The More You Know: Two Fertility Specialists Explain Why Women Need To See Them Sooner Than Later

May 13, 2019  |  

I'm not sure how to feel about this...

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From May 12-18 it’s National Women’s Health Week, an annual effort put on by the U.S. Department of Health and Human Services’ Office to encourage women to be as healthy as possible. To help observe the week, we’re speaking with experts about everything from mental health, diet, pregnancy, fertility issues and more. 

One of the biggest issues impacting women today that we are no longer being quiet about is fertility struggles. Women from all walks of life are being more forthcoming about their journey to motherhood, and the bumps in the road they’ve come across along the way; that includes stars like Eve, Gabrielle Union, Kandi Burruss and more. Most have talked about how they expected their experience trying to conceive to go completely different, the pain they felt over it and the concerns they have about it. While they are all women over 40, their stories are familiar for plenty of women, younger and older.

Though we’re being more open about all of this than ever before, we are not talking enough about the importance of seeking out fertility specialists in these conversations. According to Zaher Merhi, M.D., OB-GYN and the Director of Research and Development in IVF Technologies at New Hope Fertility Center in NYC, the sooner you go to one, the better.

“Any woman who has been having unprotected sex for one year, and she does not get pregnant, should seek fertility help,” he shared. “If she’s above 35, it’s six months of trying. If she’s not pregnant, she needs to see someone.”

“The reality is, the sooner the better, whether you’re less than 35 or more than 35,” he added. “If you’re worried about your fertility, you know your period is not coming regularly, you need to see a fertility doctor immediately. Don’t wait. A lot of times we get women who are in their late 30s, early 40s, and sometimes it’s harder for us to help them.”

Whether you’re thinking about your ability to have kids down the line, or you’re actively trying to conceive in the present, once you seek out a fertility specialist, or even your OBGYN about it, proper counsel can be offered to prospective mothers on what their options are based on their particular situation. One of the possibilities is trying egg freezing to increase your chances of pregnancy in the future. The recommended age to look into that option is earlier than many think.

“I think the ideal age for egg freezing is between 25 and 35 because you do need to be at a point where you’re emotionally ready and financially as well,” said Stephanie M. Thompson, M.D., Reproductive Endocrinology and Infertility Specialist at IRMS at Saint Barnabas in Livingston, New Jersey. “It is not cheap, but we’re seeing a lot more insurance coverage these days, and a lot of companies are now offering it as a part of their benefits package, which is great. The best outcome for egg freezing is if you’re under the age of 35. That doesn’t mean that over 35 is not an option as well. We still see good outcomes between 35 to 40, but it definitely gets much more difficult after age 40.”

Merhi agrees. He’s seen women over 40 freezing eggs of great quality, which are later used to successfully carry a healthy baby to term. Still, he believes people shouldn’t spend too much time waiting, especially since age is such an important factor in fertility.

“Once a woman freezes her eggs, the time is not ticking anymore,” he said. “Even if she’s 50 years old and post-menopausal, she can still use them and get pregnant. A woman doesn’t need a period to get pregnant.”

That doesn’t, however, mean time is indefinitely frozen with those eggs (sometimes not all of the eggs retrieved survive the thawing process), so it’s important to have a plan in place.

“In theory [eggs] can be frozen indefinitely because they’re frozen in liquid nitrogen,” Thompson said. “Realistically, most fertility centers want you to use the eggs before you turn 50. Most of the time, people aren’t coming in that far, but the eggs don’t have an expiration date that we’ve identified.”

A fertility specialist, however, may find that egg freezing isn’t for you. Sometimes it’s recommended that women instead opt for In Vitro Fertilization (IVF). It depends on her health, the sperm she’s using, the egg being used and/or number of eggs, and, as mentioned, the age of the patient.

“If her tubes are blocked, her only chances are to get IVF,” Merhi said. “Chlamydia infection for example, which is one of the most common sexually transmitted diseases in the country, is known to block the tubes. We do test the tubes. If they’re blocked, she needs IVF. If they’re not blocked, we can try something called an IUI, an insemination where we get the sperm, wash it and just push it up close to the egg through a catheter. If the sperm is severely poor, very, very low, we jump to IVF as well.”

But the first step to knowing what you need is to maintain your regular appointments with your gynecologist, who can help you identify issues like fibroids, assess what’s going on with your menstrual cycle (especially if you’re bleeding heavy), and figure out the next best steps, including the necessity of seeking out a fertility specialist. At your first appointment with one, both Thompson and Merhi say the focus will be on understanding your medical history, getting a physical exam, doing blood work to check your hormones, and getting a vaginal ultrasound to look at the ovaries and uterus. Future testing could include a hysterosalpingogram for your fallopian tubes and a possible semen analysis for your partner.

Though many women are choosing to wait to start a family, evolving with the times, our bodies, unfortunately, are not. Child-bearing can become more difficult the older you get, but there are more options available now to help change fertility struggles, so we’re encouraged to be proactive, not ashamed.

“At the end of the day, a woman shouldn’t compromise her ability to have children because of shyness,” Merhi said. “It’s important for patients to know that it’s not something they should be embarrassed or shy about.”

Marshall-Thompson says we also shouldn’t let others make us feel ashamed either, considering we all know someone who has experienced fertility issues but just didn’t address it.

“People are more aware now and talking about it, but I feel like everyone has that aunt or cousin who never had children, and everybody knows someone like that,” she said. “I don’t think it necessarily means they didn’t want to [have children], but we have hid, especially in the Black community, we hide our fertility struggles.”

With that being said, seeking out a fertility specialist could change your situation for the better, especially if you get on it early.

“While fertility treatments are excellent these days, there are certain things we can’t change,” she added. “We can’t turn back the clock. So getting early treatment and early intervention is extremely important.”

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