Saturday, February 11, 2006

Fertility testing for women

One of the things most doctors dislike having to do it is giving bad news. We just did an IVF treatment cycle for a 32 year old woman, and she grew only 6 eggs, inspite of maximal superovulation. This means that she is a poor ovarian responder - an ill-defined condition, which just means that she does not produce good quality eggs. The term which has been coined to describe this is "oopause" - the 10-year span before a woman reaches the menopause, during which her fertility declines because her ovaries get depleted of eggs ( which die every month as a result of a natural process called atresia). Unfortunately, not too many women know about this condition - and neither do too many doctors. It has no symptoms or signs, and often the only time the women finds out she has reached the oopause is when she goes to a fertility specialist, who determines she has a high FSH level, which is a marker for poor egg quality. It is not easy to explain to a young woman with regular periods that her eggs had become "too old" for her to have a baby with them.
Her first lament was - I wish I had known about this earlier, so I could have planned a baby sooner. Unfortunately, this has become an increasingly prevalent problem amongst young women who would like to pursue a career. It's often hard to balance the stress of the biological clock with the pressures of the executive ladder ! Fortunately, tests have now become availabl which allow women to judge how fast their biological clock is ticking - and how many eggs they have left. This is a simple blood test, to measure the levels of the FSH hormone.
The major killer for men is heart disease , and routine screening for cholesterol has now become institutionalised ( even though we really don't know how useful this is ! ) Unfortunately, since fertility is a woman's problem, routine blood testing for screening ovarian reserve is unlikely to become widespread - women are still second class citizens !

1 comment:

  1. Anonymous3:24 PM

    Actually, I don't think that 'would like to pursue a career is a problem'. These days, young women are faced with either looking for an unqualified job or building up to a qualified one. Not working has really stopped being an option, at least before teh children come.
    And the choice that women are faced with isn't: good job and problems having kids or bad job and no problems. The options are: good or bad job. We are only finding out in this generation how early fertility declines and it is certainly not a common knowledge out there.
    I may have chosen differently in the past if I knew that there was a choice to be made, and I don't consider myself particularly poorly informed.


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