Fertility uncertainty - start trying now?

[lightofislam]

Hey! I have had my AMH and FSH tested with at home pregnancy tests and they suggest I have low ovarian reserve. All my hormones seemed a bit out of whack but my period is regular, and my ovulation definitely seems to take place as I monitor my bbt. I’m 35 and my bf is 41 and we definitely want to have children, but the timing is not great right now with work and finances. However we don’t know if we’ve reached a point where not trying is too risky and whether we should just start to be less careful now, and if it happens sooner than expected we work it out somehow. My FSH was 19.5 umol, closer to menopausal range than “normal” range. If we immediately got pregnant we’d probably feel a bit stupid. I wish there was just a way to know!

 

[greenrock]

@lightofislam The at home fertility tests are not super accurate from what I’ve heard. I wouldn’t put too much stock into them. That being said, at your ages it’s probably worth trying within the next year. When you consider the time it takes to conceive plus ~9 months of pregnancy, you’d probably have enough time to get work/finances mostly in order (I’m assuming you’re not drowning in debt or anything).

Do you want multiple kids or only one? If you want more than one, you should start right away.

 

[sisi]

@lightofislam Ovarian reserve does not correlate with current fertility, so you are no more or less likely to get pregnant right away than any other 35-year-old. It is about egg quantity, but fertility has to do with egg quality, and the two are uncorrelated even though they both correlate negatively with age. Low AMH indicates when you are likely to go through menopause a bit earlier than average and that you are not likely to respond well to fertility drugs like those used for IVF.

What is your AMH, exactly? How long were you planning to wait outside of this consideration? And how many children do you want?

 

[wwjosh19]

@lightofislam 35F here, I really empathize with your concerns and questions! We've been tossing around the same uncertainties given age. Ultimately I think it comes down to talking to your ob-gyn, looking at your insurance plan, and deciding your perspective on (often not-cheap) consumer tests.

I recently had a pre-conception appointment with my ob-gyn (we're planning to start TTC in 1-2 months), and asked a lot of questions around 'can we proactively get fertility tested now on both sides.' Long story short, for us at least it comes down to insurance coverage. Our plan won't cover fertility testing until I've been trying for at least 6 months (since age >=35), it would be at least 12 months for age

 

[sisi]

@wwjosh19 Beyond just insurance coverage, trying for 6 months (at 35, and a year under that) before pursuing fertility testing is the medical recommendation for a reason. Basically, at 35 there is a 71% chance that you will conceive in that 6 months (and 82% chance you would in a year), based on this study (see Table 2). So it wouldn't make sense to get preemptive unnecessary testing. This is also a great post explaining why prospective fertility testing is not recommended.

 

[wwjosh19]

@sisi Great data, thanks for sharing!

 

[evan2001]

@lightofislam This is so individual but for me, it’s asking the question how would I feel if I waited and then it didn’t happen or it was very difficult, would I regret not trying earlier. Particularly if some indication that hormones are a bit wonky?
I don’t know if this is helpful and the research is limited but I’ve just started taking Coq10 in anticipation as it supposedly it good for slightly older women (obv 30s is not old but in terms of fertility!) can improve chances/ovarian health. I can’t remember the exact research or findings but there’s lots of info online