Giving advice to couples

• Put problems into perspective: In six months, 50% of couples conceive. In 12 months, 85% of couples conceive. Of the remaining 15%, a number will continue to fall pregnant, with normal intercourse over the next two or three years.
• Both partners should be advised to give up smoking.
• Women should be advised to limit alcohol to a minimum (less than four units per week).
• A weight loss and exercise programme is strongly recommended for women who are overweight. MFC generally insists on a BMI of 30 or less prior to treatment.
• There is no evidence that the use of temperature charts and urine ovulation tests improve the chance of pregnancy. Most pregnancies occur at the time of ovulation and in the five days leading up to this. Regular intercourse daily or every second day around this time is  recommended. Waiting for a positive response from a test may cause couples to try too late in the cycle.
• A woman's fertility starts to fall significantly when she reaches her late thirties. The risk of miscarriage and genetic abnormalities in the baby also increase significantly after this age. Evidence is now increasing that male fertility also starts to decline with increasing age.  (ie decreasing around 50 years)
• Women should have their Rubella status checked. Folic acid should be taken before conception, in a dose of 600mcg daily to reduce the incidence of spina bifida.