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02 May 2012
If you missed our Wednesday Lunch Club Q&A on the askamum Facebook page with Miriam Stoppard, doctor, businesswoman, journalist, broadcaster and writer, read the questions you asked her and her answers below.
>> Visit our Trying to Conceive section
Q: I’m 32 and I am considering egg freezing but I’m worried about the cost or the pain involved.
A: The costs come in at least two phases. The first is a chemical phase in order to get your ovaries to produce quite a few eggs. This in itself can be quite uncomfortable. The second stage is the harvesting of your eggs. The third stage is freezing them. And the fourth stage is unfreezing them and using them in IVF at a time of your choice. Each of these phases carries a cost and it is more than you might think. Make sure you're aware of the total expenditure involved. One further note, we know that the success rate with unfrozen eggs is higher than that with frozen eggs, so if you decide to go ahead, make sure you have accurate info on the success rate on the clinic you decide to go with.
Q: I am 28 and my husband is 40. This sounds odd, but does a man's age affect his sperm quality?
A: An emphatic no. Just think of men in their 80s who've conceived! The actor Anthony Quinn for one! Think of Des O'Connor. And what about Rod Stewart? If your husband has healthy sperm, there's no impediment to your conceiving.
Q: I’m 30 and I have been trying for a baby for 14 months without success. Every time I get my period I feel desperately low, to the point that if someone at work tells me they're pregnant I have to go to the loo to cry. I'm telling myself that I need to keep trying for a baby and that there may be nothing wrong with me – but coping with my feelings of frustration is causing arguments between me and my husband and making me feel like a failure. Can you give me any tips of coping with my feelings?
A: I know that women frequently feel that their ability to have a baby is the most crucial part of their being a woman. But it's just not the case. We're all so much more than our bodily functions, including conceiving. I have personal experience of how it feels not to conceive when you want to but honestly, the more you worry, the more frustrated you get, the more obsessive you become, the less likely you are to conceive. Please try to feel philosophical so that your relationship doesn't suffer. I think it would help you both a lot if you could sit down together to discuss your feelings around trying to have a baby, and with a counsellor if you think that would help.
Q: My partner and I have trying to conceive our second child for two years. My scans and blood tests have been fine however my partner had a sperm assessment and was told he had low morphology and around 4% were normal. Can we still conceive naturally and is there anything we can do to increase our chances?
A: Yes you could conceive naturally but I think with only 4 normal sperm out of 100, you could need some help. I think you should ask your doctor to refer you to a fertility clinic. There are really astonishing new techniques to help men with low normal sperm counts so I think you should be optimistic and positive about your chances of having a second baby. Only a fertility expert could tell you for sure but it could be that you need IVF and possibly, a special technique called ICSI which stands for Intracytoplasmic sperm injection which has a high success rate.
Q: I'm pregnant for the first time and I have been taking folic acid which is great but I have noticed that you can't take it all the way through pregnancy, is this correct or can I continue to take it?
A: I'm extremely glad that you're taking folic acid supplements as you should be. I think what the instructions actually say is that you should take folic acid for the first 12 weeks. This is to protect your unborn baby when it's going through the most vulnerable part of its development. Folic acid for the first 12 weeks of pregnancy, and for three months before (if your pregnancy is planned) is crucial. However, that's not to say that you need to stop taking it. You don't. It's just that after 12 weeks and certainly by 16 weeks, your baby doesn't need its protection.
Q: Two weeks ago I was sent into the early pregnancy unit with stomach pains and spotting. I was told I had an ectopic pregnancy, roughly 6 weeks. Unfortunately my right fallopian tube had already ruptured and the tube, and pregnancy was removed during my emergency surgery. Along with being devastated about losing my pregnancy, I am now concerned about if and how long it will take to become pregnant again.
A: You still have one healthy fallopian tube in which a new pregnancy can be conceived and transported to your womb so that the pregnancy can proceed normally. So be optimistic. I do think that you should have a consultation with your partner and an obstetrician who knows the details of your case to discuss any tests that might be appropriate to throw some light on why you had your first ectopic and how, hopefully, to prevent another. I really don't want you to lose hope because your final option can always be IVF if your remaining fallopian tube isn't perfect. And IVF is getting more and more successful all the time.
Q: After a complicated pregnancy I was induced at 34.5 weeks with mentioning of pre-eclampsia . A doctor has told me that it may be difficult to stay pregnant as my body will recognise the hormones and 'reject' pregnancies. Is this something my body can overcome or should I not put my body through it again?
A: Pre-eclampsia isn't your body rejecting the baby and I can't explain what your doctor apparently said 'your body will recognise the hormones and reject pregnancies'. Many women who have had pre-eclampsia in one pregnancy go on to have further pregnancies. With your past history it simply means that you would be very carefully monitored so that anything untoward could be spotted early and steps taken to avoid mishaps.
Q: I have fairly regular periods and we are trying to conceive a second baby, but after a year we haven't had much luck. I have endometriosis and our first baby was through IVF. I've been using ovulation predictor tests and some look as though they might be positive but I can't be sure the line is actually as dark as the control line. Others are just plain negative. Could I have regular periods but still not always be ovulating?
