Do you have a friend who just went through fertility treatment? Perhaps you know someone who expanded their family through IVF, donor eggs, reciprocal IVF, or with the help of a gestational carrier? We live in an exciting time where there are so many paths to parenthood but when it comes to knowing and understanding our fertility, there are still many who don’t fully understand the basics. In this article, we’re going to share questions you may want to ask your OB/GYN, Urologist, or Reproductive Endocrinologist.
While on the surface, this may seem like a scary question (mainly depending on what age you are), it’s essential to know how age can impact your egg quantity and quality in terms of conceiving down the road. Your doctor can provide an overview of your specific age and walk you through your options in terms of either “having more time” (meaning if you’re in your early twenties) or considering freezing your eggs if you’re a female getting close to your mid-thirties.
On that note, a common misconception is men and their age do not impact their fertility. However, more and more studies are coming out that show the older the man gets, the more their fertility declines. There was also an additional study that looked at approximately 8,000 pregnancies. It showed that conception in one year was 30% less likely for men over age 40 compared with men under age 30.
No matter your age, or gender, fertility testing is a smart idea. Some doctors may tell you it’s not yet necessary if you’re considered young, or you’re not ready to have children. However, as they say, knowledge is power. It’s better to know for sure exactly where your fertility health is at and getting the necessary testing such as blood work and an ultrasound can provide invaluable insight. Women can have blood work and an ultrasound done and men can have a sperm analysis.
Your Follicle-Stimulating Hormone (FSH) will indicate how many follicles/eggs you have in your reserve, and your Anti-Mullerian Hormone (AMH) provides insight on the quality. The ultrasound looks at a few things: the number of follicles you have on your ovaries, which correlates with the number of eggs you have in your ovarian reserve, and they will look at your uterus and fallopian tubes to see if there are any polyps, fibroids, cysts or blockage. The blood work, ultrasound, and a review of any health issues or family history, can give your doctor an overview of your fertility health.
For both men and women, habits like smoking, medical issues like diabetes or cancer, and/or medications you may be taking can impact your fertility. Health issues such as polycystic ovary syndrome, endometriosis, and uterine fibroids can affect a woman’s chances of getting pregnant or successfully carrying a pregnancy to term, so if you or your doctor suspect or know you may have issues now, taking preventative action or looking into options like donor eggs, donor sperm or a gestational carrier ahead of time can help.
Whether you’re in a same-sex relationship, you’re single and want to have a family or you’ve been diagnosed with an infertility issue, there are so many paths to parenthood you can explore. Here are a few:
Intrauterine Insemination (IUI): A catheter gives the sperm a head start by inserting past the cervix and ideally, making its way to an egg during ovulation time.
In Vitro Fertilization (IVF): Eggs are retrieved and combined with her partner or donor’s sperm to create embryos. You can discuss with your reproductive endocrinologist how many to transfer or freeze to be transferred later. Similar to IUI, the embryo(s) are put into a catheter where it is transferred to the woman’s uterus (or a gestational carrier) in the hopes that it will implant into the uterine lining.
Intracytoplasmic Sperm Injection (ICSI): intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) to help fertilize eggs. It’s when a single sperm is injected directly into an egg, rather than placing many sperm next to the egg.
Freeze All IVF Cycle: IVF cycles described above typically involve the transfer of “fresh” embryos to the uterus within three to five days after the egg retrieval. With a “Freeze All” cycle, any embryos created are frozen using a process called “vitrification”, which is a fast freeze, and the embryos are transferred later. This is recommended either if your doctor feels you could benefit from genetic testing, or they want to give a woman’s body time to get back to its natural state after undergoing the hormone stimulation.
Donor Egg or Donor Embryo: There are donor egg banks, fresh donors, or even shared donors, where a carefully screened healthy woman donates her eggs. These eggs are combined with a partner or donor sperm, and just like the IVF, the resulting embryo(s) is transferred to the intended mother or gestational surrogate’s uterus (see below).
Donor Sperm: This is an option either for LGBTQ+ couples or single women as a means of conceiving, if a male partner has no sperm, has a poor semen analysis, or when there is a known genetic concern.
Surrogacy (gestational carrier): Another woman carries your embryo or donor embryo to term and gives birth to your baby. Gestational carriers do not have a biological link to the child.
Being proactive about your fertility health is something that the future you will thank you for, so start asking questions now!