Misconceptions About Female Fertility

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Most women know about the biological clock. The concept that we as women have a window of opportunity to have children. If we miss that window, it’s just not possible. Well, with modern medicine that does not necessarily need to be the case. However, science and technology are still constrained by what is possible based on human biology.

Female fertility is plagued with many myths and many hard truths. We as women want to be educated about our bodies but turning to on line resources we find a confusing mix of fact and fiction.

Here are 5 misconceptions about female fertility

Egg count and quality decline start seriously at age 35 years 

Actually, as women, from when we are born and even before, our egg count has begun to seriously decline. We create all the eggs we will have for our fertile lifetime between 6 and 12 weeks gestational age. Around the time your mother found out for sure she was pregnant with you, and probably before she had even disclosed the pregnancy to close friends and family, you had made all of your eggs. 

Steadily, throughout childhood, before and after puberty and every month their after, eggs steadily undergo a process of selection and atresia (controlled cell death). Lots of eggs leave the safety of the sleeping resting pool within your ovary every day and go on a 100-day march towards either being chosen (for ovulation) or rejected. Nature intended us, in a world without contraception, to first conceive in our late teens. From biological standpoint, it wouldn’t matter if our eggs ran out completely after age 40 because, if we had survived that long in a natural world, a woman would have had many children by then.

Our egg numbers and quality actually start to decline significantly by age 30 years, rapidly by age 35 years and increasingly after that. If a woman goes through menopause at 40, it is considered within the normal spectrum and most women cease being fertile at least 5 to 10 years before menopause due to poor egg quality. The average age of menopause is 50 years.

The take home message is, the youngest age you are ready is the best time to start your family. Think not just about the age you will be when your first child is born. Think instead what age you may be when you  desire your last child.

Freezing eggs can be of great benefit for women who are not yet ready to have children. When you freeze eggs, more is better and younger is best. Remember you are creating a resource for your future and what goes in is what will come out of the freezer. 

Ideally eggs should be frozen before or around the age of 30 years for best prognosis outcomes.   

You can’t have a baby after menopause

Actually you can. However not with your own egg procured at that time. If you have become menopausal but have eggs and embryos frozen from when you are younger, we can still help prepare your body for pregnancy and help you to conceive.

This point is central to concepts of fertility preservation for women undergoing cancer treatments. When chemotherapy and radiotherapy is planned to save a woman’s life, there can be the unfortunate consequence of losing her fertility. Freezing eggs, embryos or ovarian tissue prior to cancer treatment can assist her to have more options later should she suffer early menopause.

The same techniques can be offered to women who freeze their eggs electively and subsequently wish to create a family later in life.

You can also conceive using a donated egg or embryo, where the donor is young healthy and fertile.

I’m single, I can’t have a baby now

If you have always wanted to be a mum and are ready but you don’t have a partner, your dreams of motherhood don’t need to be put on permanent hold.

If you are ready, you can conceive using your own eggs and sperm from a donor. This can be a clinic recruited donor, or if you prefer, a known donor like a friend.

Single woman conception doesn’t necessarily have to be through IVF. Artificial insemination techniques are often successful, especially in the absence of other medical fertility problems.

My periods aren’t regular, can I still conceive? 

For natural conception to occur, egg and sperm need to meet on the fallopian tube highway. For this to happen, sex must be well timed around the time of ovulation (release of an egg from the ovary).

Where a woman’s cycle is regular, ovulation occurs mid cycle, on average on day 14 after the start of a menstrual period. Sperm can stick around in the female reproductive tract for several days. Timing sex in the lead up to ovulation creates a 1 in 5 chance of getting pregnant each months. Humans as a species aren’t all that fertile!

It’s easy to see that if your cycle is irregular, you may have no idea when you are ovulating. Timing sex to achieve conception becomes extremely hard and you are much less likely to be successful.  

If your cycles are not regular, seek the advice of a fertility expert straight away. Seeing a CREI Fertility specialist and Reproductive Endocrinologist can assist you to regulate your cycle, find out why it was irregular in the first place, and fix the problem. You can then try with better odds to conceive naturally with your partner.

Seeking fertility help means IVF

If you seek help from an IVF only clinic, what you will mot likely get is IVF. Women’s Health Melbourne is a CREI specialist led holistic fertility practice. We care for women and couples seeking fertility, and provide the full spectrum of fertility care. We offer medical, surgical and allied health treatment options, including the full spectrum of care from the most gentle to the best of IVF science. Care tailored to your individual needs will help you achieve your best outcome as quickly as possible. 

Dr Raelia Lew is a CREI board certified Reproductive Endocrinologist and Infertility specialist, with a PhD in Reproductive Genetics 

@womenshealthmelbourne @drraelialew @knockeduppodcast