Pre-conception and Fertility

We live in a rapidly changing world and a world that has been rapidly changing over the past 50-100 years.  We’ve seen some great changes in our lives many good, others not so great.  With changing desires and expectations for housing and career, the rising cost of living, and women having the freedom to pursue careers, the age of attempting conception is increasing.  This increasing age for first conception is most likely contributing to rising rates of infertility.  In Australia, the median maternal age for first born has risen from 28.3 in 1990 to 30.7 in 2010.  In Australia, 1/6 couples are infertile.  These statistics are similar in Canada; the Government of Canada states that roughly 1/6 couples are infertility which represents a doubling of infertility since 1980.  The extra 3 years before conception does have an impact, but it’s not just through simple ageing; the three years of often unhealthy diet and lifestyle can have a cumulative effect on the quality of reproductive health and potential for conception.  This applies to men as well as women.  It is a little known fact that 30-40% of infertility is attributable to issues with the male partner alone.  

Pre-conception is essentially any time prior to conception. I like to see people in my office at least 4 months prior to attempting conception as that is about how long it takes for egg follicles and sperm to develop so intervening 4 month prior to conception should have a great impact on the quality of the egg and sperm that are available. (Remember the columns on epigenetics?  Here’s our chance to start to modify that epigenetic landscape)    Surprisingly pre-conception care and conversations are not always happening in advance like this.  With our health care system quite burdened, sometimes preventative care and discussing future scenarios are not possible.   Optimizing sleep, increasing healthy foods, decreasing alcohol, junk food and caffeine, stress management, addressing any fatigue or signs of nutrient deficiencies is extremely important prior to conceiving. Pregnancy is a significant strain on anyone, and all parents know pregnancy is just the beginning of a very challenging chapter of life, so addressing health prior to conception is a good way to help ease into parenthood and the challenges of caring for a newborn baby.  

One of the most concerning issues I see is women starting on hormonal birth control when they are young for reproductive problems like painful or irregular periods and heavy or prolonged menstrual bleeding.  As helpful has this can be in the short term (with the added benefit of contraception) it absolutely can be masking a issue that can contribute to problems with fertility later in life.  Many women and parents are unaware of this.  It’s really a recent situation that we have Naturopathic Doctors and Traditional Chinese Medicine practitioners available to help address these issues, so I’m not picking on Medical Doctors, it’s just the situation we collectively find ourselves in. 

Some major contributors to poor pregnancy outcomes and difficulty conceiving are cigarette smoking, stress, lack of sleep, poor diet and lack of exercise.  Sound familiar?  It’s a bit of a broken record regarding preventative health - but this record is one of the most important sound tracks we have.  Remember Men you count too!  The increased age for men to become fathers is also a significant factor as the quality of sperm drops with age and we are seeing studies linking issues with babies and dad’s age at conception.  To further complicate things, environmental contaminates found throughout our food supply and on new products in the form of plastics, preservatives and flame retardants can actually reek havoc on our reproductive systems and developing babies in utero.  It’s a sad state of affairs, but we can make significant positive changes with slow and sustained efforts.  Check out the book Slow Death By Rubber Duck and for more on these environmental medicine issues.