Infertility
AI Chat
Age and Egg Count
- Before birth (16-20 weeks) → 6-7 million eggs
- At birth → 1-2 million
- At puberty → 300K-500K
- At menopause → <1K
- A woman ovulates only 400-500 eggs in her lifetime!
Peak fertility is between 20-24 years and slowly declines after 30, dropping faster after 35 and sharply after 37. By 40, about 1 in 4 couplesstruggle with infertility.
Fertility Basics
- Fecundability = ability to conceive in one cycle (about 20% for young, healthy couples).
- Fecundity = ability to conceive AND give birth.
Chances of getting pregnant naturally:
- 57% after 3 months
- 72% after 6 months
- 85% after 1 year
- 93% after 2 years
Fertile Window
- Sperm live 3-5 days, but eggs last only 12-24 hours.
- Best time to conceive → 1-2 days before ovulation.
- Ovulation happens 24-36 hours after the LH surge.
- Daily intercourse during the fertile window maximizes chances!
Tracking Ovulation
Ovulation Predictor Kits (OPKs)
- Detect LH surge → check urine in the afternoon.
- Ovulation happens 14-26 hours after a positive test.
Basal Body Temperature (BBT)
- Rises 1-2 days AFTER ovulation → good for confirming, not predicting.
Progesterone Test
- >6 ng/ml confirms ovulation but won’t predict it.
Infertility Evaluation
Infertility = no pregnancy after:
- 1 year (if under 35)
- 6 months (if over 35)
- Start testing immediately if irregular periods, blocked tubes, or male factor issues.
Causes of Infertility:
- 40% = Male + Female factors combined
- 26-30% = Male factor
- 21-25% = Ovulation issues
- 14-20% = Blocked tubes
- 10-13% = Other (uterine issues, cervical factors)
- 25-28% = Unexplained
Basic Tests:
- Semen analysis
- Day 3 FSH + Estradiol (ovarian reserve check)
- Hysterosalpingogram (HSG) to check if tubes are open
Male Fertility Testing
Semen Analysis Normal Values:
- Volume → ≥1.5 mL
- Sperm count → ≥15 million/ml
- Total motility → ≥40%
- Morphology (shape) → ≥4% normal forms
- pH → >7.2
Best predictor? Sperm shape (morphology)!
Ovarian Reserve Testing
- FSH & Estradiol → Check on Day 3 of cycle.
- AMH Test → Anytime in cycle; Low AMH = lower egg supply.
- Antral Follicle Count (AFC) → Ultrasound to count small follicles.
Do NOT recommend egg freezing after 38 years old.
Imaging Tests for Fertility
- Pelvic ultrasound → Checks for fibroids or ovarian cysts.
- Hysterosalpingogram (HSG) → Gold standard to check if tubes are open.
- Hysteroscopy/Laparoscopy → More invasive; used for endometriosis or uterine issues.
When to See a Fertility Specialist?
- Over 35? → See a specialist ASAP!
- Under 35? → Try 12 months naturally, then get checked.
- If ovulation meds don’t work after 3-6 cycles, get referred.
Boosting Fertility Naturally
- Quit smoking/drugs
- Maintain BMI 20-25
- Eat a healthy diet
- Limit alcohol (<5 drinks/week)
- Limit caffeine (<250 mg/day)
- Reduce stress and intense exercise
Eggs, Age & Baby-Making: What You Should Know!
Your Egg Supply Over Time
Women are born with all the eggs they’ll ever have—and the number drops as they age:
- At birth: ~1-2 million eggs
- At puberty: ~300,000-500,000 eggs
- At menopause: Less than 1,000 eggs left!
Only 400-500 eggs will actually be ovulated in a woman’s lifetime.
When Are You Most Fertile?
Your fertility peaks between ages 20-24 and starts declining after 30, with a steeper drop after 35. By 40, about 25% of couples struggle with infertility.
Getting Pregnant: Timing is Everything!
Your “fertile window” is 6 days long—the 5 days before ovulation plus ovulation day.
Best time for baby-making? 1-2 days BEFORE ovulation!
Ovulation happens ~24-36 hours after an LH surge.
Tracking Ovulation Like a Pro!
Ovulation Predictor Kits (OPKs):
- Detects LH surge (which happens right before ovulation).
- Best to test in the afternoon (LH shows up in urine 12 hours after appearing in the blood).
- Peak fertility? The day you detect the surge + the next 2 days.
Cervical Mucus Check:
- Right before ovulation, mucus gets clear, stretchy & slippery (like egg whites!)—a perfect environment for sperm!
Basal Body Temperature:
- Temperature rises 1-2 days AFTER ovulation—helpful to confirm ovulation but too late to time sex for conception.
Progesterone Test:
- If levels are above 6 mid-cycle, you did ovulate, but this won’t help predict when to try.
Trying for a Baby? Here’s the Plan!
Have sex daily or every other day during your fertile window to maximize chances.
93% of healthy couples conceive within 2 years!
Egg freezing NOT recommended after 38, as egg quality declines.
Bottom Line: If you’re trying to conceive, track ovulation, time intercourse right, and be patient!