By Rachel Cunningham
One in 10 couples experience fertility issues if the woman is in her early to mid-thirties, rising to one in four couples if woman is in her late thirties.
“Start today” was the key message from the Dr. Bart Kuczera to anyone who is beginning to seriously consider getting pregnant.
The average age of a first-time mother in Ireland is 30.5 years old. The Beacon Care Fertility Clinic consultant warned that time is of the essence, as approximately one in 10 couples experience fertility issues if the woman is in her early to mid-thirties, rising to one in four couples if the woman is in her late thirties.
“It’s very modern to think that you have to have all of your arrangements made before you can begin to think about becoming pregnant but I’d advise not to hesitate. First of all, you have to try. It’s a very natural process and most women, even those sitting in fertility clinics, are naturally fertile and will conceive a baby within the year, even in their early forties”.
However, Dr. Kuczera warned that time is of the essence when it comes to successful pregnancy outcomes, with or without in-vitro fertilisation (IVF) intervention:
“People who come to me for treatment are sometimes not aware that their chances are dropping. People think that IVF is equally effective, regardless of age and that is incorrect. Everyone is attached to the success stories that you read about but generally the public is less aware of the amount of failure. This is a reality in natural conception and it’s a reality in IVF”, he commented.
“When you look at the natural fertility curve for the general population, you see that it’s pretty consistent until the age of 34 and then it will grow increasingly difficult to conceive every four years, on average, with a sudden drop at the age of 43. Although natural conceptions above the age of 43 are still happening, there is enough evidence to suggest that typically most women are infertile by the time they reach this age.
“Generally speaking, if a woman is not getting pregnant within half a year and she is 35, she should initiate some investigations either with her GP or directly through a fertility clinic. Obviously, the male side must be investigated as well. We cannot assume that this is only a female problem, which is a common misconception in infertility”, he said.
A male fertility issue is the sole or contributing factor in up to 50 per cent of all cases and can be identified through a simple and non-invasive semen analysis test.
Dr. Kuczera explained that the ovarian ageing patterns become more evident after the age of 35 and, for certain women, the fertility journey ends sooner, which is why medical professionals advise a six month timeframe before other options are considered.
He continued: “For women below this age bracket, who have no family history of early menopause, it’s really safe to try for at least a year before initiating investigation. This does not even necessarily mean launching them straight into treatment, they might be advised to continue with another year of natural attempts or modified natural attempts with minimal intervention to try to induce ovulation or to time intercourse over the month. If the couple has been trying for two years without success, that’s when we would definitely advise treatment.”
Single women who want to become pregnant or couples who require sperm donation can look into the option of insemination. The Beacon, like most fertility clinics in Ireland, is partnered with the European Sperm Bank, an established sperm bank in Denmark that is accredited to EU standards.
Regarding whether the Covid-19 vaccine is a safe option for those who are pregnant or are hoping to become pregnant, Dr. Kuczera agreed that it is a difficult topic to navigate, as there is not uniform advice on the subject. He highlighted that fighting the pandemic is a priority and assessed that, based on the research on pregnant women receiving the vaccine, it appears to be safe. However, he explained that the only contraindication that has been noted was in conception around the time of vaccination, owing to many people having a negative reaction to it. It is this reaction to the vaccine that has the potential to be harmful to implantation or the early embryo development and Dr. Kuczera advised looking closely at timing, and getting advice from a medical professional, to avoid any chance of a possible interference.
Dr. Kuczera concluded by underscoring the importance of managing mental health along the pregnancy journey. For those who need to use fertility clinics, the medical staff has been trained to identify when counselling may be of help and will be able to recommend fertility-specific services connected to their clinics.