The Clinic investigates the effectiveness of a drug to stop severe pneumonia due to covid-19
12 May 2020
The mental health of 46% of Spaniards is at risk due to the crisis
12 May 2020
Age and emotional state are other causes that can have a negative impact when trying to have children.
Infertility is the inability to conceive after two years of sexual relations without contraceptive protection. This situation generates a lot of stress in those couples who want to be parents and cannot achieve it. The team of doctors at Melio, the online blood testing platform, explains how and when it is convenient to undergo a fertility test. It also analyzes what values measure the level of fertility and what factors influence the result.
Ovarian reserve is the functional capacity of a woman's ovaries at a given time. This reproductive phenomenon can be evaluated using hormonal, clinical and ultrasound parameters. The study of ovarian reserve was used to recognize the response of patients to assisted reproduction treatments, but in the last decade ovarian reserve has begun to be assessed in other situations, such as for patients with a history of premature ovarian failure, menopause early in the family or polycystic ovary syndrome.
The basic study should be started when pregnancy is not achieved after one year of unprotected sexual relations. However, there are circumstances that imply that this advice must be given after six months of searching, such as in patients with genetic diseases, irregular menstrual cycles, repeat abortions, women with previous pelvic surgery, men with previous genital pathology or couples with previous sterilization. (tubal ligation or vasectomy).
In other cases, the study would be carried out before trying to get pregnant, such as in women considering fertility preservation (oocyte vitrification), egg donors, fertility preservation prior to gametotoxic treatments (chemotherapeutics) or prior to surgery. that can affect the ovary in women of reproductive age and in women with mutations in the BRCA (human tumor suppressor) genes, among others.
Fertility level
To analyze the level of fertility, it is necessary to measure through a blood test the three most important hormones to assess ovarian reserve: FSH (follicle stimulating hormone), basal estradiol and anti-Müllerian hormone (substance secreted by ovarian follicles). This analysis is done between the third and fifth day after the start of menstruation and Melio ensures the results within 48 hours.
It is also necessary to perform a gynecological ultrasound to assess the antral follicle count and ovarian volume. For patients who have irregular cycles, it is recommended to undergo a study that includes prolactin analysis (a hormone that stimulates milk secretion) and a thyroid profile study.
Main factors that influence fertility
There are internal and external factors that significantly influence when trying to conceive and they are:
- Age. After the age of 35, women's chances of conceiving both naturally and with assisted reproduction techniques decrease. Furthermore, from the age of 31 there is a decrease in the follicular reserve, which leads to different reproductive phenomena: natural sterility occurs, the ovarian reserve decreases and menstrual irregularity and a lower response to the aforementioned assisted reproduction techniques may occur. .
- Smoking. Both passive and active affect health in such a way that women see their ovarian reserve reduced and have poorer oocyte quality.
- Body mass index (BMI). It influences the couple's reproductive capacity since a healthy diet and moderate exercise have a marked positive influence on the couple's fertility. Physical activity improves insulin resistance, metabolic profile, lipid profile and BMI, thus improving the chances of pregnancy.
- Psychological interventions of a cognitive-behavioral type. The fact of wanting to be a mother or father and not achieving it naturally or after undergoing treatment can produce a stress crisis in the couple. These psychological interventions can help increase the pregnancy rate.