A: The general answer is yes you could be. There is a test system available which is better than the ovulation predictor tests that you buy over the counter, it's called DuoFertility and it's a fiendishly clever system. What it does is that it monitors through a small patch that you wear your hormones 24/7 so that the very moment of your ovulation is recorded on a remote digital system. And you will be informed. This is quite important because your ovulation can vary from month to month and it may happen during the night. That could be missed by the average ovulation predictor test. If you want to look into DuoFertility look at http://www.duofertility.com/ and take it from there. I've seen the research and they do have a higher than average success rate using their technology.
Q: Is it a myth that a woman is more likely to conceive using certain sexual positions?
A: There are all sorts of myths about sexual positions, including the position to have a boy (lie on your right side and make sure the wind is in the north) but honestly your body doesn't need any help from your sexual position in order to conceive. However, let me explain the mechanics. When your partner ejaculates, the sperm lies at the top of the vagina in two little pools called the fornices and the cervix dips into this pool to facilitate the sperm passing up through the cervical canal into the womb. This can happen even if you stand up immediately but if you're hoping to conceive it probably would be a good idea to lie still for a little while. All the rest is no more than witchcraft.
Q: How much sex should me and my husband be having to conceive?! We've been trying for six months and have sex around twice a week. Do we need to do it more often?
A: The Royal College of General Practitioners did a marvellous survey and came up with the magic formula for conceiving. They found out the highest conception rate was amongst couples who have sex every three or four days *throughout the month*. It's not a good idea to confine sex to the days around ovulation. The time of ovulation can vary from month to month, even in the same woman. So it's best not to rely on a calendar because you can become obsessed and any obsession raises your anxiety levels which can interfere with ovulation not to mention the spontaneity of your sex! Very frequent sex reduces the sperm count, so don't whatever you do, have sex daily in the hope that that will work. So you're doing the right thing!
Q: My mum is very fertile – I am one of five children. But I am 28 and have been trying for a baby for 12 months with no luck. Does fertility run in families i.e., if your parents didn't struggle to conceive, should it be relatively easy for you?
A: Yes and no. Because your mum was married to your dad, and the fertility of a couple is the sum of the fertilities of each partner, that means your mum's fertility, plus your dad's fertility made for easy conceptions. It's not possible to say this will happen to you because whatever your fertility, you're with a different man and his fertility counts. So theoretically, if you have a high fertility and your husband has a lowish one, the combination of your fertilities could result in a pregnancy. But, if your fertility is on the low-side, and so is his, you could have problems. On the other hand, if his fertility is high and yours is a bit low, you could still conceive quite easily.
Q: I am 30 and came off the pill six months ago – but my periods still haven't returned. Is this normal?
A: That depends on the pill you've been taking. When I was doing research into the pill, we found that after stopping the pill,two thirds of women conceived in the first 12 months, three quarters conceived in 18 months and 90% conceived by the end of two years. Given that it has been six months since you stopped the pill, I think you should speak to your GP to see what they think. Your ovaries may just need a little stimulation and your GP, or a gynaecologist interested in fertility will know how to do that for you.
Q: I've been told it's important to get the right vaginal conditions or environment, i.e. not using tampons or vaginal deodorants or douching, washing too often in order to stand the best chance of conceiving, is that true?
A: The vagina is a self-cleansing, self-correcting organ. As long as you don't interfere with it with vaginal douches, feminine deodorants, WORST OF ALL, antiseptic in the bath your vagina will take care of itself and create the conditions most favourable to conception. I would say that any infection should be cleared up, like candida (thrush) so if you have a smelly discharge you should see your doctor for investigation to clear that infection up. It's quite wrong to be over-obsessive about cleansing, no more than once a day, and that not too rigorous. My rule is to under-cleanse rather than over-cleanse and let nature take its course. With regard to tampons, as long as you change them often I don't think they will affect the health of the vagina or restrict fertility.
Q: I am 34 but haven't met the right man yet! I would love children, though. Is it true that fertility drops dramatically after 35?
A: Yes, but fertility starts to drop in your late 20s, so it's best not to wait too long. Don't panic! I had my first son at 36 and my second at 39 so as long as you are leading a healthy life, eating well, not putting on too much weight, you still have every chance of conceiving. The main point about waiting until your late 30s when your fertility is diminishing quite fast, is that when you meet that right man, you'll want to just switch on your fertility and I understand that. But, you may find that you can't just throw that switch, and you may have to wait a little time to conceive. That being said, you shouldn't wait too long to conceive over the age of 35. One year would be plenty, then have a chat with your doctor, because you can have some fertility tests done to clarify the picture.
Q: I am 37 years old and I have had unexplained infertility for over 5 years now. I am still struggling to fall pregnant 4 1/2 years since having my youngest. I did fall pregnant after trying for 30 months but sadly miscarried in October 2010. Apart from de-stressing, leading a healthy lifestyle and exercising can you advise me in any ways to boost my fertility levels?
A: It's a myth that you can "boost your fertility". I think this myth has grown up because supplement manufacturers keep telling you that their supplements can improve fertility, but this is simply not true. I hope this isn't a downer, but I think that you should have some investigations done to make sure that you're ovulating regularly and that you are producing a very important hormone, luteinising hormone (LH) at the right time of the month, and I'm sure that these investigations would be like a window opening on your fertility. You need your GP to refer you to these tests, possibly to a gynaecologist who specialises in fertility problems. I can give you a hopeful note to end on - you've conceived once, so your fertility is proven. However, after a pregnancy you turn what I call a metabolic corner and it could be that your hormones just need a little tweak.
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Miriam Stoppard on fertility: Read our Wednesday Lunch Club Q&A with the parenting guru
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