Fertility is a deeply personal journey, often filled with questions, hopes, and challenges. As Dr Stuart explained on Table Talk with Doug, “Fertility is a complex issue. It’s not just sperm and egg meet boom done.” In reality, countless factors influence the ability to conceive.

Common Fertility Myths Debunked

Dr Stuart highlighted a few common misconceptions:

  • “You can’t get pregnant if your periods are irregular.” Not true. Many women with irregular periods still conceive.
  • “Men’s fertility doesn’t decline with age.” False. While men can remain fertile for life, sperm quality and volume decrease after 40.
  • “You can’t be pregnant if you’re still getting periods.” Rare, but possible. This can result in what’s known as a “concealed pregnancy.”

When Does Fertility Decline?

Fertility starts at puberty. For women, it begins with menarche (the first period) and steadily declines after age 30. After 35, it drops sharply. Men also experience a decline, typically starting around 40.

Dr Stuart pointed out, “That’s why we see so many older celebrity dads with young children, they’re still technically fertile, but their sperm quality may be lower.”

Health Conditions That Can Interfere

Hormonal issues and chronic health conditions often play a role:

  • Polycystic ovarian syndrome (PCOS) can disrupt ovulation.
  • Thyroid disease may also affect fertility.
  • Diabetes, especially in men, can lead to erectile dysfunction, which indirectly impacts fertility.

Stress and Fertility

“Have you ever noticed a link between difficulty falling pregnant and stress? Oh, for sure. Massively,” said Dr Stuart. Stress can create a negative cycle, trying leads to stress, which makes it harder to conceive, causing more stress.

Lifestyle Matters

Regular, moderate exercise helps. But too much, especially among elite athletes, can disrupt ovulation or sperm production. Likewise, extreme diets or very low body fat can impact fertility.

A healthy body weight and consistent, moderate activity are ideal.

How Long Should You Try?

Dr Stuart offered some reassurance: “About 90% of couples will fall pregnant within 12 months of trying. Of those who don’t, another 90% will conceive in the second year.”

If you’ve been trying for a year without success, it’s time to talk to your doctor.

Birth Control and Delayed Fertility

Some contraceptives allow a quick return to fertility. Once removed, options like the pill, mini-pill, or coil allow women to become fertile almost immediately. However, the Depo injection can delay fertility for up to 18 months.

Fertility Testing and Treatments

If conception doesn’t happen naturally, doctors may test both partners. Issues like low sperm count or irregular ovulation can often be treated. Treatments include:

  • Ovulation stimulation
  • IVF
  • Intracytoplasmic sperm injection (ICSI) is a direct delivery of sperm to egg

“There are many options,” Dr Stuart emphasised. “It’s about finding the right journey for each couple.”

Genetic Considerations

Genetics and age of both parents affect fertility and pregnancy outcomes. For instance, the risk of chromosomal abnormalities increases with maternal age. Family history also plays a role in conditions like diabetes or cardiovascular disease.

Diet, Vitamins, and Timing

Folic acid is essential for women trying to conceive. Pre-conception vitamins help both partners. Tracking ovulation is useful if cycles are regular, but if they’re not, Dr Stuart recommends having sex every 2–3 days throughout the cycle.

If Pregnancy Isn’t Possible

For some couples, traditional pregnancy might not be possible. Options include:

  • Adoption – though it can be a long and emotional process
  • Surrogacy – depending on personal circumstances and preferences

Support is crucial during this time. “It’s a deeply distressing time for some families,” said Dr Stuart. “You are not alone.”

Ready to Stop Having Children?

Contraception remains important if you’ve decided your family is complete. Vasectomy is often a recommended final option simple, hormone-free, and effective.

Final Thoughts

Whether you’re just starting your fertility journey or facing ongoing challenges, Dr Stuart reminds us: “Humans are phenomenally good at reproducing. For most, it will happen. But if it doesn’t, there are still many paths to parenthood.”

Listen to the full conversation below.