Other factors

Caffeine

Although the evidence is not conclusive, research studies have found that high levels of caffeine consumption might prolong how long it takes to get pregnant. One study showed that women who consumed more than 500mg of caffeine per day had an 11 per cent increase in the time they took to conceive their first baby compared with women who consumed less.

The average amount of caffeine in a cup of coffee is 85mg but it can range from 40mg to 175mg depending on how the coffee is prepared and the kind of beans used.

Professor Robert Norman, an expert in reproductive medicine at the University of Adelaide, says that while the link between caffeine and infertility is weak, women trying to get pregnant should consider cutting out coffee and caffeinated drinks.

Heat

Men, keep your testes – yes, that’s your “balls” – cool if you want to father a child in the near future. Raising the body’s temperature, particularly the temperature around the testes, can reduce sperm production. Avoid hot baths, spas and saunas and sitting with your computer on your lap. There’s no clear evidence that wearing tight underwear affects a man’s fertility but best wear boxer shorts to be on the safe side.

See Andrology Australia’s website for more information on male infertility and how to prevent it.

Nutrition

A new study has found that a healthy diet in the year prior to getting pregnant is associated with a lower rate of birth defects.

Women planning on getting pregnant should avoid eating fish that have higher mercury levels and make sure they’re getting enough folate (folic acid), a B-vitamin which helps prevent neural tube birth defects such as spina bifida.

If you’re getting your folate through a multivitamin, make sure you’re taking one specifically for pregnancy or preconception because some vitamins, such as Vitamin A, are dangerous for pregnancy if taken in high amounts.

The best way to make sure you are getting enough nutrients is to have a healthy well-balanced diet rather than relying on vitamin supplements.

For more information on a well-balanced diet: Nutrition Australia

Environmental toxins

Heavy metals such as lead and mercury, and industrial chemicals, can affect a woman’s fertility. Repeated exposure may reduce fertility and increase the risk of miscarriage and birth defects.

For men, pesticides, heavy metals, toxic chemicals and radiation may affect the quality and quantity of sperm. Read the Fertility Coalition partner Andrology Australia’s booklet Your sperm – and how to look after them.

Drugs

The use of drugs should be avoided when planning a pregnancy as they can be harmful to an unborn baby.

If you are taking prescription drugs and plan to get pregnant be sure to check with your doctor that these are safe in pregnancy. Some over-the-counter drugs, supplements such as vitamins, and herbal medicines, can also be harmful to the unborn baby and if in doubt, check with your doctor.

Anabolic steroids taken for body building or competitive sports cause men’s testicles to shrink in size and sperm production to stop. They can also be harmful to general health for men who have normal testosterone levels. If you’re trying to have a baby, you should stop taking anabolic steroids. See Your sperm – and how to look after them.

Recreational drugs, including cocaine, heroin, and ecstasy, have also been shown to affect male and female fertility. There is some proof that marijuana use can lower a man’s sperm count, decrease the volume of his semen and reduce sperm motility (movement ability), which can prevent the sperm fertilising the egg. Drug use can also affect a man’s testosterone levels and sex drive. Long-term use of these drugs can lead to permanent reproductive problems and prevent you from becoming pregnant.

The Better Health Channel website has more information about pregnancy and drugs.

Medications

If a woman is planning to get pregnant, she should talk to her doctor about any prescription medications, over the counter medications or complementary medicines she is taking, to make sure they are safe.

It is not advisable for women to stop taking prescription medications without first consulting their doctor.

Genetic causes of infertility

The most common genetic causes of infertility are Klinefelter’s syndrome in men and Turner syndrome in women.

PCOS

Polycystic Ovary Syndrome (PCOS) is a chronic hormonal disorder that affects 12-18 per cent of reproductive aged women across Australia – affecting fertility, physical health and emotional wellbeing.

Jean Hailes for Women’s Health provides practical advice on diagnosis and management of PCOS , based on the latest research, for women and health professionals.

