What I wish I knew about my eggs and my fertility when I was younger
I was 35, when I first tried to get pregnant.
I felt awesome at the time, my career was blossoming, my partner was the right one. For the first time in my life, nothing serious stood in the way of me finally becoming a mother.
Periods continued coming as usual; not only that I was not getting pregnant, but my cycle actually shortened and gave me the feeling of my uterus crying with bloody tears every three weeks or so.
I will shorten the story (more details you can find here) and tell you straight away that I didn’t wait long before I made the appointment in one of the best fertility clinics in the country and scheduled a check-up.
I was incredibly lucky that the facility was only a 5-minutes walk from our house and this fact continued to play a big role later on when we started fertility treatments – it felt like walking in the other room, which reduced a lot of anxiety for me and my husband.
Already the first blood test showed that my ovarian reserve was in the red zone. Eggs were still there, but nobody could tell if they had a quality enough to spark a new life.
The thing that made everything even worse was that I should have known.
I am a cell biologist, I got a PhD for apparently knowing something about how cells work. I didn’t need to ask others about cells and what helps them grow, I was the one who was getting paid to find out about it.
And yet it happened to me. I’ve let my eggs dissapear while I was busy doing research on other people’s cells.
In today’s world, more women are putting off starting a family in favor of going to college, starting a career, traveling the world, etc.
Most young women don’t even think about fertility until they are ready to settle down and build a home with a little bundle of joy.
However, not many young women realize that the older you get, the harder it is to conceive, and there may be other fertility issues that you are unaware of.
As you get older, your ovaries, which carry a fixed number of eggs from birth to menopause, start to decrease in size.
Additionally, once we reach our 30s, cellular energy levels start to decrease. Mutations and various cellular damage accumulate, which means eggs become harder to fertilize.
If you’d like to ask me a fertility-related question or need my advice on your fertility journey, please send me an e-mail as described here and we’ll set up a Skype-consultation at a time that suits you
When is it time to see a fertility specialist
Both quality and quantity of eggs decline as women age. Furthermore, approximately 5% of women go through premature menopause, which can start as early as age 25. This can be caused by a variety of factors including lifestyle behaviors, genetics (in this post you can read more about it), chromosome defects, and autoimmune diseases, just to name a few.
Whatever the reason, ovaries at some point stop producing estrogen, which is what fuels the reproductive cycle. Menopause at a normal age can be emotionally trying, but premature menopause can be detrimental to a woman’s emotional and mental well-being, especially if she has not had children yet.
This is why early check-ups (especially if you have irregular periods or a family history of fertility problems) are essential.
This is so important that I will say it again: importance of early fertility counseling for young women can not be overestimated. Early fertility check-ups should be available to all girls from the moment they get their first period and knowing about her egg supply and her ovarial reserve should come so naturally like knowing the colour of her eyes.
Women’s bodies are ready for reproduction the moment puberty hits and the menstrual cycles begin.
That is of course far too early to start a family, so young women in their 20’s should be getting early fertility check-ups to find out if there are any possible issues with their ovarian reserve which could complicate future pregnancies.
How is a fertility test done?
A fertility check-up involves an ultrasound and blood work and most insurances will cover for it.
The ultrasound is used to look at the health of the ovaries (volume and shape), as well as measure the egg supply (please read here about Why antral follicle count is the number you need to know).
The blood work looks at the two primary fertility hormones: follicle stimulating hormone (FSH) and anti-muellerian hormone (AMH).
You want the FSH level to be low and the AMH level to be high for good fertility.
High FSH in combination with low AMH puts you at risk of early menopause and trouble conceiving a baby at any age.
To remember: High FSH in combination with low AMH puts you at risk of early menopause and trouble conceiving or sustaining a pregnancyat any age.
There are plenty of medical options to help with fertility problems for those who find out about it early enough.
For example, if you’re still young, you can freeze your eggs for future use. Or you can freeze ovarian tissue instead and then thaw and implant once you’re ready to have a baby. And IVF and ICSI are nothing new or experimental any more.
Importantly, by knowing early you can take appropriate steps to strengthen your eggs and chose a lifestyle and diet to maximize egg quality and help them remain in their best form.