Ask a fertility expert: your most common questions answered

This interview is part of Clue's partnership with LEVY Health and is for educational and informational purposes. Everybody is different, and this article is not intended to substitute a consultation with a healthcare provider who can give you advice on your specific needs and situation.

Introduction

Reproductive goals can vary from person to person and may change throughout one’s life. When your reproductive plans change, or don’t work out as you expect, it’s common to feel unsure and have many questions about what may be next. 

Typical questions may include when’s the best time for pregnancy, how long it may take to become pregnant, and what to do if becoming pregnant takes longer than expected. You may also not want to have children yet, but you may want to know more about how your fertility might change over time, and how to support your fertility in the future, including potential options available like egg freezing. 

The questions can become overwhelming for many people. They are very personal and may also look different for everyone, and the same is true for the answers. But while there are lots of questions surrounding fertility and conception, there’s also an increasing amount of science and research to empower people with science-backed solutions and possibilities for fertility preservation. 

Advice from an expert

We’re delighted that Dr. Nina Resetkova (MD, MBA) has kindly taken the time to answer some of the questions about fertility we hear most often from the Clue community. Dr. Resetkova is a reproductive endocrinologist at Boston IVF and an Instructor at Harvard Medical School. She specializes in all aspects of fertility care. She completed her residency training program in Gynecology and Obstetrics at the world-renowned Johns Hopkins Hospital in Baltimore, MD. 

Read on for Dr. Resetkova’s advice: 

When should I start thinking about if I want to get pregnant?

The optimal timing for starting to think about getting pregnant can vary from person to person, but there are several fundamental factors to consider.

Age plays a significant role. As a reproductive endocrinologist, I often advise individuals to start thinking about pregnancy in their mid to late 20s or early 30s. Fertility tends to gradually decline with age, particularly in someone’s early 30s. After the age of 37, the decline can become even more pronounced. However, please remember that age is not the only factor; people may still conceive naturally after 35 or even 40, but it may take longer and involve additional considerations.

Your health is another crucial aspect. Being in good physical health before attempting to conceive is helpful. I recommend getting your fertility checked with a fertility provider (typically an OBGYN, or a Reproductive Endocrinology and Infertility specialist) or with a service like LEVY Health that offers a comprehensive medical fertility assessment from the comfort of your home. This is essential to review your medical history, address any existing health issues, and offer guidance on optimizing your health for pregnancy.

Lifestyle factors are equally important. A balanced diet, regular exercise, maintaining a healthy weight, and avoiding smoking and excessive alcohol consumption all contribute to your reproductive health. Making these healthy choices before attempting pregnancy can positively impact your fertility and the overall well-being of your future pregnancy.

I’ve been trying to get pregnant for three months, but nothing has happened yet. Should I worry?

While it's not uncommon for conception to take some time, especially within the first few months, I understand your feelings of worry.

It's important to remember that conception is a complex process that involves the right timing between the ovulation of an egg, its fertilization with a sperm, and the resulting embryo’s implantation in the uterus. Even for those with typical fertility, it can take several months to a year of regular sexual intercourse to achieve a pregnancy. About 85% of young couples (female partners aged less than 30) will conceive within the first year of trying. Therefore, at the three-month mark, it's not necessarily a cause for alarm.

However, if you're concerned about the lack of progress, there are steps you can take. Keep track of your menstrual cycles to determine your ovulation window. You can also use an ovulation tracking app such as Clue Conceive, a mode Clue has developed to support people with cycle and fertility tracking.  

If you’re over the age of 40, it may be a good idea to work on setting up a consultation with a reproductive specialist, as it can take a little time to get an appointment and arrange for fertility testing. If you’re over the age of 35, a consultation is recommended after six months of trying to conceive through regular intercourse. 

There are also some innovative options available to initiate a fertility evaluation in this timeframe in order to get more information while you continue your efforts at natural conception. LEVY Health offers a comprehensive fertility analysis that's personalized and thorough. The analysis collects a detailed medical history, recommends the right blood tests, and delivers results within a matter of weeks. The test results from a LEVY Health evaluation are trusted by OBGYNs and fertility experts and may be able to expedite your pathway into fertility treatment if that ends up being what you need.

The goal of a fertility evaluation, whether through a specialist, OBGYN, or LEVY Health, is to identify any underlying factors that might be affecting your ability to conceive. It's a step towards understanding your unique situation better and paving the way for informed decisions about your reproductive journey.

It took my mom a long time to conceive. Does that mean it’ll be the same for me?

Your family history, including your mother's experience with conception, may offer some insights into your potential reproductive journey, but it's important to remember that everyone's situation is unique.

As mentioned before, the time it takes to conceive can be influenced by a wide range of factors, such as age, overall health, lifestyle, and underlying medical conditions. While your mother's experience might provide some context, it's not a definitive predictor for your fertility.

If you're concerned about the possibility of facing similar challenges as your mother did, it's a good idea to seek medical guidance.

What if I don't know if I want to have children yet? Should I be freezing my eggs?

If you're in a position where you're unsure if you want to have children yet, but you're concerned about the potential impact of age on your fertility, egg freezing might be worth considering. By freezing eggs at a younger age, you can preserve their quality and increase the chances of having healthy embryos in the future.

It might be helpful to think about your future plans, such as your career, relationships, and lifestyle. Egg freezing may provide flexibility, but it's essential to discuss this option with your healthcare provider to ensure that your decision aligns with your long-term goals.

Also, one of the foremost factors is your age. Egg quality and quantity decline over time, so the earlier you freeze your eggs, the better the chances of successful use in the future. Where possible, it’s ideal if eggs are frozen while someone is still under the age of 35. That said, egg freezing can still be successful after age 35, but further treatment cycles may be required to maximize the chances of future success.

If you're in a relationship, it's important to involve your partner in the decision-making process. It might be a good idea to discuss how egg freezing fits into your collective vision and plans for the future.

And lastly, learning more about your fertility, and how to help support it, is an important step. Through a comprehensive medical assessment, you can find out more about your fertility and overall health, which can provide insights into the potential success of egg freezing.