We continue our efforts to keep you updated on advances in reproductive medicine and the availability of the newest technologies at Fertility Centers of Illinois.  This letter provides information regarding a program called Fertility Awareness Checkup, which offers patients basic tests about their reproductive potential regarding ovarian reserve and semen quality.

Infertility affects approximately 15% of the reproductive age population, which is currently estimated at about 7.5 million people.  Because of the high prevalence of this disease, as well as the media and internet attention to this problem, young women and men are becoming increasingly more aware of their own fertility potential.  The Fertility Awareness Checkup is a simple test comprised of day 3 FSH, estradiol, and antral follicle count to measure ovarian reserve and semen analysis to assess sperm parameters.

The single most important factor in predicting pregnancy is the age of the female partner.  It is commonly known that as age increases, the chance of pregnancy decreases.  At the same time, the rate of spontaneous miscarriage and the chance of having a child with a chromosomal abnormality increases with increasing age.  Both the age at which women are having their first child and the age of marriage are noted to be increasing.  According to the CDC, the average age of first-time mothers in the U.S. in large metropolitan areas increased from 25.9 years in 2007 to 27.7 years in 2017.  The average age of marriage has similarly increased from 26 in 2008 to 28 in 2018. As women choose to delay marriage and childbearing, the likelihood of future infertility increases.  The monthly chance of achieving pregnancy gradually but significantly begins to decline at age 32 and decreases more rapidly after age 37.

Ovarian reserve refers to the ability of the ovary to respond to treatment to ovulation induction to produce reasonable quantity and quality of oocytes, and therefore, to achieve pregnancy. It does not predict spontaneous conception.  There are several methods to test for ovarian reserve, and the simplest include day 3 FSH and estradiol.  FSH is elevated due to the aging ovary not producing an adequate amount of inhibin, which in turn suppresses FSH. Estradiol is elevated due to an increase in FSH earlier in the menstrual cycle.  An FSH<10 mIU/ml and estradiol <70 pg/ml are considered within the range for normal ovarian reserve.  Antral follicle count is another test of ovarian reserve using transvaginal ultrasonography to measure small follicles <10mm on day 3 of the cycle.  A total number of small follicles bilaterally between10-20 is considered within the range for normal ovarian reserve.

Since male infertility comprises approximately 40% of all couples with difficulty achieving pregnancy, a semen analysis is an important step in assessing malefactor, the Fertility Centers of Illinois reference range for normal semen analyses is: volume 1.5-5.ml, concentration >15 million/ml, motility > 40%, and strict morphology >14%.

An abnormal test will most likely result in a recommendation to repeat the semen analysis with further follow up as indicated.

Fertility Awareness Checkup is a simple combination of four tests to check for ovarian reserve and semen quality.  This test may be utilized by patients who are considering their present fertility potential with possible family decision making currently or in the near future.  The cost is $90, and a nurse will call the patient back with results within one week.  If the patient decides to further consult with an FCI physician, the fee is credited towards future treatment services.