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The future of reproductive healthcare starts with you

It’s time for our healthcare system to catch up and make #fertilityscreening as standard as a Pap smear or a testicular cancer check

As a reproductive specialist who has helped thousands of women and couples start families in the past 10 years, I believe the medical community has neglected the critical tests that inform and empower us about our reproductive health and potential: what I call fertility screening, which is using diagnostic tests to understand your fertility health and making sense of it with a doctor. It’s part science and part art.

The Reality of Modern Family Planning

Why is it important to get ahead of your fertility? We’re living in a new reality when it comes to family planning. In the past, there was no reason for doctors to encourage us to focus on our fertility because most women had all their children in their 20s — and very rarely worried about their biological clock.

Today, more and more of us are putting off having kids until our thirties and forties because we are focusing on our educations, building our careers, finding our partners, and growing our bank accounts before we take the plunge into parenthood. Last year the Center for Disease Control reported that in 2015 more babies were born to women in their 30s than women in their 20s for the first time.

These changes are excellent for our lives and economic empowerment, but the problem is that our biology has not evolved to meet these changes. It’s one of the reasons that infertility has become the third most pressing global health issue. It’s why so many more patients come through my practice who need the help of reproductive medicine to conceive their families.

Critical Healthcare

This new fertility reality is why it is more critical for women, men and their doctors to give equal focus to their fertility as their bank accounts — it’s one of the most precious personal resources we’re granted, and most of us are not focused enough on monitoring it. Please don’t confuse my passion for the subject with pointing blame on the patient. It’s not your fault. While I recommend that all patients pay closer attention to their fertility care, our health care system also has to evolve to help empower us about reproductive health rather than make us feel like it’s a taboo topic. It’s time for our healthcare system to catch up and make fertility screening as standard as a Pap smear or a testicular cancer check.

What is a Fertility Screening?

Now, it’s also possible to log our fertility over time to understand our reproductive potential and obstacles –this is the beginning of preventive fertility care and personalized fertility medicine.

Fertility screening is the vital preventive medicine that I believe you should start focusing on in your 20s. It begins with a simple conversation with a trusted doctor (your OB-GYN or GP) who will listen to your plans for a family in the future and understand any concerns about your reproductive health. This conversation is important, especially if you have a family history of infertility or a condition that could get in the way of getting pregnant down the road. Many women don’t know they have a condition until it’s too late, so I believe it’s always worth learning about it sooner than later.

Technology has empowered us to take action. Through apps, we can track our sleep cycles, know how many calories we burn each day, be reminded to stand up from our desks and take a walk. Heck, we can even track our pizza delivery and our pets.

Now, it’s also possible to log our fertility over time to understand our reproductive potential and obstacles –this is the beginning of preventive fertility care and personalized fertility medicine.

For years, women patients have been told that they don’t need these tests for a battery of reasons that may sound familiar:

  • You’re too young to worry about your fertility because you’re otherwise healthy.
  • Your cycles are regular, so it’s not a concern.
  • If you’re trying to conceive, don’t worry about testing until you’ve spent a year trying to get pregnant.
  • They’re too expensive.
  • What you learn from a test like this may be scary and draw a finite conclusion like, “you can’t have children.”

Excuse my french, but this is all BS. These are not valid reasons to hold you back from taking action to understand your fertile potential — whether or not you’re planning your family now, ten years down the road, or you’ve only been trying to get pregnant for a month.

I’ve Heard Fertility Tests Aren’t Accurate

I’m sure many of you have been wondering about all the buzz about how fertility testing doesn’t offer an accurate indicator of your ability to conceive naturally. It all stems from a 2017 study published in the Journal of the American Medical Association. The study looked at women age 30–44 with no history of infertility and found that women with a low level of Antimüllerian hormone (AMH) had an 84% probability of conceiving within a year compared with a 75% chance among women with normal AMH levels. The researchers, therefore, concluded that there wasn’t a connection between diminished ovarian reserve and infertility and that women should not use their AMH levels to assess their current fertility.

