By Mr Michael Dooley, Consultant Gynaecologist at Poundbury Fertility at King Edward VII's Hospital

Sex on Female First

Sex on Female First

A recent study has shown that if a woman wants to have a 90% chance of naturally having three children, she should begin trying at the age of 23, and in the UK alone, 3.5 million people (one in seven couples) have difficulty conceiving within twelve months of trying.

If women across the UK had regular fertility tests from the age of 25, we may see a real decline in women delaying conception or struggling to conceive. Addressing any issues early could make a world of difference.

I've put together a list of the top 10 reasons to get your fertility checked - if any of these apply to you, it might be a good idea to set up an appointment with a fertility specialist but please do not worry. With time, most people do conceive. Set yourself achievable, realistic targets. Keep it simple and please keep positive.

1) You're a regular smoker

The odd cigarette here and there may be of no consequence, but if you are a regular smoker, it may take longer to conceive than you were expecting. Studies show that women who smoke more than ten cigarettes a day are more likely to have fertility problems, including premature ageing of the ovaries and fallopian tube blockage. If your partner is a smoker, you might want to ask him to kick the habit - pesky secondhand smoke exposes the body to poisonous chemicals, and together you could both be contributing to delays in conceiving.

2) You enjoy more than the odd glass of wine two

Not to point out the obvious, but having a baby is like the Tango: it takes two. If you or your partner consume alcohol excessively, conception is less likely. Research has found that alcohol causes hormonal imbalances in female reproduction, and can lower testosterone levels in men. To increase your chances of conception, stick to the Government-recommended guidelines of one to two units of alcohol per week for the female.

3) Your workout is working against you

It may be a good excuse for laziness, but the intensity and frequency of exercise could be working against you. In the same way that being overweight disturbs hormone production and ovulation, falling below a BMI range of 19-24 can have the same effect, with vigorous exercise causing ovaries to become underactive. Swap your high intensity workout for light exercises like swimming and low-intensity cardio.

4) You choose fries over salad

Eating a balanced, healthy diet is essential for reproductive health. Foods high in antioxidants and zinc are beneficial for women trying to conceive - think dark leafy greens, seafood, nuts and seeds. Vitamin B also plays a key role in conception, particularly Folic acid, which can prevent neural tube defects. On your next food shop, stock up on citrus fruits, eggs, beans and lentils, which all contain this fertility-boosting nutrient.

5) Your period is off-kilter

Knowing when your period is due is convenient, amongst other things. Not knowing when you're due because of an irregular menstrual cycle makes it hard to work out when you're ovulating, which in turn makes it harder to plan the optimum time to have sex, or rather, to make love. If you have any irregular bleeding, you miss a period or have no periods, you should go and see your health professional.

6) You suffer from stress or depression

Stress, depression and infertility often go hand-in-hand. If you're finding it hard to conceive, a yoga session or spa day might be in order. Raised stress levels may trigger the release of adrenaline, which may have a negative effect on fertility. It may also affect your natural killer cells and immune system and has been found to lower the likelihood of conception in men and women. While there is no conclusive proof that depression causes infertility, studies have identified a link between depression and increased rates of infertility.

7) You're not having enough sex

It is important to have regular sex, at least 2-3 times a week. Monitoring ovulation is often performed but can be stressful and I encourage people to have more romance, rather than timed sex. Trying to have a baby should be enjoyable and not a burden. If it is becoming stressful, go and see your doctor, in order to discuss how you can control the controllables.

8) You have low sex drive

If you have low libido, then again, there is much that can be done to help you. Some medications can and do disrupt ovulation, sometimes stopping it altogether. Certain medications can also diminish libido on both sides - and libido plays somewhat of a necessary role in baby making. Consult your GP, as dosages and drug types can be adjusted if this is found to be the root cause of your fertility issues. Low libido can also be due to other issues and it may be again useful to see a counsellor, to discuss this, if you feel it is becoming a problem.

9) You experience bleeding and pain with your periods and after sex

Abnormal bleeding after sex can indicate problems. It is therefore important that you get this assessed. Also, do get checked for STIs. If this is a concern, be proactive and get yourself tested. Pain can be associated with endometriosis and sexually transmitted diseases. This can affect your fallopian tubes and upset the ability to successfully conceive. Seeing a health professional to get this assessed is important.

10) You are ready to start a family

If you and your partner have decided that you are ready to take the plunge, it's a good idea to take a test before you start trying. Women are born with a lifetime supply of eggs, which gradually decreases throughout her 20s, 30s, and so on. Blood tests can help identify your egg levels and any underlying conditions that could reduce your chances of conception.

If having a family one day is a dream of yours, then do everything that you can to help it become a reality. Taking a fertility test is just the first step in this life changing journey.

Mr Michael Dooley is a Consultant Gynaecologist at Poundbury Fertility at King Edward VII's Hospital and the author of Fit for Fertility. Mr Dooley specialises in fertility and adopts a holistic approach to maximise his patients' chances of conceiving naturally.

You may like to undertake a quick self-check 40 point fertility questionnaire which can be found at:

http://www.thepoundburyclinic.co.uk