Our biology and its baby-making capabilities shouldn't be a surprise when life gives the green light for reproduction, and we should feel confident talking with our medical professionals when the time comes, but it can often feel overwhelming or uncomfortable to ask in person.
Here are the top 10 questions about fertility I feel my patients are often hesitant to ask.
1. Can I get pregnant?
The answer is truly you don't know until you actually conceive. We can do tests for many aspects—are you ovulating, are the tubes open, does the mucus in the cervix like your partner's sperm? Does your partner have enough sperm? And all those questions can have positive results, and still one may not conceive.
2. What about freezing my eggs when I am young? Will that guarantee a baby later when I am older?
The answer here is similar to the question above: You.don't know until you try. So you can have lovely eggs retrieved and frozen but when they are unfrozen, there is a chance that they may not be able to be fertilized. So that's why I am hesitant to reassure women that it'll guarantee pregnancy in the future. The good news is yes, in general, it does work, but not 100% of the time.
3. How does age affect fertility?
We are born with all our eggs and they get older with us, and alas harder to fertilize. Fertility starts to decline beyond age 35, not precipitously there, but substantially, with a more marked decline at age 40 or so. If a woman is under age 35, we encourage women to seek medical attention if she has been trying to conceive for a year or more and hasn't been able to conceive. If a woman is 35 or older, we encourage her to check in with us after about 6 months of trying.
4. What can I do on my own, health-habits wise, to increase my fertility?
There are a few tried and true ways to remain healthy. Try to achieve your ideal body weight as both being underweight and overweight can impact fertility. Stop smoking as it can age the ovaries, causing earlier menopause and can even increase the rate of SIDS in children. Limit your drinking and avoid drugs—a good habit to get into before conceiving. You can start taking a prenatal vitamin with folic acid—having folic acid on board when you conceive reduces the risk of a number of birth defects, including neural tube defects, like spina bifida.
5. What at-home tests can I do on my own?
There are a couple that are very easy. You can pinpoint your ovulation with ovulation predictor kits, such as the First Response ovulation predictor kit. They're very reliable and will guide you when to have sex with the most likelihood of success in conception. And if it looks like you are not ovulating, check in with your provider. You can also check up on your ovarian reserve at home to see how "zippy" your ovaries are (are there lots of eggs left?). These tests can serve as a guideline to how vigorous you should be acting on your fertility and when to speak with your doctor.
6. What specifically can men do to help with fertility?
A few things could be helpful. If he is a big drinker, encourage him to take it easy since alcohol isn't great for healthy sperm production. And if he loves to sit in a hot tub, you might "cool him down" as sperm don't like hot temperatures. If you have concerns, he can also be tested to determine his sperm production.
7. If you are having problems as a couple conceiving, should you have your partner tested?
Absolutely! About 50% of infertility is due to male factors and fortunately, it is really easy to test. They'll collect a sperm sample by masturbation, and it's off to the lab and you will get a quick answer.
8. How soon can I find out if I am pregnant?
I wouldn't test 10 minutes after having sex, but indeed, an early pregnancy detection test such as the First Response test, will turn positive as early as six days before the first day of the missed period (and to think of how long women had to wait in the past!).
9. If I am having problems conceiving, do I have to start IVF?
Not necessarily. There are many simple medications that can help women ovulate, and if the fallopian tubes are blocked, sometimes even the test can detect that. There are various procedures that can help open the tubes so don't fear that you are automatically in need of IVF. Speak to your doctor with about your specific concerns.
10. If I do need IVF, will it break the bank?
Again, not necessarily. Many states mandate insurance coverage for infertility therapy so that depends on where you live and what kind of insurance you have. Do check with your provider who can give you the information you need.