ConceiveOnline: What question do you get asked most often by people trying to conceive and how do you answer it?
Dr. Greene: The most common question that patients ask me is "what can we do to boost our chances of a pregnancy?" The simple answer is "get informed." Too often, people wait until they are pregnant to make healthier choices in their daily lives. The food that you eat, the personal care products that you use, the chemicals that you're exposed to and your lifestyle choices all can impact sperm and egg quality. In the IVF lab, we test everything for embryo toxicity -- from media to dishes, from air quality to air temperature; we leave nothing to chance. Despite our best efforts, we can't undo the effect of damage which has already been done to eggs or sperm. That is the reason that I started writing books and a blog. I want to assist people at making better choices in their daily lives so that they can optimize their chance of initiating a healthy pregnancy. The challenge that I have is explaining the latest research and then translating it into reasonable tips that people can actually use to improve their outcome.
CO: What is the most misunderstood thing about infertility or fertility, in your experience?
Dr. Greene: Although good health and fitness are important to maximize your chance of becoming pregnant, they are not independent indicators of your fertility. I meet men and women all the time that explain they’re in great shape so it must be something else that’s preventing them from becoming pregnant. Especially in women, the ability to produce a healthy egg is limited by factors like her age and the number of eggs that she was born with that have nothing to do with her overall health in determining her fertility. That’s why it is so very important to periodically perform ovarian reserve tests like checking the level of AntiMullerian Hormone (AMH) or having an antral follicle count (AFC). Monitoring ovarian reserve can empower a woman the ability to freeze her eggs or pursue a pregnancy if she finds that her fertility is waning.
CO: What’s the most exciting research, treatment, tool, or other news or innovation that you’ve heard of lately (whether available now or still in development) for those dealing with fertility problems?
Dr. Greene: I have become a big advocate for women to test and monitor their ovarian reserve. Until recently, women had to use fairly expensive testing methods which were not always accurate to estimate their fertility at any given time. That has changed with widely available AntiMullerian Hormone (AMH) test. This is a hormone that is only made by immature eggs that are actively trying to mature and become fertile. As a result, it can be measured at any given time to accurately estimate of the pool of immature eggs that a woman has at any given time. Better still, the test can be performed on any day of a woman's menstrual cycle and is not impacted by the use of birth control pills. As a result, women can not only assess their fertility at a time relative to other women their age but they can also track any changes over time by having the test repeated periodically. This test can empower women to knowingly make choices about their ability to complete their reproductive goals; especially if they feel that they would like to have more than one pregnancy.
Robert Greene, M.D., FACOG, is a physician at the CNY Fertility Center in central New York and the author of Perfect Hormone Balance for Fertility, Perfect Hormone Balance for Pregnancy, and Happy Baby, Healthy Mom Pregnancy Journal. You can read Dr. Greene's blog, The Greene Guide, and follow him on Twitter.
