Fertility check gives you an idea of how well your ovaries are working. Usually at birth 1000,000 eggs are present these come down to 1,00,000 at 35 when fertility is decreased and at 40 they are 10,000 when chances of pregnancy are greatly reduced. Thus a woman’s fertility decreases with age. Not only the quantity of eggs go down but also the quality becomes poor. These eggs usually do not end up in a healthy pregnancy. It is important, even if you are not planning a baby, to undergo a fertility check. There is an increasing incidence of decreased ovarian reserve and premature menopause. That means that the ageing changes described above occur at a much younger age. Early menopause may be due to life style changes – poor diet, lack of exercise, stress, smoking drugs etc. Also with the changing social scenario where women are spending more time on their careers and incidence of delayed marriages and childbirth are increasing fertility assessment seems to form an important tool to prognosticate them. Once fertility check is done one is able to assess how young the ovaries are and how far from menopause is the woman. Fertility check includes a few blood tests and ultrasounds. Blood tests include an Anti -mullerian hormone tests and a day 2 FSH. An ultrasound on day 2 would show the antral follicle count that is the number of basal follicles an ovary has in that cycle. An assessment of the male partner, if present, may be done with a basic semen analysis.
A complete history would be asked. The tests reports are analysed on age based graphs to assess the prognosis. It is important that the fertility specialists discuss the outcomes of the fertility check and recommend the appropriate next steps in each individual circumstance. If tests show a good ovarian reserve only reassurance is needed and one can plan a pregnancy at a later date. However if the check shows a declining ovarian reserve it is better to go in for planning a baby or for fertility preservation techniques like freezing the eggs. Lifestyle advice maybe recommended and a treatment plan outlined.
The fertility check is recommended for all women who are beyond 30 years of age, women with family history of menopause, women with autoimmune disease, irregular scanty periods indicating hormonal imbalance. Women with history of ovarian pathology or surgery where part of ovary may have been removed. Also women who have not been able to conceive despite trying for one year. It guides women on how much further can they delay getting pregnant. It also identifies women who need aggressive treatment for fertility.