PERTH FERTILITY SPECIALIST

Getting pregnant

Dr Richard Murphy

Getting pregnant

If getting pregnant is on your mind, or you are trying to conceive and not sure about your chances of falling pregnant, then it is easy to get a little bit lost or overwhelmed by too much information. My work as a Perth obstetrician and as a Fertility Specialist also includes pre-pregnancy planning and preconception counselling. On this page, I will give you an overview of the typical questions that my patients may have in this phase of their journey.

Obstetrics and gynaecology consultations at my private practice in Subiaco.

Fertility consultations at Genea Hollywood Fertility

Delivering at the Labour Ward of SJOG Subiaco Hospital

Obstetrician Perth

How can I increase my chances of getting pregnant?

If you have made the decision that you want to have a baby, you will try everything to conceive during your next cycle. However, making a baby can take time. If you’re under 35, you should seek help if you have been trying for more than a year. If you’re over 35 we recommend seeing your GP or fertility specialist after six months of trying. There are a few steps you can take to make “trying to conceive” more effective.

There is a link between reproductive success and general health:

All of the boring advice your parents and GP regularly give applies when trying to have a baby. If you or your partner have ongoing chronic medical conditions it is important to have these managed optimally.

Stop smoking:

Smoking reduces the chance of getting pregnant, and it also increases the risk of miscarriage and other pregnancy complications. What you should also know is that if you smoke, the risk of diseases such as leukaemia increases for your unborn child.

Reduce your alcohol intake:

Reducing or stopping alcohol consumption and avoidance of illicit drugs are important for both men and women. Fathers contribute 50% of the genetic code their babies inherit. Giving your baby the best quality DNA possible is important.

Maintain a healthy body weight:

Maintaining a healthy weight is important. For a lot of couples, even a modest reduction in weight can result in significantly better pregnancy outcomes. It means a higher chance of getting pregnant and a lower risk of having a miscarriage. If you have lost a lot of weight over a short period of time (such as after bariatric surgery), then you will not get the full fertility benefit until you have kept the weight off for a full year. Your body simply needs time to adjust to such a big change.

Luckily, with time, it will become easier for your body to maintain the lower weight. If you are going to need any type of fertility treatment, then experience tells us that a normal weight will improve your chances of success.

Healthy diet:

A balanced, varied diet high in plant-derived foods is important. The big rise in hormones such as progesterone can cause constipation in pregnant women, and if you have already developed a habit of eating well, you will find it easier to maintain the habit once you fall pregnant.

Food should be freshly prepared, safely stored and reheated well if needed. The risk of Listeria is very low in Australia and yet it is good to be aware of some safe practices when you prepare your meals. It’s common that most people in Australia do not consume the recommended amounts of fruit and vegetables.

Caffeine:

Recent studies looking at caffeine intake, from all sources, have found a consistent link between the amount of caffeine consumed in pregnancy and increased risk of miscarriage, intrauterine growth restriction, small for gestational age, stillbirth, childhood leukemia and childhood overweight and obesity.

There does not appear to be a safe limit to caffeine consumption so while recently standard advice was that the equivalent of 1-2 coffees per day was okay this is no longer the case and caffeine can be added to alcohol, smoking and illicit drugs as things to avoid in pregnancy.

Dietary supplements:

Supplementing your normal diet with Folic Acid will reduce the risk of Neural Tube Disease in your baby (spina bifida and anencephaly), which means that the baby’s brain and spinal cord do not develop normally. 500mcg of folic acid will reduce the risk of neural tube defects by 50%, 5mg of folic acid, 10x the dose, will reduce the risk by 85%. If there is any personal or family history of Neural Tube Disease then higher doses of folic acid are needed (5mg daily). Australia is Iodine deficient so a supplement also containing Iodine is useful.

Age factor:

The biggest single factor that will determine reproductive success is age. This applies to both men and women, though the effect is more obvious in women. Successful pregnancies are rare for women by 45 years of age. There is often not a perfect time to start a family but if you are in a relationship where children are planned then starting sooner rather than later is almost always best. Hopefully, you will meet your babies earlier and have more time with them!

Obstetrics & Fertility Perth

Why am I not falling pregnant?

If you are wondering why you are not falling pregnant, take a moment to consider this: you are not alone. Falling pregnant for human beings is often not easy. Even the most fertile couples will only have a 25% chance of conceiving each cycle. There are often recognised factors that can reduce this chance; age, weight, smoking, drug and alcohol use and medical illnesses. Social factors are important. You are more likely to conceive in a healthy, supportive, respectful, safe relationship.

“There are even more reasons why couples have difficulties conceiving. Evidence from around the developed world shows that couples are not having as much intercourse now as they did even 20 years ago. Fly-in, fly-out rosters and long working hours do not help. Testosterone levels will drop in men with increased weight, alcohol use and stress, often causing a drop in energy levels and libido.”

Dr Richard Murphy, Obstetrician Perth
The factors we will consider when assessing your fertility will include sperm quality (number, motility, morphology, anti-sperm antibodies and sperm DNA damage), the quality of ovulation, tubal disease or blockage and pelvic anatomy including endometriosis.

Obstetrician and Fertility Specialist in Perth

When should I seek help?

Preconception counselling will be of value for most couples. We now have the option of screening for unknown genetic conditions. One in two hundred babies will be born with a recessive or X-linked condition inherited from their parents which can cause significant problems in childhood and which can now be screened for prior to pregnancy.

"Cystic fibrosis is one of the most common recessive genetic conditions in Caucasian populations, where 1 in 25 people will carry one abnormal CF gene. Couples at risk in this situation have a 25% chance of any and all babies they have being affected. Thankfully there are options available to avoid this risk."

Dr Richard MurphyObstetrician Perth
Obstetrician Perth - Getting Pregnant
Performing routine antenatal blood tests for things such as Rubella, a full blood count and HIV before pregnancy will reduce the risk to mother and baby in pregnancy. Care can be coordinated with other doctors involved in your care prior to conception, especially for complicated conditions like epilepsy, Crohn’s, severe anxiety and depression.

Infertility treatment

When is fertility treatment needed?

There is a link between your age, how long you have been trying to conceive and the chance of a couple conceiving next cycle. All couples should consider review if not pregnant after 12 months trying. From 35 years of age, I would consider seeing a specialist if you have not fallen pregnant after 6 months. If there are known factors that can impact fertility like endometriosis, tubal disease, irregular cycles or previous cancer treatment then a much earlier review is appropriate.

Choosing an obstetrician Perth

Why Dr Richard Murphy as your obstetrician?

My wife and I went through an experience of loss at 25 weeks as well as the subsequent safe delivery of 3 beautiful children. When conceiving is not an easy journey for you and your partner, I understand the stress and the pain that may come with the experience of subfertility and with pregnancy loss. As your Obstetrician I aim to help you find answers, to guide you and most importantly, to support you.

"This is why I have developed a particular interest in helping couples manage complications or anxiety in pregnancy, or helping couples who have gone through the experience of miscarriage. I then consider it my role to apply my expertise in fertility to explore the treatment options with you."

Dr Richard Murphy, Obstetrician Perth
I want to listen to your personal story, understand you and help you develop the resilience needed to enjoy your pregnancy, birth experience and the postnatal course with your new baby.