The iVillage fertility chat

Dr Gillian Lockwood, the iVillage fertility expert, talked to women on the Getting Pregnant message board. Here's what what said:

traceyw37: Is it true that drinking alcohol and smoking reduce the chances of you conceiving?
Dr Lockwood: I'm afraid that both smoking and drinking alcohol reduce the chance of getting pregnant and increase the risk of miscarriage. In fact smoking reduces the chance of IVF working by a staggering 40%! Some exciting new research from Denmark shows that even very low levels of alcohol (1-2 units a week) make it harder to conceive. We all know people who chain-smoke, live on Bacardi Breezers and get pregnant without problems, but if you have even a minor fertility problem then you must stop!

yinkaoluwole: I have been trying to get pregnant for the past year and getting depressed due to stress and the frustration of the past year. My worry is that my period is very dark and now lasts for three days instead of the normal five. It is also less heavy than it used to be. Do you have any idea what might be wrong with me?
Dr Lockwood: If you have been trying to get pregnant for a year and you are getting worried and depressed, then it is time to seek some help, initially from your GP. Stress can interfere with periods, but if you are having regular periods, you are almost certainly ovulating (releasing an egg each month). The best times to conceive are around the 'middle' of each cycle (days 8-15) if you have a 28-day cycle.'Dark' periods are sometimes an early sign of endometriosis so it is important to check that your pelvis is healthy. Try and get your partner to have a sperm test too.

rdutta: I'm 28 years old and plan to have children, but not for another four or five years. I read recently that fertility levels in women over 30 are dropping and I am concerned that if I wait this long, it may be too late. Are my concerns justified?
Dr Lockwood: I'm afraid it is true... Fertility peaks in the mid-twenties and starts to decline from 33-34. Women over 35 take twice as long to get pregnant on average and after 38 the miscarriage rate climbs very rapidly. Forty per cent of all pregnancies over 40 will miscarry.

If you have 'risk factors' for low 'ovarian reserve', such as family history of early menopause, or you are a smoker or have endometriosis, you may want to reconsider your decision to delay. Have a look at my article on called Getting pregnant at 40 or even 30.

Rachel: I'd like to know what the chances are of Clomid (50mg at the moment) working. I have a history of PCOS (Polycystic Ovarian Syndrome) and have an irregular cycle. I suppose this means that my body can work, but only sporadically. Is there anything that I can do to improve the chances of Clomid working?
Dr Lockwood: Clomid is a good drug for women with PCOS but, although nearly 75 per cent of women will get a regular ovular cycle on Clomid, only half of those will get pregnant. The recommendation now is that you only have 6-12 months of Clomid max. If pregnancy hasn't occurred by then, there is probably another problem as well as PCOS. Read my article Common, curable causes of infertility.

debbiegardner: I had an appointment yesterday to see about IVF and have decided that if I'm healthy enough, I'd like to be an 'egg sharer'. About seven years ago I was diagnosed with acromegaly, although it's been in remission for about 2-3 years now. Do you think this will cause any problems being an egg sharer?
Dr Lockwood: I'm afraid that acromegaly could well stop you being an egg sharer. As you know it is caused by excess production of growth hormone. All clinics differ in their criteria for accepting egg donors and sharers. All I can advise you is to be perfectly honest with the clinic and take along as much of your medical records as you can.

smorgas1: I am currently on my third IVF cycle (day 7). I have been sniffing Syneral for the last two weeks. I know that this reduces your oestrogen. When I did a previous cycle with Clomid included, my womb lining became very thin. Is Syneral likely to have the same effect? Is there anything I can do to help? I'm already taking 75mg of aspirin a day as advised by clinic.
Dr Lockwood: Syneral works by 'switching off' your own hormones and allows the IVF clinic to 'take control' of the cycle. The stimulating injections then make your ovaries produce lots of follicles and you get high levels of oestrogen which should grow a nice thick womb lining.

Clomid can interfere with this as it is an anti-oestrogen, but this effect is more than balanced out by the stimulating injections. Ask your clinic to tell you how thick the womb lining is when you have your next scan. Ideally it should be 10mm thick at the time of egg collection.

soozlev: I am 37 and had an early miscarriage earlier this month. I just got my period and am ready to try again. My question is that it took a year to get pregnant last time and we used an ovulation predictor kit. My cycles are regular, but I have rather painful periods. Am I correct in thinking that we should just try to conceive naturally or should we be considering assisted conception due to my age. My partner is 37.
Dr Lockwood: I'm sorry to hear about your recent miscarriage. Women are especially fertile the month after an early pregnancy loss, so do take advantage of this month to try again. Thirty-seven to 38 is exactly the age at which fertility starts to decline quite rapidly and it takes twice as long to conceive as under-35. My own hunch is that if it took you a year before (longer than average), it could quite well take as long again and if it doesn't happen, fertility treatment itself will be becoming less effective for you.

I've just come back from a conference on miscarriage and the evidence is now overwhelming that even a small amount of alcohol significantly increases the risk of miscarriage (especially in 'older' women). I suggest you try naturally for no more than six months and then try something like stimulated IUI. See my article Tick Tock the Fertility Clock for more information.