WONDERING HOW YOUR FERTILITY stacks up on paper before you put it to the test in the bedroom? If you’re the curious type, you’ll probably want to dig into this chapter for clues about your fertility—how your cycles, your genetics, and your age (and your partner’s age) might influence your reproductive profile. Keep in mind as you read, however, that no fertility forecast is a sure thing. Every woman’s fertility is different, which means that certain fertility factors may never factor into your baby-making experience. And that also means you may end up making a baby a lot faster in the bedroom than you do on paper.
Rather just plunge into baby making without any fertility forecast? Skip this chapter, and get right to the action.
Inquiring (and hopeful) minds want to know: Am I fertile? How easily will I conceive once we start trying? There’s no telling for sure how your fertility stacks up until you actually take it for a test-ride (or two, or three, or many more). Even if it’s been tested in the past (and passed the test—in the form of a previous pregnancy), fertility can keep you guessing. Still, no need to be completely clueless about your fertility—especially when there are so many clues that can reveal at least part of the baby-making picture.
“I’m about to start trying to conceive and I’m so excited. Is there any way to tell whether I’m fertile or not?”
There’s really no way to know right out of the gate whether you can expect a smooth ride or a bumpy one to the baby finish line. It takes the average, healthy couple 6 to 12 months of active trying to successfully make a baby. And short of either getting pregnant or undergoing a fertility screening (which you certainly don’t need yet—and might never need), there is no way to find out definitively what your fertility prospects are at this early stage of the baby-making game.
Still, you can look to an old familiar (if not favorite) friend, your Aunt Flo, for some hints about what might lie ahead in your TTC future. In fact, tracking her monthly visits is one of the best ways to gauge your fertility and clue you in on the state of your reproductive health. So as you embark on your fledgling campaign to fill your nest, asking yourself some questions about your cycle can be a great place to start. (Keep in mind that you won’t be able to get a good read on your cycle if you’ve been on oral contraceptives or another hormonal birth control method because such cycles are “artificial” and don’t reflect what’s normal for you. That’s why it’s a good idea to get back to cycling naturally after quitting birth control pills, before you start trying to conceive.)
How long are my cycles? A “normal” cycle is usually anywhere from 26 to 35 days between periods, with 28 to 30 days the average. If your cycles are much shorter or longer than what is considered “normal,” it may be a clue to some fertility issues (though it may not be, too). Are your cycles all over the place? Occasional cycle length irregularities aren’t cause for concern. They’re usually just the result of stress, weight loss or gain, or another temporary blip in your normal routine, and as long as they reregulate, they won’t keep you from reaching your baby goal. But consistently irregular cycles can make conception slightly more elusive.
How much bleeding do I have? A normal period begins with light bleeding, builds to heavier bleeding, and then slowly tapers off, ending with light staining. Excessive bleeding (extremely heavy blood flow, blood clots, or large volumes of blood loss) or a flow that’s watery or exceptionally light in color could (but definitely doesn’t always) signal a reproductive problem.
How long do I bleed? Most women have their period for 5 to 7 days, though usually they see heavy bleeding only on days 2 and 3. Bleeding should lessen by day 4 and continue with only light staining up to day 7. Heavy bleeding that lingers longer than 6 days or periods that last longer than 8 to 9 days may possibly (but by no means necessarily) be a sign that something is off reproductively. Ditto for periods that have very light blood flow for longer than 8 or 9 days or ones that end abruptly after 1 or 2 days.
Do I have pain or cramping? Some aches, pains, and cramps come with the time-of-the-month territory, though a few lucky women don’t feel a thing. What’s not normal is extremely severe cramping, nausea, vomiting, acute backache, dizziness, or headaches right before or during your period. Any of these could signal (though not necessarily) a reproductive problem.
Are my cycles erratic? If you go months without a period and then have a few periods in a row and then go months again without bleeding, it could signal fertility challenges ahead (unless, again, it’s a sign of stress on your body—in which case the erratic cycles and the potential for fertility challenges should disappear when the stress does).
If there are any red flags in your period assessment—or if you have any other reason to believe you may be facing a fertility issue—talk over your concerns with your gynecologist. Chances are, you’ll get the reassurance you’re looking for—and marching orders right onto the baby dance floor. If it turns out that your menstrual irregularities may signal a fertility issue, now’s the time to have it checked out, diagnosed, and treated, so you can get back on the track to parenthood as quickly as possible.
