Fertility preservation is a hot topic these days. With recent dramatic improvements in live birth rates using previously frozen eggs, the American Society for Reproductive Medicine (ASRM) just declared in October 2012 that freezing your eggs prior to cancer treatment is no longer experimental. They stopped short of endorsing egg freezing for all reasons, but clearly egg freezing for fertility preservation is starting to become more main stream. This is exciting, cutting-edge technology, but please do not forget the simple things you can do right now to preserve your fertility and maintain reproductive health.
More and more women who are concerned about aging ovaries but not yet ready or in the right circumstances to have a baby are coming in to my office to consider freezing their eggs. More and more referring physicians, friends and neighbors are asking about it too. One of the biggest barriers to this technology is that it is expensive (8 to 15 thousand dollars to freeze each “batch” of eggs) and is not covered by insurance (many insurers are starting to cover freezing prior to cancer, but elective egg freezing is almost universally not covered). Many women who are interested in egg freezing may not have the means to freeze their eggs. However, even if you think you cannot afford it, it may be very worth your while to at least sit down for a consult with a reproductive endocrinologist experienced with egg freezing to get an evaluation of your current fertility, your fertility risks and a detailed discussion of the process and whether or not it Is something that is reasonable for you to consider.
What are other things that can be done to preserve your fertility besides freezing your eggs?
Number one – get healthy. A healthy body and mind support fertility and may even protect against infertility.
Smoking will cause you to go through menopause 1 to 2 years earlier, and even more importantly, before menopause there is a significant association between smoking and diminished ovarian reserve. Bottom line – smoking prematurely ages your ovaries – also your skin. And don’t forget about the dramatically increased risks for cancer, heart attack and stroke! Quit smoking! Do it now – while you still have eggs. Nicotine patches, gum, Zyban (Wellbutrin) and even Chantix may be healthier alternatives to smoking. Talk with your doctor if you feel you need help to quit.
Smoking is such a powerful ovarian (and testicular) toxin that, in one large study, even when neither partner smoked, if only one partner was regularly exposed to second hand smoke, these couples had higher rates of infertility, miscarriages and children with birth defects.
GET TO OR MAINTAIN A HEALTHY WEIGHT THROUGH A HEALTHY DIET AND EXERCISE ROUTINE
Overweight and obesity is associated with many medical problems including higher rates of cancer, cardiovascular disease, diabetes, kidney, liver and joint problems. It is also associated with significantly higher rates of infertility, miscarriages and birth defects. We also know from a very large study by Drs. Chavarro and Willet at Harvard that a low glycemic index diet is associated with higher rates of fertility. A low glycemic index diet is essentially a healthy diet – one that avoids sugars and processed carbohydrates and has lots of vegetables and is low in fat and high in nutrients. Even people with a normal weight can improve their fertility by improving their diet.
Exercise in addition to a healthy diet can help with getting to or maintaining a healthy weight.
SEE YOUR DOCTOR FOR REGULAR CHECK UPS
Make sure you have a yearly visit to your gynecologist and primary care doctor. The practice of medicine is becoming more proactive today and we are starting to learn much more about wellness. While doctor’s visits in the past were all about diagnosing and treating disease, good doctors today can help you do the right things today to lower your risks for disease tomorrow.
ADDRESS SPECIFIC RISK FACTORS
Your doctor can address specific risk factors to help you be healthier. Do you have a family history of diabetes? You may need to be more careful about your diet even if you are a normal weight. Does anyone in your family have endometriosis? That increases your risk for endometriosis significantly. Endometriosis is strongly associated with infertility and women on birth control pills tend to have much slower progression of their endometriosis. So if you have endometriosis, part of your fertility preservation plan may be to take birth control pills.
Birth control pills may be a good fertility preservation plan for women with irregular cycles. Many women with irregular periods or no periods have a condition known as PCOS or PolyCystic Ovarian Syndrome. Birth control pills can normalize the hormonal environment in these women’s bodies and lower their increased risks for ovarian cancer and endometrial cancer (cancer of the lining of the uterus).
For women with no periods due to a condition called hypothalamic amenorrhea, birth control pills can also help them to stay healthy by maintaining hormonal support of their reproductive organs and protecting their bones from osteoporosis.
Do you have a family history of premature ovarian failure? Do any genetic diseases run in your family? Do you have fibroids? Does anyone in your family have fibroids? Have you had previous pelvic surgery? These are examples of factors that may impact your reproductive health risks. Talk with your doctor about your personal and family medical history to assess your personal risks. Talk with your doctor about ways to further assess those risks and to lower them.
DON’T DELAY FOR NO REASON – THE BIOLOGICAL CLOCK IS REAL
You cannot have a baby before you are ready, but at the same time, do not delay becoming pregnant for no reason. Infertility treatments today are quite successful but do not guarantee success. Age related female infertility is still one of the most difficult forms of infertility to treat successfully. Be informed about your decisions – don’t be someone who “forgot” to have a baby.
PRESERVING YOUR FERTILITY IS MORE THAN FREEZING YOUR EGGS
Bottom line – even if egg freezing is not for you, you can help to preserve your fertility by creating healthy habits, breaking unhealthy habits and becoming informed and proactive about your own, personal risk factors for infertility.