If you know you want kids ~at some point~, here’s some essential information.
There is a drop-off in fertility, especially for women, as you get older. But it might not be as dramatic as you think.
If you're a woman, your chance of conceiving each time you have unprotected sex starts to drop in about your mid-thirties. But media reports of a “fertility cliff” are overblown.
“There certainly is a reduction in female fertility in age,” Tim Child, a consultant gynaecologist and professor at the University of Oxford, tells BuzzFeed News. “But it's certainly not a cliff. It's a gradual decline that steepens as you get towards your late thirties.” A couple where the woman is 40 “has about a 50% chance of conceiving” in 12 months of trying, he says, although the risk of miscarriage is higher.
Robert Winston, an emeritus professor of fertility studies at Imperial College London, agrees. “Women are more fertile than they realise, for a long time,” he tells BuzzFeed News. “The average age of having your first baby is over 30 now, and there isn't any decrease in national fertility that we can see. So the idea that you are becoming infertile at 30 is nonsense.”
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If you’re trying to conceive and don’t get pregnant right away, you really don’t need to worry.
If you're trying to get pregnant, each month that passes can feel incredibly long. But it's pretty rare to get pregnant straight away.
“The chance of a British couple getting pregnant each cycle is about 20%,” says Winston. “It's a bit higher in Australia, where people have a bit more sex; it's a bit lower in France, where people have less.
“So on average, it takes five months to get pregnant. You're not unusual unless you've gone 10 months or a year. I wouldn't dream of examining someone until it's been a year, unless there was some specific reason you thought there was a problem.”
Dr Helen Munro, a sexual and reproductive health consultant, agrees. “If a couple have been having sex two or three times a week for a year and still not fallen pregnant, they'd be the ones I'd look at,” she told BuzzFeed News. “Otherwise, you're fertile until proven otherwise.”
Child says “the chances of a healthy couple conceiving in a year is about 80%, and importantly, half of the ones who haven't will conceive naturally the year after. Often it just takes longer.”
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Contraception can’t make you infertile.
“The number one thing with our female patients starting contraception is they have these ideas about contraception causing infertility. The pill making you infertile, or a coil making you infertile,” says Munro.
“I spend a lot of time reassuring young women that contraception can't make you infertile. The myths are maybe from people who've come off contraception and then struggle to get pregnant, but it's not to do with the contraception. As a doctor, I want to first do no harm. If there was any reason we thought that contraception could cause infertility, that would be harm, and I couldn't do it.”
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Your risks of failing to conceive and of miscarriage increase into your late thirties and forties.
Women are born with between 2 million and 3 million eggs in their ovaries, says Child. “The common myth is that [you become infertile when] you run out of eggs,” he says. “Occasionally that's the case, but generally it's that as you get older, the eggs that remain are of poorer quality. We don't really know why.”
So you may continue ovulating, but your eggs are more likely to have genetic problems. That means that if they're fertilised, they're less likely to implant, and if they do implant, you're more likely to have a miscarriage further along in the pregnancy.
How late you want to leave it depends on lots of things. “We're living longer and working longer,” says Munro. “We have different priorities – our priority isn't having a baby at 21, and that's a good thing. But our bodies haven't changed. We're still at peak fertility in our mid-twenties.”
Adam Balen, a consultant in reproductive medicine and chair of the British Fertility Society, says that if you want a “really good” chance of having a larger family, it is better to start earlier. “If you just want one, you can probably wait until your early thirties and still have a really good chance,” he tells BuzzFeed News. But if you want more than that, to give yourself the best shot, he says, it may be worth considering starting earlier.
But, Munro says, media focus on this can be unhelpful. “Women are inherently aware. We know this and don't need to be told,” she says. “As clinicians, we'll work with the choices of the woman, so if she's busy in her career at age 35 and doesn't want an unplanned pregnancy, I'll give her options for good contraception.”
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