Maybe you’re one of those daughters who can talk to your mom about anything. Or maybe you’re one of those women who pick and choose certain topics to avoid family drama. If you fall into that latter group and are thinking about starting a family, you should woman-up: It's time to have a conversation with your mom about fertility.
“We know it can be a difficult subject, but women are much more open today than in the past when it comes to issues of reproduction, and your mom’s reproductive history can influence your own,” said reproductive endocrinologist Dr. Amber Cooper, medical director of Vios Fertility Institute in St. Louis, Illinois, and scientific adviser to Celmatix.
But know this: If your mom had difficulty getting pregnant, that doesn’t mean you will, too.
“Women shouldn’t have a false sense of security if their moms got pregnant easily, but on the other hand, they shouldn’t panic because their moms had a tough time,” Cooper added.
"Fertility is actually very complex, and lifestyle and environment play a big role,” noted reproductive endocrinologist Dr. Brooke Rossi of University Hospitals Cleveland Medical Center in Ohio.
Although you may not want to make your mom (or yourself) uncomfortable dredging up a potentially painful pregnancy history, it’s still a conversation worth having. “Families deal with things in different ways and some simply don’t want to open up 'Pandora’s Box,' but if women are struggling with infertility and they don’t know (their) family history, it can complicate things,” Rossi said.
There's no easy way to start the conversation, but both doctors agree the time to have it is before you plan on starting a family. “Women actually should be proactive about this,” Rossi said. But don’t be upset if you don’t get specific answers.
“Women today need to remember that technology and medicine have advanced dramatically compared to your mom’s era, and she may not know why she had a tough time conceiving,” she continued.
Here are a few questions that you should be prepared to ask your mom regarding specific conditions that can affect fertility.
1. At what age did you go through menopause?
Menopause is far from a taboo subject anymore. But your mom’s age at natural menopause can influence the age at which you go through menopause, and obviously, your fertility. Menopause is defined as the point in a woman's life when she has stopped menstruating for at least a year. Most women start perimenopause, a time of hormonal changes leading up to menopause, in their late 30s or 40s. It takes about five years before a woman stops menstruating.
Natural menopause generally occurs at about age 51, but women can have premature menopause before age 40, and an early menopause between the ages of 40 to 45. But remember, some medical treatments can affect age of menopause as can smoking and other lifestyle issues. So, for example, if your mom smoked, but you don’t, and she went through an earlier-than-average menopause that could be a result of lifestyle. That is especially true if the women in her family, such as her mom and sisters, went through menopause at a later age, Rossi explained.
2. Did you have endometriosis?
Endometriosis, a condition in which endometrium-like tissue is found outside the uterus, affects about one in five to one in 10 women of reproductive age. Researchers aren’t exactly sure what causes the painful condition, but some evidence points to certain genes making some women much more likely to develop it.
Women are at higher risk if their moms or sisters are affected. Most women with endometriosis do not have trouble conceiving, but about 30 to 40 percent of women with endometriosis are infertile. “Treatments are available and are very personalized,” Cooper said.
3. Did you have polycystic ovary syndrome?
Polycystic ovary syndrome, or PCOS, is an endocrine system disorder resulting in menstrual cycle changes and excessive hair growth. It can lead to a host of problems including diabetes, heart disease and infertility. Although doctors don’t know the exact cause of the disease, there appears to be a genetic component. Women with a mother or sister with PCOS are more likely to develop it than those without a family history of the disease.
There are other things you can learn from mom, too. If diabetes runs in your family, you are at higher risk for gestational diabetes, especially if a parent has the condition. “But maintaining a healthy weight and keeping fit can go a long way in preventing this,” Rossi said.
Though certain pregnancy issues, like miscarriages and birthing big babies are rarely hereditary. “People often think that big babies run in families, that’s not necessarily true since it’s really more dependent on your size and that of your partner,” she added.
Bottom line: DNA isn’t always destiny. “Lifestyle is a very important factor for fertility and it is something that you can control,” Cooper says. So don’t smoke, avoid heavy drinking, stay active and maintain a healthy body weight. Your partner isn’t off the hook, either, since sperm can also be affected by lifestyle choices, too.