How to Navigate Reproductive Health with Confidence

During Canadian Fertility Awareness Week (April 21-27), it's a great time to shine a spotlight on reproductive health. Fertility education plays a pivotal role in empowering individuals to make informed decisions about their futures. Here are the top five insights to remember when navigating your reproductive health and fertility journey.

Age and timing matter

Age-related fertility decline has become more prevalent in women due to a lack of education, awareness, and planning. Over the age of 35, the quantity and quality of women's eggs significantly diminish, making conception more difficult. While men also experience age-related declines in fertility, they affect outcomes less. Because of this, women in their 30s and early 40s may face increased difficulties conceiving naturally.

Discussions about family planning and fertility preservation options (egg and sperm freezing) should start early to optimize reproductive outcomes. After age 30, if you haven't conceived with appropriately timed intercourse for 6 months, it's time to seek a fertility specialist's help. That recommendation turns into only 3 months of trying after age 35.

In addition, tracking menstrual cycles, identifying signs of ovulation and optimizing your fertility with targeted vitamin supplementation can maximize the chances of conceiving. Maintaining your optimal health is critical, along with booking an appointment with a fertility specialist in a proactive way.

Lifestyle impacts fertility

Lifestyle factors, including diet, exercise, and stress management, play a pivotal role in reproductive health. Obesity, sedentary behavior, and high levels of stress have been associated with decreased fertility in both men and women. By prioritizing healthy lifestyle habits, you can increase your chances of conception.

New advancements in fertility technology opens up access

Recent advancements in reproductive technologies allow for higher success rates, reduced risks and increased efficiency for patients trying to conceive. These technologies have also helped those in historically marginalized communities to have the opportunity to become parents and expand their families, such as members of the LGBTQIA+ community. Some examples include:

Cryopreservation techniques

Improved freezing techniques have enhanced the survival of thawed embryos and eggs. This means more frozen embryos are available for subsequent transfers, increasing the chances of a successful pregnancy. This is also why we can now provide future fertility preservation through egg freezing; the freezing technology (vitrification) has come a long way.

Single embryo transfer (SET)

SET has become the gold standard, supported by advancements in embryo selection technologies. This reduces the risk of multiple pregnancies and their associated complications while maintaining high success rates.

Preimplantation genetic testing for aneuploidy (PGTA)

This allows for screening embryos for genetic abnormalities before they are transferred, helping to select embryos with the best chance of a healthy pregnancy. This has improved outcomes by reducing the risk of certain genetic disorders and increasing the likelihood of a successful pregnancy.

Time-lapse imaging

This involves continuous monitoring of embryo development in the incubator, providing more information about embryo quality without disturbing the culture environment. This non-invasive method can help embryologists select the best embryos for transfer, potentially improving pregnancy rates.

Endometrial receptivity testing

In recent years, the assessment of the receptivity of the uterine lining through endometrial receptivity testing has become more sophisticated. This allows for better timing of embryo transfer and increases the chances of successful implantation.

Fertility doesn't discriminate

Contrary to common misconceptions, fertility awareness is not solely for women. Men play an equally essential role in the conception process. Up to 50% of infertility is due to male factors, such as sperm quality, quantity, and lifestyle choices.

Lifestyle modifications, including quitting smoking, moderation of alcohol consumption, and maintaining a healthy weight, can positively impact men's reproductive health. Similarly, women can optimize their fertility by familiarizing themselves with the details of their menstrual cycles and their specific fertility parameters (AMH, FSH and antral follicle count).

Access to the right care matters

Access to comprehensive reproductive health care is essential for individuals seeking to address fertility concerns. From education to fertility testing and infertility treatments, everyone should have access to a full range of reproductive health services tailored to their needs.

Advanced reproductive technologies offered include in vitro fertilization, egg freezing, genetic testing, embryo selection and further higher options of egg donation and gestational surrogacy for those who don't have viable eggs or who are unable to carry a pregnancy. It is essential for us all to understand the complexities of having children at older ages and support & respect our patients' rights to autonomy and self-determination. We, as experts, can provide the details of the risks in each specific case and ensure that we personalize the care to mitigate them.

Author:

Dr. Marjorie Dixon is an award-winning Obstetrics and Gynaecology specialist with an Accredited Fellowship in Reproductive Endocrinology and Infertility. In 2016, Dr. Dixon founded Anova Fertility & Reproductive Health, where she is the CEO & Medical Director of four leading fertility and IVF centers in Ontario. She is also an assistant professor of the University of Toronto and actively involved in postgraduate education.