Protecting Your Fertility
By Dr. Spencer Richlin, Board-Certified Reproductive Endocrinologist, Partner and Surgical Director with RMA of Connecticut.
Based on 20 years of experience working with patients struggling to conceive, I believe reproductive aging and autonomy need to be openly discussed. With advancement in the uses of alternative reproductive technologies, considering planned-conception earlier can assist women seeking to create or expand their families.
If you think back to your high school health class, there was an emphasis on students learning about contraception and safe sex. Fertility aging was never discussed. Early education, included in high school health curricula, I believe, can help patients protect their fertility potential and help to ensure an easier family-building journey.
Women are designed biologically different from men. A fundamental biological and reproductive difference between men and women is the production of male sperm vs. female eggs, “oocytes”. Men make new sperm every 90 days. Yet, women are born with their full complement of two million eggs for their lifetime. Healthy pregnancies require 23 chromosomes from the egg and 23 chromosomes from the sperm. As women advance in age, the ovaries release eggs without 23 chromosomes. This diminished ovarian reserve increases the chance for an unhealthy pregnancy and an unhealthy baby.
Here are some relevant tips and guidelines to help both women on their
Maintain (or create) a healthy lifestyle. For women, a healthy lifestyle can protect their eggs. A healthy lifestyle includes exercise, such as yoga, making healthy food choices and getting enough sleep (recommended 6-8 hours a night). If a woman is trying to conceive, she should start taking a prenatal vitamin. Some of my patients even do acupuncture, reporting positive results. Engaging in safe sex practices and using condoms decrease the chance of contracting sexually transmitted diseases (STDs). Often, STDs have no visible symptoms alerting patients that there’s a problem. Undiagnosed STDs can damage a woman’s fallopian tubes making pregnancy more difficult. Lastly, limit alcohol intake and avoid smoking as it ages oocytes.
Fertility tests. For women, there are three simple fertility tests that will give information on the health of her ovaries. These tests are usually done on day three of a woman’s menstrual cycle. The first test is a transvaginal ultrasound which will enable a physician to count the follicles of a woman’s ovaries. The greater the number of follicles, the better. In addition to this ultrasound, two hormone-blood tests should be drawn. The first test is follicle stimulating-hormone (FSH) and the second is the Anti-Mullerian Hormone test (AMH). The results of these hormone tests reflect oocyte quality and reproductive potential and may influence a patient’s reproductive timeline.
You don’t have to wait for the perfect partner! You do not have to find the perfect partner to become pregnant. I work with many women who know their egg quality will decrease with advancing age. Using donor sperm can assist many single moms-to-be who are ready to become pregnant without a partner.
Freeze your eggs. Excellent news, egg freezing is no longer experimental and is considered mainstream. In fact, companies like Facebook, Apple, and Google cover egg freezing for their employees. Many patients are protecting their fertility and extending their reproductive years by doing In Vitro Fertilization (IVF) and freezing their “eggs.”. When I see patients who do not yet have a partner or are not ready to build their family, I often tell them, “Your eggs will never be younger than they are today.” Doing a cycle of IVF and freezing oocytes is fairly uncomplicated and often takes less than three weeks. These oocytes can be used in the future with a partner or donor sperm.
Cancer patients should seek counseling and fertility preservation. All cancer patients, before undergoing any treatment, should sit down with a reproductive endocrinologist and investigate the options of egg or embryo freezing. We have patients with cancers who are going to need chemotherapy as part of their treatment. Even while treatments like chemotherapeutic agents save lives, they can damage a women’s eggs and make her infertile. Before a patient undergoes cancer treatment, we can do IVF and freeze oocytes or embryos for future use. After a patient’s treatment is successful and she is ready for family building, these oocytes or embryos can be thawed and transferred back to the uterus. This is truly fertility preservation.
As a veteran, Board-Certified Reproductive Endocrinologist, I can say with confidence, family building truly has no barriers. When it comes to fertility, I encourage my patients to be informed and proactive. Earlier understanding of reproductive aging can provide women with greater autonomy in making informed choices towards family building