Dr Mahshid Nickkho-Amiry answers your questions on fertility

Dr Mahshid Nickkho-Amiry is a Consultant Obstetrician and Gynaecologist at The Wilmslow Hospital and The Portland Hospital Outpatients, Hale. She provides expert guidance to patients with fertility concerns, ovulation disorders, and other reproductive challenges.

What affects fertility?

Many different things affect it and pregnancy success. In women, fertility naturally begins to decline around the age of 30, with a more noticeable drop off after the age of 35. Lifestyle choices also have a real impact. Smoking and excessive alcohol consumption can all affect reproductive health, as can poor nutrition, lack of exercise, and high stress levels. If a woman has a known gynaecology condition like endometriosis or fibroids, she may need additional support. In men, low testosterone or exposure to prolonged heat, i.e. laptops directly on the lap for a long time, can reduce the quality of sperm, so being mindful of your daily activities and making changes if you’re wanting to start a family can go a long way. In fact, even if you aren’t quite ready to start a family yet, checking what your fertility status is so you can plan for the future is a good idea.

My partner and I are trying to get pregnant but it is taking longer than expected. When should I see a doctor?

We generally advise couples to try for up to 12 months before seeing a doctor - but with a few important caveats. If after six months of regular (every 2-3 days) unprotected sex with no success, then it’s worth speaking to a fertility health professional, especially if the woman is 35 years or older. Similarly, if irregular or absent periods are a problem, the woman has PCOS or has a history of multiple miscarriages, it’s advisable to both get checked out earlier rather than later.

What to expect at a fertility appointment?

Your consultation will typically begin with a detailed discussion where you’ll be asked how long you’ve been trying, the woman’s menstrual cycle and any unusual symptoms (like pain or irregularity), your weight/height will be recorded as well as features about your lifestyle, diet, exercise – the same will be asked of your partner. Following this, you’ll likely have some blood tests taken to check your hormone levels and ovarian reserve, a pelvic ultrasound to examine the womb, ovaries, fallopian tubes and follicles present. Your partner will also undergo semen analysis to check sperm count, motility and shape to present a full picture of your fertility health before we put together a treatment plan.