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. This letter provides information regarding our Fertility Awareness program, which offers patients a “snapshot” of their reproductive potential.  Specifically, it includes 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 chance of having a child with 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.  The monthly chance of achieving pregnancy gradually but significantly begins to decline at age 32 and decreases more rapidly after age 37. Other modifiable factors that are known to impact a patient’s fertility include tobacco use and obesity.

Ovarian reserve assesses the “age” of the ovary in an attempt to further predict a patient’s reproductive potential beyond her chronological age. In other words, ovarian reserve testing helps to better predict an individual’s age-related reproductive decline. For instance, a 30 year old patient who is a smoker often demonstrates decreased ovarian reserve (DOR) compared to a non-smoker of the same age.

Ovarian reserve testing is associated with the ability of the ovary to respond to fertility treatments and does not predict spontaneous conception or age of menopause. There are several methods to test for ovarian reserve, and these include day 3 FSH and estradiol.  FSH is elevated due to the aging ovary not producing adequate amount of inhibin, which in turn suppresses FSH. Estradiol is elevated due to increase in FSH earlier in the menstrual cycle.  An FSH15 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 program 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 a Fertility Centers of Illinois physician, the fee is credited towards future treatment services.

If you would like a Fertility Awareness Checkup referral form please click here. Your Fertility Centers of Illinois physician liaison will also be happy to provide you with a print version of these forms to use for your patient referrals. Please call 877.324.4483 or you may email a request for a tablet of forms to: fcipatientservices@integramed.com and we will be happy to deliver them to your office.

Suggested readings

The Committee on Gynecologic Practice of the American College of Obstetricians and Gynecologists and The Practice Committee of the American Society for Reproductive Medicine.  Age-related fertility decline:  a committee opinion.  Fertility and Sterility 2008; 90: S154-155.

The Committee on Gynecologic Practice of the American College of Obstetricians and Gynecologists and The Practice Committee of the American Society for Reproductive Medicine.  Testing and interpreting measures of ovarian reserve: a committee opinion. Fertility and Sterility. 2012;98: 1407-15.