Author: Kayla Pike
Fertility, or the ability to conceive, is unique to every individual. Understanding the basics of reproductive health and being proactive about your goals can help you make informed decisions. Whether you're planning for the near future or years down the road, knowledge and support are powerful tools for your fertility journey.
Andrea Starostanko, MD, a Trinity Health affiliated reproductive endocrinologist, and Kathryn Born, MD, a Trinity Health Medical Group OBGYN, share expert insights on common fertility issues and concerns.
How Fertility is Measured
With many factors affecting fertility, there is not a single definitive test. Evaluating the following indicators can help with determining fertility levels:
- Anti-Müllerian Hormone (AMH): A blood test for AMH measures hormone levels related to your egg supply. While it can give insight into ovarian reserve, it doesn’t predict your ability to conceive with certainty.
- Day 3 Follicle Stimulating Hormone (FSH): A blood test for FSH looks at how hard your brain – specifically your pituitary gland – is working to stimulate your ovaries. Again, there is not a specific FSH level that shows you can or cannot get pregnant.
- Regular Periods: One of the best "vital signs" of reproductive health is having regular periods. Consistent cycles are a good indicator that ovulation is likely happening.
- Uterine Health: An imaging evaluation of the uterine cavity helps with identifying any structural issues that could interfere with implantation.
How Age Affects Fertility
Fertility gradually declines after age 30 and more rapidly after age 35. By 40, the monthly chance of conception drops to about 5%.
Egg quality also diminishes over time. While about 80% of eggs in your 20s may be chromosomally normal, that number drops to around 70–75% by age 35, and around 55% or lower by age 40. This is one reason why it becomes harder to conceive or maintain a pregnancy as women age, according to Dr. Born.
Health & Lifestyle Factors
“A lot of factors cannot be measured by science, but we know a balanced diet, regular exercise, and sleep all support fertility,” said Dr. Born.
Unmanaged health conditions like diabetes or autoimmune issues can also negatively impact reproductive health, as can excessive stress and environmental exposures to chemicals. Dr. Starostanko recommends checking makeup, lotions, hair products and anything else that is applied to the skin to make sure these products are phthalate and paraben free. Fast food, which tends to be nutrient deficient, can also hide a variety of harmful chemicals.
When to See a Fertility Specialist
The standard recommendations for otherwise healthy individuals to see a fertility specialist are as follows:
- Under age 35: After 12 months of trying to conceive
- Age 35–40: After 6 months of trying to conceive
- Over age 40: Consider seeing a specialist right away.
However, Dr. Starostanko encourages seeing a specialist sooner than later if you have a known medical condition like endometriosis or polycystic ovary syndrome (PCOS), you’re a BRCA1/2 carrier and concerned about passing on a genetic mutation or if you’re facing a cancer diagnosis or other illness that could affect fertility.
Natural Family Planning
Natural family planning involves tracking ovulation and timing conception. Learning to chart your cycle and recognize signs of increased fertility can help time intercourse more accurately, increasing the chances of conception, especially when trying to conceive without medical intervention.
Talk to Your Provider
Being in tune with your body is key. If something doesn’t seem right—irregular periods, sudden changes in cycle pattern, or persistent symptoms—it’s always worth speaking with your health care provider.