Check biological clock before it's too late

By Choi Ji-young

One out of seven married couples has been reported to be infertile in Korea, and it has become a detrimental social issue along with the noticeable decrease in the number of babies born each year. This is where assisted reproductive technology (ART) kicks in.

During the last two decades, great advances have been made in the field of assisted reproductive technology. Fertility treatments including in vitro fertilization (IVF) and intracytoplasmic sperm insemination (ICSI) have given new hope to many subfertile patients. It has even come to the point where these treatments yield the pregnancy rate of 40 to 45 percent. In order to avoid side effects of ART that may occur due to the use of gonadotrophin injections, there have been attempts to use less of these fertility drugs as well as approaching via single embryo transfer to avoid multiple pregnancies.

However, despite such developments in ART, there are yet numerous couples who fail to conceive. Many of these infertile patients who walk into our offices seem rather exhausted and weary owing to stress coming from repeated failure of previous ART procedures. Most of these women are over 40, or their ovarian reserve is as low as that of pre-menopausal women in spite of their young chronological age.

Most people think that as they walk into a fertility center, they have done their part, meaning most people think that available fertility treatment offers solutions to every couple that visits the clinic. Unfortunately, not every couple may benefit from ART. ART procedures cannot serve as the solution to all infertile couples and they do have limitations. For such reasons, it would be best to prevent infertility or rather know the possible circumstances of delaying the actual attempt to get pregnant. Except for the cases where women present themselves with a low ovarian reserve, infertility may even be prevented to a certain extent.

The most important factor is the women’s age. It is strongly recommended that women start their attempt to get pregnant as young as possible. Women are known to have 3,000,000 oocytes when they are born. However, as they grow old, the number of oocytes decreases rapidly. Not only that, as the women grow old, so do the rest of the organs including the ovaries, therefore the oocytes’ quality tends to be less productive compared to those of the younger women. It has been reported that as the women reach the age of 35, the ovarian function begin to decline, and they cannot prevent this rapid decline.

Therefore, the importance of trying to conceive before the age of 35 cannot be emphasized too much. Those aged between 35 and 40 may benefit from ART procedures and many of them actually have been rescued by fertility treatment. However, it is not so with those over 40. Therefore, for those who are married before the age of 35, an evaluation is warranted if the couple has failed to achieve a successful pregnancy after 12 months of trying regular unprotected intercourse. However, for those who got married after the age of 35, it is recommended that they go through infertility evaluation as soon as possible, so that they could find their own appropriate method to conceive depending on their fertility condition. Also, for women over age 30 who do plan to get married and pregnant as well, it is recommended that they check their ovarian reserve through hormonal test.

Another factor that should be taken into consideration is women’s general health condition. In order for one to have good quality oocyte, one should try to stay healthy so that hormonal balance is reassured and thus the ovulation. If one is diagnosed as being overweight she should try to lose weight through regular exercise and aim to reach an ideal body weight. Power walking, jogging, swimming, and mountain hiking are some of the examples of exercise that are recommended for those who wish to stay fit for a better prognosis.

Last but not least, a stressful environment is another important factor one should stay away from. There have been many reports asserting that stressful environment also has direct negative effect on estradiol, not to mention the general health status. In fact, it has been shown to increase the likelihood of getting pregnant when mind-body medical treatment is offered along with fertility treatment. Women who try to conceive at a relatively older age should have optimistic and positive mind.

Unlike our mothers who became moms in their 20s, it has become a social trend for women to continue on with their studies and career; this results in the postponement of the age to become a mom. Please do pay attention to your biological clocks before it is too late. Also, do not hesitate to visit fertility clinics for evaluations. Above all, staying healthy both physically and mentally should not be neglected.

The writer is a doctor at Maria Fertility Hospital in Seoul. For further questions, send an email to the writer at jychoi@mariababy.com, or call the hospital’s English-speaking coordinator at 82 (Korea country code) 2 (Seoul area code) 2250-5577, or visit the hospital’s Website, https://eng.mariababy.com/.