Health

22 Things You Should Know About Fertility

If you're ever thinking of having kids, here are some things you should know.

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Heads up: This story addresses fertility issues that specifically apply to cisgender men and women. Cisgender means that you identify with the gender you were assigned at birth. Here is Part 2 of this story: 20 Things Transgender People Should Know About Having Kids.

1. If you think you might ever want kids, you should start thinking about it and planning for it in your twenties.

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Yes, seriously! "Just like we plan for retirement, we should plan for reproduction," Dr. Lubna Pal, reproductive science specialist, OB-GYN, and director of the Polycystic Ovary Syndrome Program at the Yale University School of Medicine tells BuzzFeed Life. That's because there are a lot of things that might make it harder for you to get pregnant in the future, and it's important for you to know about them now so that you can better understand your own risks and make informed choices about your potential timeline. Start talking to your doctor about it, if you haven't already.

2. Fertility issues can affect both men and women. It's a couple's issue, not just a woman's problem.

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When a couple seeks help for fertility issues, about a third of the time it's due to male-factor infertility, a third of the time it's female-factor infertility, and the other third is a combination problem — where both partners are contributing, Dr. Landon Trost, assistant professor of urology and head of Male Infertility and Andrology at Mayo Clinic in Rochester, MN, tells BuzzFeed Life.

3. It can take a while to get pregnant, even for young, fertile, healthy couples.

"In any given month, a healthy fertile couple only have about a 20% chance of getting pregnant," Dr. Thomas Molinaro, a reproductive endocrinologist at Reproductive Medicine Associates of New Jersey (RMANJ) in Eatontown, tells BuzzFeed Life. This is a surprise to a lot of people, according to a recent national survey of 1,000 people, conducted by RMANJ. "Over 90% of the [survey respondents] thought that getting pregnant wasn't going to be a problem at all," Molinaro says.

This means that it's totally normal to try unsuccessfully for many months, and not necessarily a sign that anything is wrong if it's taking some time.

4. If you think that you might put off having kids until your mid- to late-thirties, you should get an evaluation well before that to find out if that's a viable option for you.

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"Get an evaluation, and get one early," Molinaro says. "Going in at 32 or 35 makes a world of difference. Anyone who's thinking about delaying childbearing in their thirties, it's a good idea to go in for an evaluation, just to see where you're at. If you get an evaluation that looks good, then you know you have a few more years. But you don't want to show up [in your late thirties] and you've been putting it off, and find out that it's too late."

5. Doctors can perform a blood test to check on your egg reserve, and you can get it anytime.

This is something worth asking about if you're considering putting off having kids for a few years. "It's just a simple blood test on day three of the menstrual cycle, to allow a woman to know if she has time, or doesn't have time, and needs to think about it more quickly," Dr. Jane Frederick, specialist in reproductive endocrinology and infertility, and medical director of HRC Fertility in Orange County, California, tells BuzzFeed Life. While you're getting the blood test, you can also talk to your doctor about your unique health factors, lifestyle choices, and family history indicators, all of which can impact your ability to get pregnant.

6. One in eight couples have trouble with fertility.

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But that doesn't mean that one in eight couples will never have babies. More on this here.

7. If you're a woman under 35 and trying to get pregnant, you and your partner should try for a year before going to see a specialist for help. If you're 35 or over, seek help from a specialist after six months.

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The recommendations change at 35 because it becomes harder to get pregnant, there's an increased risk of miscarriage, and an increased risk of genetic problems. According to the CDC, about a third of couples where the woman is over 35 have fertility problems.

8. If you're a woman 40 or over and trying to get pregnant, you should probably go to a specialist at the outset, to learn more about your odds and your options.

"Anyone over the age of 40, we recommend to just go directly to the specialist and get some testing done," Frederick, says. "We can then advise that woman on what her chances are of conceiving." This is true even if you've already had a baby without any issues.

9. Age is a major factor, even if you're in perfect health.

If you're a woman, your fertility is expected to end roughly five to ten years before you hit menopause, according to the American Society of Reproductive Medicine (ASRM). After 35, the number of eggs you have, and the health of those eggs, starts to dramatically decline. To put it in perspective: A healthy 40-year-old woman has a 5% chance of getting pregnant each menstrual cycle, compared to the 20% odds of a woman ten years younger, according to the ASRM. This doesn't mean that it's impossible to get pregnant naturally in your late thirties or early forties, just that the odds become lower across the general population.

10. Other factors and influences can make your age a bigger deal.

You should think of your reproductive health as a continuum, Pal says — there are a lot of different factors that can influence your fertility. "The process of aging becomes even more meaningful when I put family history in context, or smoking in context, or a history of sexually transmitted infections in context," Pal says. It's important to understand all the factors, and take them all into consideration when planning for your future.

11. Here are some lifestyle factors that can play a role:

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Small changes to your lifestyle can potentially make a huge difference in your fertility — that's true for both men and women, Trost says. These factors include:

WOMEN:

• Smoking cigarettes — according to the ASRM, women who smoke go through menopause roughly four years earlier than women who don't. Infertility rates among smokers are also about TWICE as high as among nonsmokers.

