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By: Danielle E. Lane, MD

I was born in the 1970’s. The era of female emancipation.  I was a part of the generation who was told that they could do anything and have it all.  We had contraception available to us, could plan the number of children we wanted and had the choice to delay child-bearing until a time that was convenient. Convenient meant that we had completed our education, succeeded in our career and traveled the world all before finding our mate and settling down to have our first child sometime after the age of 35.

There are at least two problems with this thinking.  First, no one mentioned that our own reproductive systems had a different timeline;  that our fertility would begin to decline after the age of 20, and once we reached the age of 35, there was a good chance that we would need some help to have our children. Second, no one mentioned that if we stayed on birth control for 20 years, that some of the signs of declining fertility would be masked by the normal cycles that we had secondary to our daily doses of hormones. Third, no one mentioned that just as it was starting to get hard to conceive on our own, it would be right around the time that we were actually ready to have our children, and that the emotional toll of our life choices would be devastating.

Understanding the limitations and variations of our reproductive systems is the first step to changing the fertility conversation.  At birth, there is already variation amongst us. The ovarian reserve (the number of eggs available to us to use during our reproductive lifespan) can vary in the newborn from 250,000-500,000 per ovary. This means that some women have 50% fewer eggs available to them from the start. In addition the rate at which these eggs disappear differ in each of us and accelerates tremendously after the age of 38.  Given the fact that the average age of menopause (relative exhaustion of eggs) in the United States is 51, (the range is from 40-60), it takes some women 50% longer to exhaust their follicular pool than it does others. We know that genetics influence this rate of exhaustion, since the menopausal age of a woman is strongly correlated with the age of menopause in her mother and sisters. Other factors that impact the rate of ovarian reserve decline are whether or not you have already had a child, nutrition, race, socioeconomic status, and individual habits such as smoking.

When I talk to patients about the importance of prioritizing their fertility, it is because it is a path I have traveled.  With  my training in the field of obstetrics and gynecology with a subspecialty in fertility I understood the importance of planning for my family as I planned for my career. My mother still insists that I would have been fine.  She said, “Other women have fertility issues but not you”. However hundreds and thousands of data points tell us otherwise.  Many women are not aware of this data. The choices were to have children while I was working 80 hours a week as a resident, to not travel the world and to have much less financial security when our first child was born. The career choices involved creating a practice setting where I could be flexible and available to my family.

My vision with Lane Fertility Magazine is to use this publication as a platform to change the conversation of fertility from reactive (I have a fertility challenge) to proactive (I am doing all I can to prevent a fertility challenge). This will be done through a quarterly publication, an interactive website, and annual seminars that cover current issues in the field of fertility. The goal: to provide you, the reader, with the information to make informed choices about your own family planning. I want women not just to worry about how to avoid pregnancy, but to be educated on what the limitations are for getting pregnant.

In our inaugural issue, we introduce the basics of fertility and various approaches to helping people achieve success.

In “Should I Be Concerned?” we discuss the possible causes of fertility challenges. In “On Opposite Ends of the Couch”, we learn some skills to work on your personal relationships as you begin your fertility journey. “Eating to Optimize Your Fertility” and our monthly recipe will give you some lifestyle ideas to boost your fertility.  Please don’t forget to check out this issue’s “Patient Perspective” which will remind you that there are millions of people on the same journey as yourself!

With all of the emancipation and choice that we have as women, let us use this knowledge as a way that protects our ability to conceive.

 

ABOUT THE AUTHOR

DanielleDanielle E Lane, MD, Reproductive Endorcinology and Infertility Specialist. Dr. Lane attended McGill University before completing her medical training at the University of Pittsburgh School of Medicine, her residency at Yale-New Haven Hospital and her fellowship at the University of California, San Francisco. She opened the Center for Reproductive Health at Kaiser Permanente in Napa-Sola-no in 2005. In 2009 she founded Lane Fertility Institute. The Institute has grown to a three physician practice with a state of the art embryology laboratory. She is committed to providing education for women about preservation of their fertility and developing lower cost models to improve access to care.