Here is what men and women can do to increase their chance of getting pregnant and having a healthy baby.1. Learnaboutthetopfivefertilityfactors.2. Completethe‘Preconceptionhealthchecklist’atwww.yourfertility.org.autotaketoyourdoctor.3. Visityourdoctortodiscusshowtooptimiseyourchanceofconceivingandhavingahealthybaby.4. Visitwww.yourfertility.org.auformoreinformation.

AgeFertilitydeclineswithage,soifyouarethinkingabouthavingababy,considertryingsoonerratherthanlater.

Onaverage,women’sfertilitystartstodeclineintheirearlythirtiesanddeclinesmorerapidlyafterage 35.Themonthlychanceofconceivingisabout20%forawomaninhertwenties.Byage40itisonly5%.

Men’sfertilitystartstodeclineataboutage 45.Menovertheageof40are30%lesslikelythanyoungermentoachieveconceptionwithinayear.

Considerseeingafertilityspecialistif:

• thefemalepartnerisyounger than 35andyouhavetriedtogetpregnantfor a year or more

• thefemalepartnerisolder than 35andyouhavetriedtogetpregnantfor six months or more.

WeightSizematters!Studiesshowthatfertilityandthehealthofababyatbirthandintoadulthoodareaffectedbythehealthoftheparentsevenbeforeconception.

• Beingoverweightcanresultinhormoneimbalancesthataffectovulationandspermquality.

• Beingveryoverweightlowersfertilityandincreasestheriskofpregnancycomplications.

• Ahealthydiettogetherwithregularexercisecanhelpreduceandmaintainweightinthehealthyrange.

• Yourdoctorcanpointyouintherightdirectionifyouwanttoloseweight.

Top Five Fertility Factors

Thinking about having a baby?Talk to your doctor!

Fertile windowMost fertile days

% li

kelih

ood

of c

once

ivin

g

OV

ULA

TIO

N D

AY

Day of intercourse relative to ovulation

0%

10%

16%14%

27%

31%33%

0%

-6 -5 -4 -3 -2 -1 0 +1

SmokingSmokinghasdamagingeffectsonthewholebody,includingeggsandsperm.Italsoincreasestherisksofpregnancycomplicationsandhealthproblemsforthebaby.Quittingbeforeconceptionistheonlywaytoreducetheserisks.

AlcoholForwomen,notdrinkingalcoholisthesafestoptionifyouarepregnantortryingtohaveababy.

Formen,avoiddrinkingexcessiveamountsofalcoholtoimproveyourspermquality.

Timing of sexWhenyouwanttohaveababyyoucanimprovetheoddsofthishappeningifyouhavesexduringthe‘fertilewindow’ofthemenstrualcycle.

Ovulationiswhenaneggisreleasedfromtheovary.Thishappenstwoweeksbeforeaperiodstarts.Technically,pregnancyispossibleduringthesixdaysleadinguptoandincludingovulation.But,thelikelihoodofpregnancyisdramaticallyincreasedifyouhaveintercourseduringthethreedaysleadinguptoandincludingthedayofovulation.

Thelengthofawoman’smenstrualcycledetermineswhenovulationoccurs:

• in28daycyclesthemostfertiledaysaredays12to14

• in24daycyclesthemostfertiledaysaredays8to10

• in35daycyclesthemostfertiledaysarebetweendays19and21.

Forwomenwithirregularcycles,yourdoctorcanorderbloodteststocheckifyouareovulating.

Ifallthisseemstoocomplicated,analternativeistohavesexeverytwotothreedays-thatwayyouaresuretocoverallbaseswithoutgettingtootechnicalaboutwhenthechanceofconceivingisgreatest.

Visitwww.yourfertility.org.auformoreinformationaboutthe‘fertilewindow’andanovulationcalculator.

General healthHereareotherfactorsthatcanaffectmaleandfemalefertilityandthehealthofthebaby:

• somemedicalconditionsandmedications,includingherbaloralternativemedicines

• untreatedsexuallytransmittedinfections(STIs)

• ahistoryofgenitalsurgeryorhavingmumpsasanadult

• recreationaldrugsandtheuseofanabolicsteroids

• exposuretopesticides,heavymetals,toxicchemicals,harmfulplasticsorradiation,allofwhichcanaffectfertility.