• Exposure to secondhand cigarette smoke

• Chronic stress

• Drinking alcohol

• Eating a poor diet and not getting enough exercise

MEN:

• Smoking marijuana can definitely hurt your sperm

• Taking testosterone to build muscles can hurt your fertility

• Drinking alcohol and using cocaine

• Smoking cigarettes

• Eating a poor diet

12. And here are some health conditions that can also make it harder to conceive:

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WOMEN:

• Being overweight or underweight

• Infrequent and inconsistent periods

• Endometriosis

• Polycystic ovarian syndrome (PCOS)

• Uterine fibroids

• Endocrine disorders

and more

MEN

• Weight issues

• Varicoceles (or varicose veins around the testicles)

• Hormone disorders

• Diabetes

• Thyroid problems

• Previous trauma to the area

and more

13. Your mom's pregnancy and menopause history might be able to tell you something about your own fertility.

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If your mother went through menopause in her early forties or late thirties, that could be a sign that you might struggle with infertility. The same is true for if she experienced difficult pregnancies, uterine fibroids, or endometriosis. Be sure to talk to your doctor about your family's reproductive history.

14. And STIs can impact your fertility, so if you've ever had one, you should talk to your doctor about what that might mean.

Chlamydia and gonorrhea can cause damage to your fallopian tubes, which can make it harder to get pregnant and could also significantly increase your risk of ectopic pregnancy. And other STIs can also have an impact. Read 22 Things You Should Know About STDs and Your Fertility for more information.

15. Technology is wonderful, but it's not a sure thing.

In the RMANJ survey, roughly 2/3 of millennials surveyed said they thought that science was good enough that they didn't have to worry about infertility — that they'd be able to get pregnant regardless, Molinaro says. And fertility technology has made tremendous and exciting advancements, to be sure. "But there are limitations to our treatments," he says. For instance, click here to see national success rates for IVF, broken apart by age.

There's also the fact that sometimes it might be too late to undergo certain fertility treatments. "We don't know how to make new eggs or grow new eggs," Molinaro says. "Once a woman is out of eggs, she's out of eggs. She can use donor eggs, but that's all." This means that it's possible to wait too long to seek certain fertility treatments, if your goal is to use your own uterus and your own eggs to have a baby (rather than a surrogate or donor eggs).

16. You never know what other people have been through to get pregnant, and you shouldn't compare yourself to them.

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"I think the most important thing that people need to understand is that every case is different, every couple is different, and what you might have heard about [someone else] getting pregnant in different ways is not necessarily 100% correct," Molinaro says. "A lot of patients come in because they had a friend get a certain treatment. But the truth of the matter is that every situation is different and you don't know what lengths people have gone through to get pregnant."

For example: Celebrities who get pregnant in their late forties may very well have done so using donor eggs, or using their own eggs that they had frozen years before. But the tabloids don't go into that detail, and you wouldn't know either way. The point is: Don't assume something will work for you because it worked for someone else.

17. If you're going to freeze your eggs, the best time to do it is in your twenties or early thirties.

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BuzzFeed Life reported on this previously in 11 Things You Should Know About Freezing Your Eggs. The younger you are when you get your eggs frozen, the more likely it is that the eggs you've frozen are viable and high-quality. If you're in your mid- to late-thirties when you freeze your eggs, though, you risk not having enough healthy eggs available for when you want to use them down the line.

18. Egg-freezing as an elective procedure is still considered "experimental."

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In 2012, the ASRM declared that egg freezing shouldn't be considered experimental for women who use it to preserve their fertility (for instance, if they have endometriosis, or if they have cancer and plan to undergo chemotherapy). But in the same report, they indicated that voluntary egg-freezing should still be considered experimental, because there's not enough research to prove that it's worth it. Read 11 Things You Should Know About Freezing Your Eggs to learn more about this.

19. Age impacts sperm, also.

People used to believe that male age had no impact on fertility, and that men could conceive children no matter how old they were. And it's true that a man can father children well into his 70s and even older. That said, newer research is showing that kids born to older dads have higher rates of psychiatric conditions, like autism and schizophrenia, Trost says.

20. Problems with sperm count and motility can sometimes be fixed with a simple operation, or even some small lifestyle changes.

It's a common misconception that male infertility isn't ever treatable, Trost says. Sometimes that's unfortunately true, but in many cases small lifestyle changes can make a big difference — like stopping smoking marijuana and drinking alcohol, and losing weight. For certain conditions, like varicoceles, the doctor can perform a small operation that can fix the problem. And with obstructed ejaculatory pipes, there are also things doctors can do.

21. Don't assume that a year of not getting pregnant means that you won't ever have babies.

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"Infertility treatment has come a long way in the last decade," Molinaro says. "We've gotten a lot more successful at helping people get pregnant. The hardest step is the first step — looking to go get that evaluation. For a lot of patients, a lot of people are suffering in private. Infertility is common, lots of people go through it, and taking that first step is really important. Reaching out to get an evaluation and see a fertility specialist, reaching out to find out what's going on. You'll never know if you don't get your evaluation to figure out what's happened."

22. Bottom line: if you know you want to conceive one day, you should start thinking about and planning for that early.

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Take care of your body, think about your family history, think about your own medical history, and talk to your doctor about what you need to do and what tests you might want to get in advance. This way you can know early enough if you probably have the luxury of waiting until you're in your mid-thirties to get going, or if you might want to think about other plans.