Q: Why is it important to know about your fertility potential sooner?
A: The earlier one knows about fertility related problems, namely that of ovarian reserve, the sooner one can make decisions about future pregnancy and family. Clearly, a woman who is faced with the diagnosis of low ovarian reserve or other fertility issues may make life altering decisions about timing of future pregnancy and building a family. Having this information will allow any given woman to make these important decisions, potentially reevaluating thoughts about how to conduct her life. It is hard to imagine more substantive or life altering information that can be obtained so easily.
Q: What role does ovarian reserve have in fertility?
A: Ovarian reserve is the single most important factor affecting fertility potential in a woman or any given couple. Other factors such as male issues, uterine issues, etc., are important; but they are secondary in significance to ovarian reserve. Low ovarian reserve is the one problem that cannot be overcome or easily dealt with by clinical treatments other than IVF. Low ovarian reserve affects IVF outcome as well. Thus, our most successful treatment (in vitro fertilization) starts to have reduced success with patients who are older as well as patients who have low ovarian reserve regardless of age. Certainly, non IVF treatments are going to be even more significantly impacted by low ovarian reserve as far as success potential. Thus, low reserve ultimately is our most important concern with respect to evaluating reproduction. Knowing the reserve status is going to have the most significant impact on decision making with respect to treatment options and how these treatments can be conducted optimally as well as their potential outcomes.
Q: At what age does ovarian reserve begin to measurably decline?
A: The decline of ovarian reserve starts to occur measurably and noticeably in the late twenties. Any given woman is born with as many eggs in the ovaries as she will ever have. Throughout life, even before she has her first menstrual period around the age of eleven or twelve, the reserve is decreasing steadily. It is generally believed that loss of ovarian reserve starts to accelerate in the mid thirties.
Q: How soon should one screen for FSH or other tests?
A: Clearly ovarian reserve screening with tests such as FSH should be undertaken if there is any clinical issue such as irregular menses, ovulation dysfunction, or in a woman who has had previous ovarian surgery. In addition, any patient in her early to mid thirties should undertake this testing as a screening process. Discussing these matters, whether the test is normal or not, with a qualified health care professional knowledgeable in the arena of fertility should also be undertaken. Assessment of ovarian reserve can be undertaken in any patient regardless of age with simple testing.
Q: When should one consult with a physician about fertility?
A: I believe that any woman in her mid to late twenties should discuss this topic with a healthcare
professional or physician. Depending upon the patient's mind set and personal medical history, such a discussion might lead to simple testing which ultimately can be life altering. Such discussions with healthcare professionals of course will provide information and knowledge with which a patient can make such important decisions. Asking questions leads to education, and simply understanding these concepts of ovarian reserve and then incorporating these concepts into the context of an individual's personal circumstances can make all the difference. Patients can be empowered with such information to make important decisions about future fertility and subsequently family. Discussion with your physician, simple ovarian reserve testing, and understanding these concepts are simple critical first steps in evaluating the importance of fertility in any given circumstance.
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Dr. Peter Ahlering, MD
Dr. Peter Ahlering is a board certified obstetrician/gynecologist (OB/GYN) with a focus in operative laparoscopy and advanced laparoscopic procedures. A native of St. Louis, Missouri, Dr. Ahlering comes from a medical background with his father and brothers also specializing in OB/GYN.
Dr. Ahlering graduated from the accelerated, six-year medical program at the University of Missouri in Kansas City. His post-graduate training, including internship and residency, was at St John's Hospital. During residency, he participated as a consultant editor for the book "Practical Guide to High Risk Pregnancy and Delivery, 2nd edition."
Since then, he has participated in publishing several peer reviewed papers.
He is a member of several societies and, after several years of exclusive practice in the field of OB/GYN, he now focuses solely in the realm of Reproductive Medicine and Infertility (since 1999).
Dr. Peter Ahlering receives compensation for his participation in FIRST RESPONSE® communications.
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