Talktoyourdoctorifanyofthesefactorsapplytoyou.

Herearesomethingsyoucandotogiveyourbabythebeststartinlife:

• forwomen,takingfolicacidtabletsforthetwomonthsormorebeforeconceptionandinthefirstthreemonthsofpregnancytoreducetheriskofbirthdefects

• forwomen,GermanMeasles(Rubella)inpregnancycancauseseverebirthdefects.YourdoctorwillorderatesttomakesureyouareimmunetoRubellaandifyouarenot,youshouldbevaccinatedbeforeyouconceive

• forwomenandmen,avoidingexposuretochemicalsathomeandatwork.

Questions to ask your doctor

Your Fertility is a national public education campaign funded by the Australian Government Department of Health.

Facts about fertility to share with patients Thisisasummaryofexistingscientificevidenceaboutthe‘Top5FertilityFactors’.Areferencelistisavailableatwww.yourfertility.org.au.Inadditiontothese,manyotherfactorsinfluencefertilityandreproductiveoutcomesincludingsexuallytransmittedinfection(STIs),environmentaltoxins,diet,andexercise.

Age • Women’sfertilitydeclinesgraduallystartingat

about32yearsofage.Itdecreasesmorerapidlyafter35yearsofage.

• Theriskofmiscarriageincreasesasawomangetsolder.

• Thequantityandqualityofspermdeclinesasmengetolder,startingatabout45yearsofage.

• Femalepartnersofmenovertheageof45takefivetimeslongertoconceivecomparedtopartnersofmenaged25orless.

• Asmengetolder,theriskofchromosomalabnormalitiesandbirthdefectsinthechildrentheyfatherincreases.Also,childrenofolderfathershaveanincreasedriskofhavinganautismspectrumdisorder.

• Postponingparenthoodincreasestheriskofinvoluntarychildlessnessandsmallerfamiliesthandesired.

• Assistedreproductivetreatment(ART)cannotovercomeage-relatedinfertility.

• Therisksofpregnancycomplicationssuchasgestationaldiabetes,pre-eclampsia,placentalabruption,intrauterinegrowthrestriction,prematurebirth,stillbirth,andcaesareansectionincreaseaswomengetolder.

Most people want and expect to have children sometime in their life. For some, age and lifestyle factors reduce their chance of having a baby. Health care professionals are in an ideal position to raise awareness about the effects of age and lifestyle on fertility and pregnancy outcomes and the importance of preconception health.

You can help your patients by asking them if they wish to have children and making them aware of the factors that will help or hinder being able to conceive and have a healthy baby. Consultations about reproductive health matters provide an opportunity to begin a conversation about fertility.

The Your Fertility program aims to give women and men who want to become parents the information they need to optimize their chance of achieving this. www.yourfertility.org.au provides clear and accurate information for the general public and health professionals about the factors that influence fertility and pregnancy health.

Fertility facts for health professionals

Weight • Obesityinwomencancausehormonalchangesthat

interferewithovulationandreduceawoman’sfertility.

• Obesewomentakesignificantlylongertoconceivethanwomeninthehealthyweightrange.

• ThechanceofsuccesswithARTtreatmentissignificantlylowerforobesewomenthanforwomeninthehealthyweightrange.

• Inmen,obesityisassociatedwithlowerfertility.Thisislikelyduetoacombinationoffactorsincludinghormoneproblems,sexualdysfunctionand/orotherhealthconditionslinkedtoobesity.

• Obesityinwomenincreasestheriskofmiscarriage,gestationaldiabetes,hypertension,andprematurebirth,congenitalabnormalities,highbirthweight,stillbirthandperinataldeath.

• Childrenborntoobesemothershavepoorerhealthoutcomesatbirthandintoadulthoodthanthosewithmothersinthehealthyweightrange.

Smoking • Smokersaremorelikelytobeinfertile.

• Womenexposedtopassivesmokingtakelongertoconceive.

• Womenwhosmokereachmenopauseearlier.

• Maternalsmokingincreasestheriskoflowbirthweightandbirthdefects.

