Face it, for most 20-somethings, getting pregnant isn't top priority. Not getting pregnant is more like it. But the truth is, it's never too early to protect your fertility for the future. Otherwise, when you are ready to start a family, getting pregnant might not be as easy as you envisioned.
In fact, infertility affects about 7.3 million U.S. couples, or roughly 12 percent of those trying to have a child, according to the American Society for Reproductive Medicine. About one third of infertility cases can be attributed to female factors—such as blocked fallopian tubes, endometriosis, uterine fibroids, or ovarian cysts—and a similar number result from male problems, such as diminished sperm production. For the remaining couples, it's a combination of problems in both partners, or it is simply unexplained.
The good news is that 85 percent to 90 percent of infertility cases can be treated with drug therapy or surgical procedures, the ASRM estimates. Fewer than 3 percent require costly advanced reproductive technologies, such as in vitro fertilization.
To steer clear of potential roadblocks, you can do myriad things years before you decide to have a child. Here are five strategies to safeguard your fertility.
1. Don't wait too long. "Many women don't realize that their peak fertility time is in their mid-20s and already starting to fall by their late 20s," says Jamie Grifo, program director of the New York University Fertility Center. Infertility rates about double for women between the early 30s and early 40s. The percentage of married, 25-to-29-year-old women who are infertile is 9 percent, according to ASRM data. By 35 to 39, the percentage has climbed to 22 percent, and by the early 40s, it has jumped to 29 percent. Moreover, a healthy 30-year-old who's trying to get pregnant has a 20 percent chance per month. By age 40, her odds are only about 5 percent a month. And yet, approximately 20 percent of women wait until after age 35 to begin their families.
Male fertility isn't timeless, either. After 50, some men may experience a decline in sperm quality—they produce more misshapen cells and fewer that can swim well—which can make fertilization trickier.
"Don't assume fertility is a guarantee," Grifo says. "It isn't like they told us in high school. The most important thing you can do is start early."
2. Practice safe sex. Sexually transmitted diseases can drastically reduce one's ability to get pregnant—so abstinence or consistent condom use can simultaneously prevent pregnancy today and preserve fertility for the future. Chlamydia and gonorrhea are two leading causes of infertility; untreated, either can cause pelvic inflammatory disease. PID can lead to permanent scarring in the fallopian tubes, uterus, and surrounding tissues, which, in addition to impairing fertility, sometimes produces chronic pelvic pain and potentially fatal ectopic pregnancies, where the fetus develops outside the uterus.
The statistics are eye-opening. An estimated 2.3 million cases of chlamydia and more than 700,000 cases of gonorrhea occur annually nationwide, according to the Centers for Disease Control and Prevention. Both sexes are equally at risk, and the diseases can be acquired during vaginal, anal, or oral sex. About 1 in 4 U.S. women ages 14 to 19 is infected with at least one sexually transmitted infection. Up to 40 percent of women with untreated chlamydia develop PID.
"Chlamydia is incredibly prevalent in young women today," says Nancy Sanders of Women OB/GYN Physicians in Washington, D.C. "It's easily treatable and cured with antibiotics, but if it's not cared for, it can cause infertility, and that's heartbreaking."
Chlamydia and gonorrhea often go undetected, in part because they often have no symptoms. The CDC recommends annual chlamydia screening for all sexually active females 25 and under and for any older woman who has a new sex partner, multiple partners, or other risk factors.
3. Eat right. While there is no real fertility diet, says NYU's Grifo, good eating habits will help keep your hormone levels on an even keel. In a 2007 study of 17,544 married women, Harvard researchers found that those with the lowest risk of infertility due to anovulation—the failure to produce a viable egg every month—tended to eat diets that emphasized monosaturated fats like olive oil, consumed more fiber and iron, and got their protein from plant sources such as beans and nuts rather than from red meat. The message: Opt for a healthful diet of fruit and vegetables, and choose whole grains instead of refined carbohydrates. Carbs can cause a rapid rise in blood sugar and higher insulin levels, which can hamper ovulation.
4. Avoid environmental toxins. There's mounting evidence that numerous environmental factors have an effect onfertility. In a recent laboratory study, for instance, researchers at the University of California-San Francisco found that bisphenol A, a chemical used in rigid plastic packaging for many foods and beverages, decreased the division of uterine cells, which could potentially prevent an embryo from attaching to the uterus. Postdoctoral fellow Lusine Aghajanova presented the finding last month at the annual ASRM meeting. To be safe, don't microwave polycarbonate plastic food containers (recycling code No. 7) and avoid canned foods, since cans are often coated on the inside with BPA.
Other, more established environmental threats include lead and lead compounds, which can cause hormonal and menstrual irregularities, and radiation like X-rays, which damage rapidly dividing cells. Benzene—used to make certain rubbers, lubricants, dyes, and detergents and found in some paint, nail polish, and hair dyes—can cause women to stop having periods; exposed men may experience decreased sperm count, according to the American Fertility Association, a New York City-based nonprofit organization. Researchers are also finding that phthalates, a class of chemicals found in many cosmetics, have the potential to cause irregularities in ovulation and decrease sperm quality.
5. Maintain a good weight and healthful habits. Studies have shown that being too thin—or too heavy—can throw off women's hormone levels and suppress ovulation. Overweight men could have hormonal problems associated with low sperm count and quality.
Exercise is, of course, a key to staying on top of your reproductive game. Men, however, might be cautious about working out in tight-fitting pants like biking shorts, which can overheat the testicles. Prolonged and repeated exposure to heat can impair sperm count and movement. Smoking also damages sperm and lowers sperm counts. And, in women, smoking appears to accelerate the loss of eggs, potentially advancing the onset of menopause by several years.