“My mother had trouble conceiving me. Does that mean I’m going to have trouble conceiving, too?”
Like mother, like daughter? While it’s not necessarily true that your mother’s reproductive difficulties will be passed on to you (you may have a fertility walk in the park), there are genetic components to some fertility-related disorders and it’s worth exploring your female family tree to see what may—or may not—be lurking beneath the leaves. Ask your sisters, mother, grandmother, aunts, and even female cousins about their TTC experiences and whether they had or have endometriosis, ovarian cysts, fibroids, thyroid disorders, or other potential fertility stumbling blocks. It may also be helpful to know how long it took each of them to conceive. Take all this information with you on your baby-making journey (being sure to let your practitioner know about it, too).
“I’m 37 years old. Is it true that I should expect a harder time becoming pregnant?”
Thirty-five may be the new 25, and 40 the new 30—but the question is, have your reproductive parts gotten the memo? Can baby making be on your calendar no matter how many calendars you’ve gone through?
Absolutely. Birthrates are currently soaring for women (and men) well into their 30s and 40s—proof positive that babies can come to those who wait (even if they sometimes come with a little help from a fertility specialist). If it’s true that a woman’s life begins at 30 (or even 40), it’s also true that, more and more often these days, so does her active reproductive life. Fewer women are jumping on the baby train in their 20s, and a full 1 in 5 are opting to wait until they’re well into their 30s and 40s to start a family.
Many of these moms are able to conceive within just a few months of trying (and have healthy pregnancies and healthy babies to show for it soon after). But for some “older” hopeful moms, the wait continues even after they’ve decided to take the baby plunge. They find it takes longer to conceive, or they find that they need a little help—or sometimes even a lot of help—from fertility treatments to make their baby dreams a cuddly reality.
That’s because women are at their most fertile in their very early 20s, well before most are ready to tap into that fertility. By their early 30s, fertility has started to wane—the chances of getting pregnant goes from 20 to 25 percent per cycle for women 25 and under, gradually down to about 15 percent per cycle for women in your age bracket, 35 to 39. Average chances of conceiving naturally at age 40—about 5 percent per cycle. Still potentially doable, but clearly not as easy to do.
What causes this drop in fertility? Fewer eggs (by age 30, only 12 percent of eggs are left) and less frequent ovulation, for one thing. For another, eggs that have been sitting on the shelf longer. As a woman ages, so do her eggs—and older eggs are less easily fertilized. Still another challenge: Older women don’t make cervical mucus like they used to—the quantity and quality of this fertility-friendly fluid also tends to lessen as a woman ages. A woman in her 20s can expect 2 to 4 days of fertile (clear, thin, slippery, stretchy, egg white–like) cervical mucus per cycle, while a woman in her late 30s often has only 1 or 2 days of fertile CM. Less CM may spell more challenging swimming conditions for egg-seeking sperm. Gynecological problems that can interfere with fertility—such as endometriosis or fibroids—are also more common as women get older, as are general health issues such as high blood pressure or diabetes that can make it harder to conceive. Those who do conceive have a somewhat higher rate of miscarriage, in large part due to those aging eggs.
Feeling daunted? Don’t. The vast majority of women your age—70 percent—conceive naturally and without a hitch. Even women who’ve passed their fortieth birthday have about a 40 percent chance of conceiving naturally. So don’t bog yourself down with the numbers now. Instead, relax and go about your baby-making business (though you’ll probably want to pay some extra attention to your cycles, so you can give yourself every fertility edge; see Chapter 5 for tips). If you’re 35 to 38 and you haven’t conceived within 3 to 6 months of active efforts, check in with your practitioner to see if it’s time for a little help in the fertility department. Check in sooner (after 3 months) if you’re over 38, and check in right away if you’re over 40.
And, here’s something else you may want to keep in mind. Being over 35 means conception can be a little trickier, but it can also make it more fruitful—meaning that when it rains babies, it can pour. Older moms have a greater chance of conceiving twins, even if they conceive naturally, without the benefit of fertility treatments. That’s because older moms tend to ovulate irregularly, and because they produce more follicle-stimulating hormone (FSH), their ovaries are more likely to be stimulated into dropping two eggs at a time (see facing page). Two fertilized eggs—and presto, you’ve got two babies.