• SmokingcandamagespermDNA.

Alcohol • Thereisanegativerelationshipbetweenthechance

ofconceptionandtheamountofalcoholconsumed.

• Partnersofmenwhoconsumemorethan20drinksofalcoholperweektakelongertoconceivethanpartnersofmenwhodrinkless.

• TheNationalHealthandMedicalResearchCounciladvisesthatforwomenwhoarepregnantorplanningapregnancy,notdrinkingalcoholisthesafestoption.

Timing of sex • Whileconceptionistheoreticallypossibleduring

the‘fertilewindow’whichisthesixdaysleadinguptoovulation,thechanceofconceptionisdramaticallyincreasedifintercourseoccursduringthethreedaysleadinguptoandthedayofovulation.

• Timeofovulationcanbecalculatedbysubtracting14daysfromtheaveragecyclelength.

• Payingattentiontotheappearanceofcervicalmucuschangescanhelpidentifythefertilewindow.Afewdaysbeforeovulation,thecervicalmucusincreasesandbecomesclear,stretchyandslippery.

• Anovulationcalculatorisavailableatwww.yourfertility.org.au

Fertility facts for health professionals

Your Fertility is a national public education campaign funded by the Australian Government Department of Health.

This list of references reflects current evidence about the impact of parental age and lifestyle factors on: fertility; chance of success with assisted reproductive technology (ART) treatment; pregnancy health; and the health of the baby at birth and into adulthood. The list also includes references relating to the fertile window in the menstrual cycle. In addition to these, many other factors influence fertility and reproductive outcomes including sexually transmitted infection (STIs), environmental toxins, diet, and exercise.

Visitwww.yourfertility.org.auformoreinformationaboutfertilityandpreconceptionhealth.

Age Cooke,Lynne,andScottM.Nelson.ReproductiveAgeingandFertilityinanAgeingPopulation.TheObstetrician&Gynaecologist.2011;13(3):161-68.

deGraaffAA,LandJA,KesselsAGH,EversJLH.Demographicageshifttowardlaterconceptionresultsinanincreasedageinthesubfertilepopulationandanincreaseddemandformedicalcare.FertilityandSterility.2011;95(1):61-7.

D’Onofrio,B.M.,M.E.Rickert,E.Frans,R.Kuja-Halkola,C.Almqvist,A.Sjolander,H.Larsson,andP.Lichtenstein.Paternalageatchildbearingandoffspringpsychiatricandacademicmorbidity.JAMAPsychiatry.2014;71(4);432-8.

Lawson,Gerald,andRichardFletcher.Delayedfatherhood.JournalofFamilyPlanningandReproductiveHealthCare.2014;40(4):283-88.

MazzaD,CannoldL,NagleC,McKayF,BrijnathB.Makingdecisionsaboutfertility:ThreefactsGPsneedtocommunicatetowomen.AustralianFamilyPhysician.2012;41:343-46.

Ramasamy,Ranjith,KojiChiba,PeterButler,andDoloresJ.Lamb.Malebiologicalclock:Acriticalanalysisofadvancedpaternalage.FertilityandSterility.2015;doi:10.1016/j.fertnstert.2015.03.011.

SchmidtL,SobotkaT,BentzenJG,NyboeAndersenA.Demographicandmedicalconsequencesofthepostponementofparenthood.HumanReproductionUpdate.2011;18(1):29-43.

WeightDerbyshire,E.PreparingforPregnancy:Abodyweightperspectiveandupdateoftheliterature.CurrentNutritionandFoodScience.2011;7:216-20.

GesinkLawDC,MaclehoseRF,LongneckerMP.Obesityandtimetopregnancy.HumanReproduction.2007;22(2):414-20.

HammoudA,CarrellD,GibsonM,PetersonC,MeikleA.Updatesontherelationofweightexcessandreproductivefunctioninmen:sleepapneaasanewareaofinterest.AsianJournalofAndrology.2012;14:77-81.

Koepp,UM,LFAndersen,KDahl-Joergensen,HStigum,ONass,andWNystad.Maternalpre-pregnantbodymassindex,maternalweightchangeandoffspringbirthweight.ActaObstetricaetGynecologicaScandinavica.2012;91(2):243-49.