There’s a Difference Between Conceiving a Baby and Having a Baby

There is a huge difference between conceiving a baby and having a healthy baby. Another study based on the same set of data published in the journal Fertility and Sterility showed that women with an AMH of less than .6 had a higher risk of miscarriages because they had lower quality eggs. So these tests do offer valuable information. If your AMH is low, it could mean that your egg quality is lower, which could increase your chance of miscarriage.

While age is the best indicator of your egg quality and ability to get pregnant naturally, these fertility tests can provide you with a snapshot of the current state of your fertility. If you continue to take these tests over time, you can learn how your fertility is tracking relative to your age. The test can also tell you if you have any flags for early menopause, a high chance of having PCOS and where you are on the fertility meter — high, medium or low fertility. Just because you have many eggs doesn’t mean they will be high-quality eggs. Alternatively, a low AMH doesn’t necessarily mean you’re infertile.

What the Egg Awareness Panel Measures

My Egg Whisperer Fertility Awareness Panel measures three critical hormones connected to your fertility. Antimüllerian hormone (AMH) is responsible for stimulating the growth of the ovarian follicles that hold your eggs. Follicle Stimulating Hormone (FSH) is produced by your pituitary gland and signals your ovaries to release an egg every month. E2 or Estradiol is another female sex hormone produced in the ovaries that regulates your menstrual cycle. Together, these three hormones regulate your reproductive system and help your body conceive when you’re ready.

Who Should Consider a Fertility Screening?

● You are at least 25 years of age or older. Earlier if you have a family history of early menopause.
● If you’ve delivered your first child and you are planning for more children.
● You are preparing for a pap smear.
● You are renewing your birth control prescription or annually if you have an IUD.
● If you’re considering an abortion (you’ll want to ensure this is not the last biological child you can conceive). Yes, you can check your AMH in pregnancy and I’ve seen patients end a pregnancy before realizing that they conceived as they were entering menopause.
● If you have a personal or family history of conditions like endometriosis, fibroids, early menopause or autoimmune disease, which all threaten fertility.

Information is power and can save you a lot of money and anxiety in the future. A trusted doctor can piece together the parts of your personal health history and fertility tests to put together your fertility profile and an action plan specific to you. It doesn’t matter what you “think” about your fertility. It doesn’t matter what your friends have told you or what your family members have experienced. Your best care, your personalized fertility care, starts with getting to know the scientific data of your reproductive health — about YOU.

There are 3 Simple Steps Involved in a Fertility Screening:

1. Get a read on your fertility hormones. Simple and affordable tests like my Egg Whisperer Fertiltiy Awareness Panel and an at-home sperm test can make it a no-brainer.

2. Review your results with a doctor, discuss family history, and determine the need for more tests.

3. With the help of your doctor, consider a pelvic ultrasound, which will determine if you have a condition such as endometriosis or Polycystic Ovarian Syndrome (PCOS), which could affect your fertility in the future, and a DNA test.

My mission is to make it so that everyone is empowered with knowledge about his or her fertility and has easy and affordable access to care from a doctor — wherever you are. Get to know your body through science, make sense of it with with the help of a trusted doctor, and put an action plan in place that makes sense for you and your family planning goals.

If you’re thinking about freezing your eggs or if you’re considering IVF, these fertility tests can also offer valuable information about how you might respond to the hormones that will stimulate your ovaries to grow. Fertility screening will help you determine your best personal timing and also help guide the doctors who are involved in your fertility planning.

You can also catch more of me and topics like this through the Egg Whisperer Show. The episodes are live-streamed on YouTube, Facebook, and Twitter and on Wednesdays at 7 PM PST. Subscribe to the podcast too!

Fertility Doctor, Reproductive Endocrinologist, Egg Whisperer:

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