fbpx Fertility Health Is Important—Even for Those Not Trying to Conceive

Fertility Health Is Important—Even for Those Not Trying to Conceive

Early knowledge empowers you to make decisions about your future family planning.
Britany Robinson
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Britany Robinson

I rarely have questions for my gynecologist and I keep my answers short. Sexually active? Yes. Any concerns? Nope. The speculum is extracted and we're done. But last year, I wanted to know about my fertility health.

At the height of pandemic loneliness, my mind lingered on a persistent panic: I was single and wanted to be a mom. My doctor told me we shouldn't worry about any testing until I turned 35. (I was 34 at the time.) But my gut told me this was important now, so I drove 10 hours for an appointment at a fertility clinic in San Francisco—the only place I could get into without a referral. There, I was told my AMH levels were extremely low. Translation: If I wanted to have a baby, my window was likely closing. Had I waited on testing another year, it could have been too late.

Fertility health was not on my radar until it was imminently important. This seems to be the case for many women these days. Until someone is actively trying—or, worse, already struggling—to get pregnant, the mechanics, choices surrounding, and interconnectedness of fertility health and overall health are rarely discussed.

This missing information is buried further beneath societal expectations that delay family planning for many. People are continuing to push parenthood further down the line, often in the face of crushing student debt or an inability to compete in increasingly competitive housing markets, or because they're working jobs that reward a level of commitment that doesn't leave room for parenthood.

When (if) someone does find the right time/money/partner combination to consider procreating, they might find themselves scrambling to understand their position and their options. It's like turning on a light in a room you've been standing in your whole life—and suddenly finding it's shrunk, or you've grown. Either way, the walls are closing in, because fertility inevitably declines for both men and women as they age.

"If having kids is something that may be important to you, it's vital to start the conversation as soon as possible," said Reem Sabouni, M.D., of Houston Fertility Institute.

I was proactive and lucky—I decided I wanted to have a family, and the pieces fell into place. I met a wonderful partner, and with the knowledge of our potentially limited timeline, we made decisions that led to a positive pregnancy test just one year after our first date.

Most of us are familiar with the concept of a "biological clock." Unfortunately, it's basically impossible to exactly know "what time" it is when it comes to fertility, but understanding fertility health can reveal so much information that might influence current and future decisions—regardless of whether or not you want to have children.

Understanding fertility health is healthy

"Fertility health" refers to a person's ability to conceive children. But fertility health has important overlaps with our overall health, too—especially for women, whose well-being can be greatly impacted by their monthly cycle. Understanding fertility health can lead to a better understanding of your cycle, your overall health and your future in terms of your ability to conceive and when you might experience perimenopause and menopause.

For example, one of the hormones doctors will measure in an initial fertility assessment is AMH, or anti-müllerian hormone. This hormone is considered reflective of your ovarian reserve, or how many eggs you have left. Women are born with all of the eggs they will ever have, and that number declines as we age. In our 30s, it declines more rapidly.

While AMH cannot tell you definitively how much time you have left in your fertile years, it can tip you off to premature ovarian aging or early menopause, which can help you recognize symptoms such as mood swings, brain fog and hot flashes.

If you are hoping to have children one day, knowing your AMH levels can help you make an informed decision on timing. If your level is on the lower end and you want to have several kids, it might be wise to start soon or consider egg-freezing. And if your level is average or high for your age, then you can rest assured that you have time to make family planning decisions.

Fertility health education is also a great way to get educated on organs and systems we may have learned about in health class many years ago but have gone largely unmentioned since.

Did you know that a history of certain STIs, fibroids, pelvic inflammatory disease (PID) and endometriosis can all cause blockages in the fallopian tubes that might prevent an egg from passing through after ovulation? Did you know that, on the bright side, you only need one working fallopian tube to get pregnant? I didn't—until a nurse at the fertility clinic showed me a diagram and explained. I learned so much about my body in that very first consultation.

Recommendations for healthy fertility

Information about our fertility health can also help us make lifestyle choices that lead to better overall health. "The most important thing you can do to boost your fertility is to live a generally healthy life," said Kristin Bendikson, M.D., a reproductive endocrinologist and director of Clinical Development at Kindbody (the clinic I visited in San Francisco). "Eating well and exercising to maintain a healthy weight is a good place to start."

Bendikson also recommends sticking to organic food, or washing your produce thoroughly so it's free of pesticides as they've been linked to reduced fertility in women. Pesticides have also been linked to increased rates of certain cancers along with a host of acute health problems, so avoiding them is a good idea regardless of where you're at in family planning.

Find a doctor who supports you at every stage

I did not have a positive experience when inquiring about fertility health with my own OB-GYN. Sabouni said, unfortunately, that's not uncommon. "Getting brushed off by a provider may be a sign that your provider is not well-versed in fertility, or perhaps doesn't have time to go into great depth in the fertility conversation."

I think we can give our doctors the benefit of the doubt here—they're unlikely to be intentionally neglectful or disinterested in your questions. They may simply be stretched too thin—especially these days, as our healthcare system is being stressed to its breaking point— or they may be more specialized in other aspects of women's health.

Still, our OB-GYNs are a good place to start when learning about fertility health. "They're the frontline for bringing up the topic with patients," Sabouni said.

Opening the door for that conversation is the first step, and it's especially important if you suspect there may be problems with your fertility health.

"If there's a family history of fertility health issues, or something's going on with your ovulation, or you're not ovulating every month, then you need to talk to your doctor," said Stephanie Seitz, N.D., who specializes in women's health.

And if you're not getting the response or support that feels right to you, then it might be time to find another provider. "You don't have to stick with your OB-GYN if you're not happy with them—you can go someplace else," Seitz added.

For more specialized insight on fertility health, consider making an appointment at a fertility clinic. You might also try an at-home hormone test, like Modern Fertility or Everylywell, which allow you to mail in a blood sample that is used to measure important biomarkers for fertility, including progesterone, follicle-stimulating hormone (FSH), estradiol and AMH. The results of these tests should always be discussed with a doctor, but by utilizing an at-home test, you can empower yourself to begin that conversation with a baseline of information.

Fertility health is important—but shouldn't take over your life

Learning about my low AMH level initially gave me a lot of anxiety. But it also motivated me to have frank conversations with a new partner about my desire to start a family. Had we not been on the same page, I could have explored other options, including freezing my eggs or opting to end the relationship and pursue pregnancy on my own.

If you think you want to become pregnant someday, then learning about your fertility health can be a frustrating combination of empowering and unclear. I didn't know how many years of healthy fertility I'd have left, even after a complete fertility assessment, but I knew that my odds were getting worse and worse, likely faster than most people my age. And that it was time to make some decisions.

The fact remains that until you're actively trying to conceive (or deciding that parenthood isn't right for you), then there will always be unknowns about you and/or your partner's ability to do so. Those unknowns can be scary. But what's scarier is making decisions about your life and your future without understanding the basics.

For me, and I suspect for many, fertility health education opened the door to questions I hadn't known to ask—or hadn't known how to ask. It gave me the courage to make decisions, and to take steps toward starting the family I knew I wanted.

"The most important thing for women is to have regular check-ins with yourself," said Sabouni. "And to remember that fertility is a time-limited opportunity. From there, you can better understand your options."