Phil Kieran: I have IBS and am worried it might be more difficult to conceive

With irritable bowel syndrome (IBS) there is no clear evidence the condition has a major effect on ability to conceive. Some studies show lower child-bearing rates but a number of factors other than IBS could be at play in these cases.

With regard to specific advice around IBS and trying to conceive I would suggest the following: I assume you’re already trying to follow any dietary or behavioural measure to limit your symptoms and this is important as if you’re are feeling unwell you are less likely to be in the mood for sex and this will naturally reduce your likelihood of conceiving.

• In this point though I would caution you to ensure you are getting enough nutrition. Having too low a body weight, poor vitamin intake, or a relative energy deficit (burning more energy than you consume) will reduce ovulation and impair female fertility;
• Ask your GP about any medications you are on and how these may impact your fertility. It may be a good idea to check your iron and folic acid levels before you start trying and to get these up before you do start. I would recommend for most women trying to conceive to take 400mcg folic acid;
• With IBS specifically you may find that pregnancy or preconception supplements can cause worsening of symptoms (often due to the iron content).

That’s largely all the IBS-specific advice but I would like to take this opportunity to give some general advice about conceiving.

You asked what you can do to help conceive — but conception takes both partners and fertility issues are evenly spread between men and women. 

Society focuses more on female fertility issues and I have seen partnerships where the man doesn’t accept any responsibility for fertility issues. 

A lot of the advice I have given so far applies more to women than men so here is what the men should be taking responsibility for.

• Firstly smoking, lack of exercise, and eating highly-processed food have significant impacts on sperm count and quality;
• Alcohol and cannabis can both reduce sperm count too;
• A big contributor to sperm quality is the temperature of the testicles. Tight-fitting underwear, heated car seats, and long baths have a significant effect on male fertility.

For both of you: Try to have unprotected sex about every two days around the middle of the menstrual cycle. 

Don’t get hung up on trying to predict ovulation as this is unreliable and adds stress — and ideally you want to have had sex the day before ovulation so the tests are often a bit late anyway.