linked to changes to levels of menstrual cycle-related hormones such as FSH, LH, progesterone and estradiol. So, if you’re looking for ways to optimise your chances of success for future baby making, make that 8 hours of sleep a night a priority.

When it comes to exercise, it’s not actually a case of the more the better. Whilst moderate physical activity has been shown to have a positive impact on your fertility and success rates for women undergoing IVF, over-exercising or not eating enough calories can also put you at risk of a condition called hypothalamic amenorrhea causing your periods to stop completely. So, when it comes to exercise, the key is to not overdo it.

What you eat and how much you eat is also a big part of preconception care. Just as being underweight can cause issues, there is also evidence that being significantly overweight can affect your fertility too. Recently, exposure to some chemicals (known as endocrine disruptors), such as heavy metals (like lead and mercury) and certain pesticides, have been shown to affect reproductive health so it’s important to be mindful of what and how much you're putting into your body to avoid impacting your reproductive health.

Menopause is confirmed in women over 45 years old when they have not had a period for over 12 months whilst not on hormonal contraception. However, at least 1 in 100 women under 40 years old will actually undergo menopause prematurely so if you have symptoms of menopause such as irregular periods and hot flashes, it’s best to check by measuring your Follicle-Stimulating Hormone (FSH) levels. Our at-home tests will check in on your FSH levels along with other hormones which are known to indicate a diminished ovarian reserve and menopause, such as Anti-Müllerian Hormone (AMH), Luteinising hormone (LH) and Estradiol.