When Should a Woman Seek Fertility Help

15 May

When should a woman seek fertility help is a common question and concern for patients of Sher New Jersey, as well as most women who have not yet had children as they enter their 30s. In general, most doctors will encourage a fertility evaluation after one year of unprotected intercourse without conception. However, I (Dr. Albert Peters) would argue that for most patients, this might already be too late. One of the most common reasons for infertility is a condition known as “decreased ovarian reserve” (DOR). This means that the aging effect has decreased the quality of the remaining eggs in the ovaries, thus rendering the individual less likely to conceive. Once DOR occurs, the aging effect cannot be reversed, leaving more and more aggressive therapies or donor eggs as the only viable alternative to initiate pregnancy.

Of course, there are other factors that should give rise to concern with regard to fertility problems. These conditions include disorders of sperm, irregular periods and damaged fallopian tubes. In fact, any couple concerned about conception should be encouraged to have the male partner set up a semen analysis, and the female partner should have ovarian reserve testing. This will include 2 tests. One is a measurement of follicle stimulating hormone (FSH) and the other a measurement of antimullerian hormone (AMH). These tests will give the woman a good idea if DOR exists. Once egg and sperm quality have been tested, if the history of the individual dictates, testing of the fallopian tubes can be done.

In my opinion, one should not wait until fertility difficulties occur. I believe all women who are approaching their mid-30s and who have future interests in fertility should ask their ob/gyn or primary care doctor to test their ovarian reserve. If DOR is discovered, the patient can then make an informed decision as to whether or not to act on this. Unfortunately, I have women coming in to see me way too often in their mid-30s, who are being tested for the first time, only to find out that they have severe DOR. Had this condition been diagnosed earlier, outcomes inevitably would have been better.

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