Testing for Fertility

 If you are more in the grandma stage of life than the mom stage, please share this information with the young women in your life who are in their childbearing years.

 Our baby makers don’t work forever. Thank goodness. Can you imagine if they did? But if we keep an eye on our fertility clock, we can help make sure that when our lives are ready for pregnancy, childproofing, and dirty little handprints all over our walls (and our hearts), so are our bodies. Perimenopause may start earlier than you think, so too does your fertility begin to wane earlier than is commonly known. In order to take charge of your fertility and family planning, here are some tips for you:

About 95 percent of 30-year-old women have only 12 percent of their original number of ovarian follicular cells, which can develop into eggs. And at 40, only 3 percent of the cells remain, according to research from the University of Edinburgh.  Now, the good news: The research says that before birth, females have roughly 600,000 ovarian follicular cells. That means that even if you lose 88 percent of them by the time you blow out 30 candles, you can still celebrate having 72,000 cells left.

While it’s easiest for women to become pregnant before age 35, all egg-laying ovaries are not created equal, says David B. Smotrich, M.D., a Diplomate of the American Board of Obstetrics and Gynecology specializing in Reproductive Endocrinology and Fertility. During your early 30s, your eggs can decline in quality and you might begin ovulating less frequently, even if you are having regular periods, according to Smotrich. A 30-year-old woman has a 20 percent chance of getting pregnant per cycle, but by the time she’s 40, her odds drop to 5 percent per cycle. That’s where some newfangled fertility tests come in.

If you plan to have a baby in the great “someday,” Smotrich recommends treating yourself to a baseline exam or two for your 30^th birthday. Follow-up with yearly tests until age 35, semi-annual tests (I suggest you time them with the Victoria’s Secret semi-annual sales!) until 39, and quarterly tests thereafter to monitor your fertility.

It is amazing what you can learn about your fertility with just one blood test. Speak to your healthcare professional about these fertility tests:

• Follicle-Stimulating Hormone (FSH) Test   Follicle-stimulating hormone (FSH) levels are sometimes measured to confirm menopause. This test is also used to determine a woman’s likelihood of conceiving a child. The test is generally repeated over several months to account for fluctuations in hormone levels that may be occurring. After several tests, if a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause. Some doctors prefer to test the anti-Mullerian hormone (AMH) levels instead. The AMH levels are decreased in perimenopause. Fertility doctors have been using this test for years as they find that the levels are not affected by taking birth control pills.

• 25-Hydroxy Vitamin D Test A blood test that determines if your body is deficient in calcidiol, your body’s main form of stored vitamin D. Calcidiol levels generally decline with age and deficiencies can predispose your baby to health complications, according to Smotrich.

• Estradiol Test This is the main type of estrogen produced in the body, secreted by the ovaries. Low levels can cause memory lapses, anxiety, depression, uncontrollable bursts of anger, sleeplessness, night sweats and more.

• Anti-Mullerian Hormone (AMH) Test A blood test that estimates the number of the eggs in the ovaries.

If the ticking of your biological clock has become deafening and time is running out, medical interventions can help women older than 35 conceive. During in vitro fertilization, for instance, eggs are harvested from your ovaries, frozen unfertilized, and stored for later use. Your eggs can then be thawed, combined with sperm in a lab, and implanted in your uterus. In women ages 35 and younger who undergo up to six cycles of in vitro fertilization therapy, the live-birth rate ranges from 65 to 86 percent. Women ages 40 and older have half the chance of giving birth from in vitro therapy, with their rate ranging from 23 to 42 percent, according to an analysis of more than 6,000 patients published in The New England Journal of Medicine. 

During perimenopause (the 6-10 years before you reach menopause), it is possible to conceive a healthy baby, while at the same transitioning to menopause, he says. However, since the risk of chromosomal complications increases with the mother’s age, Smotrich recommends women older than age 35 talk to their doctor about having their developing baby monitored for chromosomal conditions including Down syndrome. Tests include a nuchal scan, a type of ultrasound, and amniocentesis, also referred to as an amniotic fluid test or AFT, in which a small amount of amniotic fluid, which contains fetal tissues, is sampled.

BTW, no matter what kind of medical tests you are having, always ask for a copy of the lab results and keep them in a notebook or electronic folder.

Do not be shy about asking for these simple blood tests to help ensure that you are in charge of your fertility and family planning.

Remember:  Suffering in silence is OUT!  Reaching out is IN.

For more great tips on how to find a menopause specialist and deal with menopause download my free ebook: MENOPAUSE MONDAYS  the Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause.    

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