Determine Your Fertility Potential
The
National Fertility Directory is designed to provide a variety
of resources for overcoming infertility. An important early
step is to determine one's own fertility potential.
The
likelihood of a woman achieving pregnancy depends on several
factors, including age, hormone levels, partner's sperm
count and pelvic anatomy.
Age
of the female partner is an important prognostic factor
for fertility. The following graph illustrates the decline
in pregnancy rates and live birth rates with advancing age
in patients undergoing IVF.
Miscarriage
rates also significantly rise with increasing age.
The
decline in pregnancy rates and rise in miscarriage rates
constitutes the time that is running out with respect to
the so-called "biological clock" in women.
Pregnancy
and Live Birth Rates for IVF Cycles Using Fresh, Nondonor
Eggs or Embryos, by Age of Women
Reference:
CDC reports in December 2001 (for cases in 1999)
Live
Births per Transfer Rate for Fresh Embryos from Own and
Donor Eggs, by Age of Recipient in
Reference:
CDC reports in December 2001 (for cases in 1999)
FSH
The
level of follicle stimulating hormone (FSH) on day three
is an important predictor of ovarian reserve. Depletion
of ovarian reserve coincides with a drop in ovarian Inhibin,
a hormone that suppresses pituitary FSH. The drop in Inhibin
results in elevated FSH levels. The higher the level of
FSH, the lower is a woman's chance of achieving a successful
pregnancy with her own eggs.
Estradiol
The
level of Estradiol on day three is a useful predictor of
ovarian reserve in conjunction with the simultaneous level
of FSH. Higher levels of Estradiol, especially >70 pg/mL,
suggest a worse prognosis with IVF.
Sperm
Count
The
normal sperm count is between 20 - 200 million sperms per
mL of semen. About 50% of sperm should be motile and at
least 14% should have normal shape by strict criteria (Kruger
Method). Severe abnormalities in sperm count or function
previously meant sterility for a couple. The use of IVF
with sperm injection can now be used to achieve successful
pregnancy in the majority of patients with male factor due
to sperm abnormalities.
Fallopian
Tubes
The
fallopian tubes are required for the normal transport of
eggs, sperm cells and the early cleaving embryo. Blocked
tubes may be due to prior pelvic infection, inflammation
or endometriosis. Laser laparoscopy and microsurgery have
limited roles in overcoming infertility in these cases.
Removal of scar tissue around the ends of the tubes frequently
can overcome infertility from this cause. Tubes damaged
within their lining have lost not only their patentcy, but
also intrinsic functions promoting cellular transport. Tubal
repair in these cases result in pregnancy rates usually
below 20%. Most patients will require IVF and can expect
excellent pregnancy rates.
