Almost one in eight couples will seek help when trying to conceive. It is expected that more couples will need help with either starting or completing the family. It would be helpful for men and women to be able to do a self-check and know if their fertility might be at risk. It is well known that diagnosing conditions at an early stage may result in timely advice and treatment. This in turn reduces the emotional stress on the individuals, couples and relationships. There are a variety of factors that can affect male and female fertility.
Age is one of the most important factors to influence female fertility. The golden age of female fertility is between 25 and 30 years. It slowly continues to decline and gathers pace around thirty five onwards. Women over forty two would have a very small chance of conceiving naturally. Age does not influence male fertility to the same extent, though it is now believed that age may affect male fertility much later in life.
When self-assessing your fertility profile, one should also take into consideration any medical illnesses or related treatments. In women, conditions such as polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease or PID, fibroids, to name a few, may affect fertility. These conditions may either result in irregular ovulation, blockage of fallopian tubes or affect womb lining resulting in failure of implantation. Other medical conditions such as inflammatory bowel disease (crohn’s or Ulcerative colitis), uncontrolled diabetes, thyroid dysfunction, autoimmune conditions, etc may affect both male and female fertility. Any pelvic or abdominal operations have a potential to affect female fertility by causing blockage of fallopian tubes or affecting ovarian reserve. In men it can be, undescended testis, operations to correct undescended testes, torsion of testis, operations to fix inguinal hernia, use of steroids in gym, or cancer treatments, especially where there has been exposure to chemo-radiotherapy. Besides these, sexually transmitted infection such as chlamydia may affect both male and female fertility.
There are many lifestyle factors that can affect fertility. It is well known that moderate to heavy smoking can affect both male and female fertility. Excess consumption of alcohol, caffeine and recreational substances can affect fertility. Morbid obesity (body mass index of more than 35) may affect both male and female fertility.
If you identify any one of the above factors and have not completed your family, then you should either speak to your Doctor or a fertility specialist. If you are seeing a specialist for your condition, then discuss with your specialist about the effect of the condition on fertility. Also, one should discuss with the specialist managing your condition the effect of any medicines that you have been prescribed. Besides prescription medicines, you should specifically ask about the impact of any planned operations on fertility where relevant. There are also some things that individuals can address on their own such as weight management, smoking cessation or cutting down on alcohol consumption.
It is very much possible to do an overall fertility self-assessment. If there are any identifiable factors or for those individual who prefer to be informed about their health, then it may be worthwhile seeing a fertility specialist and taking some basic fertility tests. Couples who are thinking of starting a family may also consider taking a basic fertility check as part of their proactive approach. Those who are thinking of delaying starting or completing their family would also benefit from such tests. For women, the fertility check can be either a full assessment of basic fertility or a more directed approach. The full basic fertility assessment will include tests to check the ovarian reserve and fallopian tubes. The directed approach may be considered based on the individualised assessment by a fertility specialist. In men basic semen analysis serves as an initial screening test.
For most individuals or couples, a normal fertility assessment is reassuring. A normal fertility assessment means that there is no reduction in their chances of getting pregnant when they actively start trying to conceive. However, a normal fertility test does not guarantee fertility. Hopefully, in future there may be tests that would give clearer answers so that individuals and couples can make better informed decisions.