A child on demand? The 1970s feminist ideal of 'when I want' is increasingly challenged today. More young couples face infertility, with striking statistics: one in six (15.6% of couples of childbearing age) seeks medical help, and one in ten turns to IVF. Chances are, you know someone—a friend, family member, or colleague—dealing with this.
Infertility causes vary widely, with some mysteries remaining in nature's complexities. Yet, established factors stand out. For those without underlying issues, a healthy lifestyle and balanced diet are foundational. The body may also need time to rebound after prolonged contraception. Importantly, a more active love life boosts conception odds. 'A baby is made for two,' stresses Dr. Sylvie Epelboin, obstetrician-gynecologist and reproductive medicine specialist at Paris' Bichat-Claude Bernard Hospital Group (1). 'When couples struggle to conceive, we evaluate both partners' fertility.' Genetic or infectious issues, often detectable and treatable today, can affect either partner. Lifestyle factors of our modern era play a significant role too.
'Age is the leading cause of fertility challenges,' states Professor Jean-Philippe Wolf, Head of the Histology-Embryology-Reproductive Biology Department at Paris' Cochin Hospital (2). 'Over 20 years, the average age of first pregnancy has shifted from 21 to 30, compressing women's fertile window since menopause timing hasn't changed. Fertility plummets after 37.'
Few gynecologists openly discuss the biological clock, notes Dr. Epelboin. 'No one's dictating family timing, but informing about infertility risks—without alarm—is essential. Those glamorous 50-year-old moms on magazine covers often used donor eggs. A colleague puts it well: "young in life, old in reproduction." We see vibrant 35-year-olds needing egg donation soon. Extended education, career hurdles, and societal gaps in maternity support delay decisions. Plus, 30% of women don't meet their future co-parent until after 30.'
Extreme thinness can halt menstruation (amenorrhea), while excess weight disrupts cycles. Surging obesity is now a top concern. 'Visceral fat around the abdomen is especially harmful,' explains Prof. Wolf. 'It causes ovulation issues and insulin resistance, complicating IVF. Overweight affects men's sperm production and motility too—but it's fully reversible with weight management.'
1. Obstetrician-gynecologist and reproductive physician at the Bichat-Claude Bernard Hospital Group in Paris.
2. Head of the histology-embryology-reproductive biology department at Cochin Hospital in Paris.
