Want a baby one day? Here’s how to safeguard your fertility

From condoms to the contraceptive pill, sex education for teens and young adults typically includes information on how to avoid pregnancy but often lacks information on how to safeguard our fertility.

Many of us desire to become a parent one day. So how can we be ready for a smooth transition from ‘no way!’ to ‘maybe baby’?

As an expert in Fertility and Women’s Health, Professor Louise Hull knows taking a little time to plan ahead can be beneficial for safeguarding future fertility.

“We can support people in keeping options open in case they want to become a parent one day,” says Professor Hull.

“This can be particularly helpful for those managing disease or health conditions, and for people transitioning genders.”

Making healthy lifestyle choices, freezing eggs, sperm or embryos through assisted reproductive technologies (ART), and careful medication planning are all available as options.

Let’s take a look.

Live well, and plan ahead

The simplest way to support future fertility is to look at your lifestyle.

“Avoiding smoking, staying active, enjoying a healthy diet and limiting caffeine and alcohol are all important for fertility, regardless of your gender,” Professor Hull says.

“But for women and those assigned female at birth, age is the single biggest factor that impacts fertility rates.”

The number of eggs available for ovulation becomes progressively lower as women get older. Age also increases the chance of errors in packages of DNA called chromosomes.

“Shifts in how chromosomes are arranged in an egg can result in failed conception, miscarriage or a pregnancy in which the child has increased health risks later – for example, Down’s Syndrome,” shares Professor Hull.

“Freezing eggs or embryos using ART at a younger rather than older age usually means higher numbers of eggs and more chance eggs will have a normal complement of chromosomes.”

Talk with your healthcare team

A range of diseases and health conditions can affect fertility in both men and women.

Women with Fragile X syndrome or Turner’s syndrome can experience accelerated loss of eggs from their ovaries and may wish to consider freezing eggs in their adolescence to keep options open for later.

Some heart, kidney and immune system conditions – including endometriosis – can lower egg numbers and quality too, or require medications that make pregnancy challenging.

“In these situations, women should speak with their treating medical team to see whether there are ways of preserving fertility that might improve their chances of parenthood,” Professor Hull says.

Men who might require fertility preservation, i.e. due to loss of a testicle or prior to a vasectomy or cancer therapy, can freeze sperm to provide a sense of security in case of future fertility challenges or change of circumstances.

I’ve got cancer. What can I do?

A cancer diagnosis is confronting and challenging in many ways.

An additional consideration for young people is whether to safeguard their future fertility. This can be particularly pressing for those having total body irradiation for bone marrow transplantation, or radiotherapy or chemotherapy with specific agents.

“Depending on the urgency of treatment and each individual’s situation, the option of freezing eggs, sperm or embryos, or even whole pieces of ovary or testis should be discussed before cancer therapy begins,” Professor Hull says.

“For women, we also have ways to shield ovaries from the effects of some kinds of treatment – patients should speak with their doctors about what might be suitable for them.”

Supporting fertility for transgender people

In transgender medicine, fertility preservation is possible with the right planning.

“For people assigned male at birth, sperm freezing before starting estrogen should be discussed,” Professor Hull says.

“People with ovaries may choose to have an egg collection before they commence androgen hormone treatment, although itis still possible after treatment. .”

Managing gender transition or a health condition can feel overwhelming even at the best of times – and thinking ahead to hypothetical children can feel like too much in the moment.

But the door to parenthood can be kept open if the right conversations are encouraged early on.

Professor Louise Hull is an internationally renowned expert in fertility and women’s health. She leads research in chronic reproductive diseases such as endometriosis at the Robinson Research Institute and provides clinical care in fertility, endometriosis, adolescent gynaecology, and recurrent miscarriage.