Generalizing broadly, most women’s attitudes towards our own fertility can be summarized by this line, which seems to come up whenever I talk to my friends about having babies: “You spend your whole life trying not to get pregnant. Then when you actually do want to get pregnant, it’s like…what now?”
From assuming it’ll happen easily (sometimes yes, often no) to vague ideas that you can wait until you’re 50 (hey, it worked for Janet Jackson!), there’s a lot of fuzziness around women’s fertility—especially when it comes to millennial women. Chalk it up to a little bit of ignorance, a societal unwillingness to talk about women’s bodies (which TBH, we’re hella over), the tendency to rely a little *too* heavily on medical info we heard “from a friend of a friend,” and a lot of plain old misinformation; starting with the idea that fertility is only something you should be thinking about if you’re a 41-year-old singleton.
But fear not, because FLARE has gathered the experts for a myth-busting, frequently-asked-question-airing, my-cousin-told-me fact-checking session. If you’ve ever wondered how quickly you can get pregnant when you come off the pill, pondered whether or not prenatal vitamins are a scam, or heck, even if you’re just wildly ambivalent about the whole kid thing but you like to be informed anyway, then right this way—the doctor will see you now.
For anyone whose ever tossed and turned at night fretting over this, don’t lose any more sleep. According to Dr. Marjorie Dixon, a Toronto-based specialist in reproductive medicine, this myth is false. “Being on birth control does not affect your ability to conceive later,” Dixon says. “If you pull your goalie, assume you’re going to get pregnant.” Dixon adds that while some people who menstruate may experience a slight lag coming off the pill (meaning it might take a bit of time for some people to ovulate regularly again), most ovulate the very next month (sometimes even twice as your body is resetting!)
But, just remember: You don’t have to have had a period in order to ovulate. So if you’re, say, breastfeeding and assume you can’t get pregnant until you get your period back…don’t.
And while the myth may be that prolonged use of birth control can impede fertility, it’s actually kind of the other way around. In fact, as Dr. Yolanda Kirkham—an obstetrician gynaecologist and assistant professor at Unity Health and Women’s College Hospitals in Toronto—adds, “birth control can actually help protect your fertility.” For example, women with endometriosis may use it to manage their debilitating periods. “It prevents pelvic adhesions that could otherwise scar their tubes and decrease their fertility later,” Kirkham explains. And, she adds, “people should also know that five to ten years’ use of birth control reduces their risk of uterine and ovarian cancer by 50%.”
Which is nothing to scoff at.
True! If you’re under the age of 35 and trying to get pregnant, you should only go see a gynaecologist or fertility specialist after a year of trying—and that’s 12 months of “properly timed” intercourse, Dixon says; meaning you’ve had sex during your “fertile window,” which is the three days before you ovulate each month. (Don’t know when you ovulate? Dixon recommends getting a period tracker app).
“The general population of people under 35 having sex willy nilly has about a 20 to 25% chance of getting pregnant each cycle,” Dixon says.
If you’re over 35, however, you should see a specialist after six months of consciously trying.
Thankfully, this is 100% incorrect. (Also LOL, who are we, one of King Henry VIII’s wives?)
“Up to 50% of infertility can be attributable, at least in part, to male factor infertility,” Dixon says, adding: “The ability to conceive is not just about the egg. It’s about the sperm, too.”
When it comes to infertility and sperm, it could be an issue of production (i.e. there aren’t enough swimmers in the pool), the sperm’s shape (true story: some sperm can have two heads) or “motility,” meaning how purposefully or speedily the swimmers are moving. And while it’s important to rule out certain medical conditions or genetic factors, Dixon says things like saunas, drinking, drugs or smoking can all affect sperm quality. Luckily, she says, “Testicles are like sperm production factories. If you stop smoking or drinking or going in hot tubs, three months later they’ve recovered and you’re fine.”