Sexually transmitted infections and fertility

Sexually transmitted infections (STIs), particularly gonorrhoea and chlamydia, can affect the fertility of both women and men.

There’s only one way to avoid a sexually transmitted infection. Actually, there are two but the first involves not having sex at all. So, it’s better to have safe sex by using a condom or dental dam. When you’re ready to have a family, both parties involved can be tested for STIs, so you don’t risk passing on an infection to a partner or child.

Chlamydia

Chlamydia is a very common bacterial infection that can affect any person who has unprotected sex.

It’s estimated that at least 75 per cent of women and 25 per cent of men will experience no symptoms. As symptoms of chlamydia can be similar to those of other conditions such as thrush and cystitis, it may also be overlooked. If symptoms do occur they can include:

Women

• pelvic pain
• painful and heavy periods
• deep pain with vaginal sex
• bleeding between periods or after having sex
• frequent and burning urination
• unusual vaginal discharge.

Men

• discharge from the penis
• burning or pain when urinating
• itching or irritation around the opening of the penis
• pain or soreness in the testicles.

How chlamydia can affect women’s fertility

Chlamydia causes inflammation of the urethra (tube from the bladder to the urinary opening) and/or the cervix (neck of the uterus). If left untreated the infection can travel to the uterus, fallopian tubes and ovaries. When the infection moves to these areas it is referred to as pelvic inflammatory disease (PID). PID may form scar tissue and adhesions which can result in serious health issues including chronic pelvic pain, ectopic pregnancy and fertility problems. Symptoms of PID include:

• lower abdominal pain and tenderness
• deep pain during sexual intercourse
• heavy and painful periods
• fever.

How chlamydia can affect men’s fertility

Chlamydia causes inflammation of the urethra. If left untreated chlamydia can progress to the epididymis (the tubes which carry sperm). This can cause pain, scarring and, rarely, fertility problems.

How is chlamydia treated?

Chlamydia is treated with antibiotics.

Gonorrhoea

Gonorrhoea is a bacterial infection that usually affects the genital area, although the throat or anus may also be affected. Gonorrhoea can affect both men and women and is easily transmitted during vaginal intercourse. It can also be transmitted during anal or oral sex.

Gonorrhoea symptoms for women

A lack of specific signs and symptoms means gonorrhoea may go undetected for longer in women. Often there are no symptoms. Sometimes, gonorrhoea causes:

• an unusual discharge from the vagina
• pain while urinating.

How gonorrhoea can affect women’s fertility

If left untreated, gonorrhoea can lead to pelvic inflammatory disease (PID), which can cause infertility. Symptoms of PID include:

• lower abdominal pain and tenderness
• deep pain during sexual intercourse
• heavy and painful periods
• fever.

Women who have had PID need to be especially careful about gonorrhoea, because the risk of infertility increases with each bout of inflammation.

Gonorrhoea symptoms for men

Men may experience a burning sensation while urinating. Gonorrhoea commonly infects the inside of the penis (the urethra). Symptoms may include:

• a burning sensation while urinating or passing water
• a white or yellow pus-like discharge from the penis
• swelling and pain in the testicles, which can occur if the gonorrhoea infection goes untreated.

In a small percentage of men there are no symptoms at all.

How gonorrhoea can affect men’s fertility

Gonorrhoea, can damage the epididymis (the tubes which carry sperm), preventing sperm from passing from the testes, or ‘balls’ into the ejaculate.

How is gonorrhoea treated?

Gonorrhoea is treated with antibiotics.

For more information about sexually transmitted infections, tests and treatment, contact a sexual health clinic in your state.

Men can find more information about sexually transmitted infections and men’s fertility at Andrology Australia’s website.

The Better Health website also has information about sexually transmitted infections.

Cancer treatment and fertility

Cancer treatment can affect a person’s fertility. For more information about oncofertility – options for preserving fertility for people with cancer, visit the Reproductive Health section of the Victorian Assisted Reproductive Treatment Authority (VARTA) website.