There is no denying that the delay in pregnancy has become a trend especially in urban states. Women delays pregnancy to pursue careers, doing business etc. And, it is unlikely that this trend of delaying parenthood is not going to change anytime soon. But what can you do to assess your fertility health, what really are your chances of having a baby in your late 30s and is there anything you can do to preserve your fertility?
The key to fertility is a woman’s ovarian reserve i.e. the availability of healthy eggs. A decline in ovarian reserve means that not only do the ovaries have fewer eggs to offer, but the eggs they do have are of poorer quality. The challenge for many women choosing to have their first child mid-30s or later is that as part of the body’s natural aging process, a woman’s eggs age too. This can lead to infertility and/or miscarriage.
Achieving a natural pregnancy after 40 years of age is a challenge for many women, but getting pregnant is only half the journey. Miscarriage rates over 40 are 50% and rise quickly with each advancing year.
Hormone testing to assess egg quality and number:
Three simple blood tests can check hormone levels and reveal more information about egg quality and number. These tests may also help diagnose infertility in a younger woman, who ordinarily would not be experiencing diminished ovarian reserve or poor quality, but may be living with an undiagnosed condition:
1. Basic FSH Test: FSH (follicle stimulating hormone) is the main hormone involved in producing mature eggs in the ovaries. If this test reveals excessive
levels of FSH in the body, it is a signal that the brain is trying to boost poorly performing ovaries into action. In other words, the ovaries may need extra help to make eggs.
2. Estradiol: Estradiol is the most important form of oestrogen found in the body, and is responsible for maintaining healthy eggs in a woman’s ovaries, as well as for facilitating a healthy pregnancy. If a blood test shows high levels of Estradiol, it indicates a problem with egg numbers and/or quality.
3. Anti-mullerian hormone testing (AMH): AMH is a blood test that directly measures ovarian reserve. It is produced directly by early stage ovarian follicles. High levels (over 1.0 ng/mL or 8 pmol/L) are favourable, while low levels (less than 1.0 ng/mL or 8 pmol/L) indicate decreased ovarian reserve. AMH may be the best measure of the menopausal transition and ovarian age.
Ultrasound evaluation to assess egg quantity:
An ultrasound allows us to evaluate the uterus, uterine cavity, and ovaries. We recommend that this scan is performed just prior to ovulation - from this we can make sure there are no fibroids or other growths that could affect fertility, as well as assessing the number of small follicles (antral follicles) in the ovaries, referred to as an antral follicle count (AFC). These give us a good indication of the ovarian reserve.
IVF is readily available choice today. However, delays parenthood is a personal choice. One can also have an option to freeze eggs or sperms.