Not so, alas. “Miscarriages are very common,” says Kirkham, explaining that they can happen in about 15% of pregnancies in women under 35. “Over 35, the risk rises to over 25%, and in the early 40s it’s about 50%,” she says. Most miscarriages occur in the first 12 weeks of pregnancy, after which losses are much more rare.
Something Kirkham makes very clear is that most losses occur as a result of cell abnormalities in the egg or sperm or in the photocopies of those cells that form the embryo. “There is no reason to feel guilt or lay blame,” she emphasizes. “Mother Nature ends a process that was not progressing perfectly.” And, thankfully, after miscarrying “most women go on to have normal pregnancies later.”
We have no idea where we got this idea that jogging—or even mildly intense power walking—would somehow dislodge an embryonic life from your womb. Thankfully, it’s completely ungrounded in science. In fact, the opposite is true. If you want to get pregnant…“Exercise!” says Dixon with great feeling. “Blood flow to your muscles means blood flow to your organs, including your ovaries. And we need good vasculature to be putting out healthful eggs.”
In fact, she says, good blood flow is everything when you’re trying to “optimize” your chances of getting pregnant. It’s why Dixon advises those who are trying to get pregnant to quit smoking, limit caffeine and potentially look into acupuncture to stimulate blood flow.
Another tip from Dixon to ensure you have the best chance of getting pregnant? Get a good night’s sleep, “because you generally ovulate at night time,” she says. In addition to that, Dixon recommends eating a low-glycemic diet to make sure your blood sugar isn’t going on wild swings throughout the day. And, while firmly body positive, Dixon also emphasizes the importance of maintaining a healthy BMI. “It’s critical to pregnancy because, if you’re too thin or too heavy, that impedes implantation, and it may take you longer to get pregnant on either end of that spectrum.”
We’ve all seen the celebrities who give birth at like, 45. The thing is? “They’re using people like me,” says Dixon, who founded Anova Fertility and Reproductive Health in Toronto, meaning that these stars are likely using fertility specialists to help them conceive. “By the time you’re 40, you only have a 5% chance of getting pregnant each month.” By the time you’re that age, you’ve depleted 97% of the eggs you were born with, and, “the 3% that are left are not so good.” (Fun fact: The most eggs you ever had was when your mother was five months pregnant with you. Since then, you’ve been losing them through a process called “apoptosis,” which is “programmed cell death.” By the time you had your first period, you were down from up to 2 million to around 400,000. By the time you turn 35, 90% of that egg supply is gone, although the 10% that’s left is relatively well-functioning.)
And all of that doesn’t take into account other factors like mumps, endometriosis, or radiation, which can accelerate this egg-loss process. This is why Dixon is an advocate of a “fertility check up” for everyone before they’re 30. This check up would entail seeing a fertility specialist who would run a series of tests to determine if you have any underlying challenges that might make it harder for you to conceive, and, should there be any flags, help you to make informed decisions about your reproductive future. Biology, it seems, has not heard that 40 is the new 30.
Even beyond getting pregnant, however, Kirkham also flags the higher risk of pregnancy complications the older you get, including things like preterm labour, pregnancy diabetes, high-blood pressure or needing to have a C-section. “The earlier the better,” she says of getting pregnant, while acknowledging that “individual life circumstances affect that.”
That, alas, is false. When it comes to freezing your eggs, the earlier you do it, the better, Dixon says, because your eggs are ageing with you. TL; DR: Older eggs = harder to get pregnant. “You should seriously think about freezing your eggs between [the] 25 and 35,” Dixon advises, adding that she plans to talk to her own daughter about cryopreserving her eggs when she’s in her 20s, if she doesn’t have a partner and is interested in having children. “It’s like an insurance plan,” she explains.”Sometimes women freeze their eggs and never use them—and sometimes they come back and we make babies with them.”
If you’re interested in finding out more about egg freezing in Canada, and your own options, speak with your doctor or check here for a fertility clinic near you.
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