LaneM,RobkerRL,RobertsonSA.Parentingfrombeforeconception.Science.2014;345(6198):756-60.

Fertility factors reference list

Marchi,J.,Berg,M.,Dencker,A.,Olander,E.K.,Begley,C.,Risksassociatedwithobesityinpregnancy,forthemotherandbaby:asystematicreviewofreviews.ObesityReviews2015;DOI:10.1111/obr.12288.

MafteiO,WhitrowMJ,DaviesMJ,GilesLC,OwensJA,MooreVM.Maternalbodysizepriortopregnancy,gestationaldiabetesandweightgain:associationswithinsulinresistanceinchildrenat9-10years.DiabeticMedicine.2014;32(2):174-80.

MoragianniAA,JonesS-ML,RyleyDA.Theeffectofbodymassindexontheoutcomesoffirstassistedreproductivetechnologycycles.FertilityandSterility.2012;98(1):102-8.

TennantPWG,RankinJ,BellR.Maternalbodymassindexandtheriskoffetalandinfantdeath:acohortstudyfromtheNorthofEngland.HumanReproduction.2011;26(6):1501-11.

SmokingAugoodC,DuckittK,TempletonAA.Smokingandfemaleinfertility:asystematicreviewandmeta-analysis.HumanReproduction.1998;13(6):1532-9.

DechanetC,AnahoryT,MathieuDaudeJC,QuantinX,ReyftmannL,HamamahS,etal.Effectsofcigarettesmokingonreproduction.HumanReproductionUpdate.2011;17(1):76-95.

HackshawA,RodeckC,BonifaceS.Maternalsmokinginpregnancyandbirthdefects:asystematicreviewbasedon173687malformedcasesand11.7millioncontrols.HumanReproductionUpdate.2011;17(5):589-604.

HomanGF,DaviesMJ,NormanRJ.Theimpactoflifestylefactorsonreproductiveperformanceinthegeneralpopulationandthoseundergoinginfertilitytreatment:areview.HumanReproductionUpdate.2007;13(3):209-23.

HullMGR,NorthK,Taylor,FarrowA,FordC.Delayedconceptionandactiveandpassivesmoking.FertilityandSterility.2000;74(4):725-33.

AlcoholFloydL,JackB,CefaloR,AtrashH,MahoneyJ,etal.Theclinicalcontentofpreconceptioncare:alcohol,tobacco,andillicitdrugexposures.AmericanJournalofObstetricsandGynecology2008;December:s333-s39.

HassanMAM,KillickSR.Negativelifestyleisassociatedwithsignificantreductioninfecundity.FertilityandSterility.2004;81(2):384-92.

HomanGF,DaviesMJ,NormanRJ.Theimpactoflifestylefactorsonreproductiveperformanceinthegeneralpopulationandthoseundergoinginfertilitytreatment:areview.HumanReproductionUpdate.2007;13(3):209-23.

Klonoff-CohenH,Lam-KruglickP,GonzalezC.Effectsofmaternalandpaternalalcoholconsumptiononthesuccessofinvitrofertilizationandgameteintrafallopiantransfer.FertilityandSterility.2003;79(2):330-9.

Timing of sexBerglundScherwitzlE,LindenHirschbergA,ScherwitzlR.IdentificationandpredictionofthefertilewindowusingNaturalCycles.TheEuropeanJournalofContraceptionandReproductiveHealthCare.2015;Jan16:1-6.

EcochardR,DuterqueO,LeivaR,BouchardT,VigilP.Self-identificationoftheclinicalfertilewindowandtheovulationperiod.FertilityandSterility.2015;103(5):1319-25.e3.

PracticeCommitteeoftheAmericanSocietyforReproductiveMedicineincollaborationwiththeSocietyforReproductiveEndocrinologyandInfertility.Optimizingnaturalfertility.FertilityandSterility.2008;90(Suppl3):S1-S6.

StanfordJB.Revisitingthefertilewindow.FertilityandSterility.2015;103(5):1152-3.

Your Fertility is a national public education campaign funded by the Australian Government Department of Health.

Fertility factors reference list