Female fertility at “Fertility First”
Healthy men and women have healthy babies one would imagine. And it is true that young, fit, non smoking, healthy eating and cautiously drinking couples who never take drugs are more likely to have healthy babies. Nevertheless one in six couples have difficulty conceiving and many more suffer recurrent miscarriages. If you and your partner have a twinkle in your eye, then you need to take some preparatory steps to enhance your chances of conceiving and of the baby being healthy.
You will need:
- An up to date cervical smear;
- Fertility advice from the doctor as to when you are most fertile;
- How to identify ovulation changes in your body;
- Routine blood tests to make sure you are not anaemic, b12 deficient or liver problems or high serum cholesterol or have haemochromatosis.
Blood tests at day 3 of your cycle for Follicle Stimulating Hormone (FSH), which is a good predictor of ovarian reserve and a snapshot of your fertility on this particular cycle.
DAY 21 blood tests for progesterone levels, to see whether you are ovulating in this cycle.
A special ultrasound scan for the ovaries to rule out Polycystic Ovarian Syndrome(PCOS) which can interfere with fertility.
Anti Mullerian Hormone (A.M.H.)
There is a very reliable blood test called Anti Mullerian Hormone (A.M.H.) which measures ovarian reserve and can give an approximation of when you may expect to go into the menopause.
A.M.H.is a protein that is secreted by the developing egg sacs (follicles. The level of A.M.H. in the blood, which can be measured any time in a woman's cycle, is a good indicator of the number of eggs left in the woman's ovaries and of her predictive fertility.
Low A.M.H. suggests that the number of ovarian follicles have deteriorated or diminished and this happens naturally as a woman gets older.
Some women with Polycystic Ovarian Syndrome will have abnormally high A.M.H. which reflects the fact that women with P.C.O.S have a greater number than normal of ovarian follicles. Too much is as bad as too little in fertility terms as very high numbers of follicles can also interfere with fertility. Women with P.C.O.S will usually show very high numbers of small follicles on their ovaries when they have an antral follicle count on ultrasound examination. There are treatments available and early detection and referral for treatment can save a couple much heartache.
It is useful to know that most women's fertility declines at least ten years before the menopause and the average age of menopause is 51. Nowadays women are studying and following their careers into their late twenties and many are leaving it too late to try for a baby which can cause terrible heartache. We women are born with the number of eggs we will ever have and they age with us so generally it is best to try to conceive before the age of 35 if possible. Many woman however are fertile into their forties and the A.M.H. level will be reassuringly high for these women and they can be reassured that their ovarian reserve is fine.
Men, on the other hand, produce sperm every 80 days approximately but again the sperm quality can decline after the age of forty or if the man has illness, obesity, is a heavy smoker or drinker or takes drugs. The quality of a man's sperm can only recently be tested due to the Sperm DNA fragmentation test.