A Q&A with fertility expert Zita West - Mind The Baby

Focus on the sperm! A Q&A with fertility expert Zita West

Zita West is a well-known name in the world of fertility and conception. If such a thing as a “celebrity fertility expert” exists, it is she. Kate Winslet, Cate Blanchett, Stella McCartney and Jemma Kidd have all sung her praises but her clientele at her London holistic fertility clinic are also just regular Joes and Joannas trying to have a baby. A practicing midwife, acupuncturist and nutritional advisor, her work is renowned for combining cutting edge medicine with complementary therapies.

Zita has written a number of fertility and pregnancy books and her latest, Eat Yourself Pregnant, has just been published. I was lucky enough to grab a quick Q&A with Zita and one of her colleagues in the clinic, Jane Knight, who answered some questions for me about fertility and trying to conceive.

What are your thoughts on all of the messaging targeted at women these days about 35 being a significant birthday and fertility decreasing rapidly from that point onwards? Would you agree or is it unnecessarily putting pressure on women?
Zita: Many women I see panic when they are getting close to 35 because they think their fertility is going to drop off a cliff on their birthday. We can now check with a scan and blood test for a woman’s egg reserves. But we do find that, even if the result is low, many do go on to get pregnant because women in their 30s are likely to have more chromosomally normal eggs than in their 40s. We know that you are born with all the eggs that you are ever going to have but I think that the environment in which the eggs are growing can make a difference: so good nutrients, a healthy diet, no smoking and limited alcohol all play their part. An important question all women should ask their mothers is at what age they had the menopause. This is generally genetically determined, so if your mother had her menopause in her 40s, the same might follow for you.

Do you think contraceptive choices before trying to conceive have a big impact on fertility and would you have any recommendations there?
Jane:  Most women who stop taking the combined pill find their periods come back very quickly as soon as they stop the pill. One study (Cronin 2009) of almost 60,000 pill users found that of those who stopped the pill to conceive, over 20% conceived on the first cycle and 80% had conceived by one year after stopping the pill. Women who are either very underweight or overweight are more likely to experience delays in conceiving after stopping the pill.

A comprehensive review of the medical literature by Diane Mansour (Mansour 2009) analysed 17 studies reporting the return of fertility after different contraceptive methods and looked at the pregnancy rate one year after topping the method.

Typical pregnancy rates after one year were:

​• Oral contraceptives or the intrauterine system (hormonal IUD): 79% – 96%

​• Intrauterine devices (copper IUDs): 71% – 91%

​• Contraceptive implant: 77% – 86% (but one study showed less than 50%)

​• Contraceptive injections: 73% – 83%

There was no evidence of increased pregnancy complications or congenital abnormalities after stopping any of these methods. These rates are very similar to the use of barrier methods or no method.

There is some evidence of damage to fertility for women who have not had a child if they have an IUD in place for over six years (Doll 2001). However since the time this study was conducted, the types of IUD have improved, as too has infection screening. Despite this, women who have not had a child or not completed their family, may be well-advised to avoid long-term use of the IUD and to consider other less invasive methods such as barrier methods (condoms or diaphragm) or to learn Fertility Awareness Methods.*

​The main concern with long-term contraceptive use of any kind is not the contraceptive effect itself, but rather that the longer the woman uses a method, the older she gets and a woman’s age is the most significant factor. The only other concern with women who take the pill or use any other hormonal method for any length of time, is that it could mask any gynaecological or hormonal problems (such as polycystic ovarian syndrome) as she will continue to have regular ‘periods’ (hormone withdrawal bleeds)

Do you think that couples who are planning to have a baby seek out professional help too quickly these days, or not quickly enough?
Zita: You cannot generalise: in my clinic no two couples are the same. It’s dependent on many factors. However, if you are 35 and have been having sex regularly, i.e. at least three times a week for a six month period, and you are not pregnant, then I think you should seek investigation.

What are your top tips for anyone trying to conceive or planning to start a family soon?
Zita: Manage your expectations: it can take up to a year to conceive. Make sure you understand when your fertile time is. Don’t put pressure on one another around ovulation. Focus on the sperm: if you’re having sex three times a week, you are ensuring there is plenty of sperm to fertilise the egg as it lasts 3 to 5 days inside you. Remember ovulation is a random event, and the egg only lasts 24 hours maximum.

Stick around for my review of Zita’s new book Eat Yourself Pregnant tomorrow. I went all interactive for you guys and did the Five Day Detox she recommends in the book. Much to share!

Zita West clinic consultations are also available in Dublin and Cork with Anita O’Neill. Visit www.zitawest.com for more information and upcoming dates.

What do you think?