Medical contribution by Lauren Roth, M.D.

Lauren Roth, M.D., is the Medical Director of SGF, and board certified in obstetrics and gynecology and reproductive endocrinology and infertility. She has published research on a range of fertility topics including polycystic ovary syndrome (PCOS) and the impact of weight on reproductive hormones. Dr. Roth sees patients in SGF’s Rockville, Maryland office.

Dr. Lauren Roth, SGF’s Medical Director, shares her best recommendations for women who are planning on starting a family later on in life.

Dr. Roth also answered questions such as the following:

  • Does stress really affect fertility?
  • Can weight and lifestyle choices affect your ability to get pregnant?
  • What are the consequences of postponing pregnancy for career?
  • What should every woman over age 35 consider if they want to have children later on?
  • What should women do if they’re ‘doing everything right’ and still not getting pregnant?
  • When is it time to see a fertility specialist?

Stress and Pregnancy

Q: Does stress decrease your chances of getting pregnant?
Dr. Roth: I often get asked about stress and fertility. The correlation between stress and fertility is just so difficult to study because something that stresses you out, might not stress me out, and vice versa.

Furthermore, even if we can identify the causes of stress, there is not always a clear remedy for stress.

I can’t tell you “don’t be stressed.” That is unreasonable! Stress likely plays a part in fertility, but it’s not the only thing making it harder to get pregnant. It is good for everyone to reduce stress when they can (through healthy diet, exercise, time with friends, good sleep).

Do not put off going to see a fertility specialist because you think “it’s all related to stress.” Often, having an appointment will help decrease anxiety and stress.

Weight and Infertility

Q: Does being overweight affect your ability to have a baby?
Dr. Roth: There are a many different lifestyle factors that can impact fertility. Weight is one of them. When looking at weight and fertility, it is actually the extremes of weight (underweight and overweight) that decrease the chances for pregnancy even with fertility treatments. Calculate your BMI.

Watch: Weight On-Demand Webinar

Q: Can living a healthy lifestyle increase your chances of conceiving?
Dr. Roth: Maintaining a healthy lifestyle is one of the best things you can do for general health and fertility. Healthy lifestyle includes no smoking, minimal to moderate alcohol, no drug use, maintaining a healthy weight, sleeping, and moderate exercise. I am also supportive of acupuncture and other complementary therapies if patients want to try it.

Remember extremes of anything are bad. This includes extreme amounts of exercise. Extreme exercise and rapid weight loss can actually be counterproductive for fertility.

Effects of Postponing Pregnancy for Career

Q: Many women are waiting longer to have children. They are focusing on their careers and pushing pregnancy later in life. I know many women trying to get pregnant at 40. What are the fertility consequences?
Dr. Roth: Waiting to have a baby until a woman is more established in her career is an increasing trend. It is also a large majority of patients that we see. The age of first pregnancy is increasing for everyone and certainly for professional women.

Unfortunately, the prime time for fertility is typically when women are starting out in their careers. Unfortunately, our society is not always supportive of pregnancy and motherhood at the time women are establishing themselves career-wise.

By the time women are more established, they are often older. Age is one of the biggest causes of fertility problems. Our fertility declines with age due to decreasing egg number and decreasing egg quality. Even though society has advanced, the egg and the ovary haven’t caught up.

Q: What advice do you have for women who are planning for children later in life?
Dr. Roth: Freeze your eggs. Egg freezing has become a viable option for women who are planning for children later in life. With egg freezing, you are actually freezing the eggs in time.

Your eggs are the best quality that they are going to be right now. Your egg quantity and quality are going to decline over time. They will be frozen in time for when and if you need to use them. If you can’t get pregnant on your own when you are ready; you will have those frozen eggs as a backup. More on egg freezing.

Doing Everything Right and Still Not Getting Pregnant

Q: Dr. Roth, what if I’m ‘doing everything right’ and still can’t get pregnant?
Dr. Roth: This is a concern for many people. Despite a healthy lifestyle and ‘doing everything right,’ they have been unable to conceive. Unfortunately, you just have limited control over fertility. Fortunately, we now have treatments available to help nearly everyone conceive.

When to See a Fertility Specialist

Q: When would you encourage a couple who has been trying to have a baby come in and see you?
Dr. Roth: It depends on the couple and different types of parameters. But the general advice is:

  • Women under 35 years of age – make an appointment after 1 year of unprotected intercourse and no conception
  • Women 35 to 39 – make an appointment after 6 months of unprotected sex and no conception
  • Trying to get pregnant at 40 – more immediate evaluation and treatment are warranted
  • Come sooner if there are other issues that may make getting pregnant more difficult (irregular periods, endometriosis, prior pelvic surgery)

Almost no one comes too early. Most people wait or try to get pregnant on their own for much longer than we would recommend. And I get that going to see a fertility doctor is a very big decision.

Q: Why do you think people wait too long to seek fertility help?
Dr. Roth: Trying to get pregnant is personal and intimate. Of course, you want to get pregnant at home, for free, without anyone else involved! However, it is important to keep the larger goal of having a family in mind.

Couples should know that they aren’t the only ones who are having fertility issues. Infertility is very common, impacting 1 out of 8 couples. Many do not share their struggle, but everyone knows someone with infertility.

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