If motherhood is not in your short-term plans, it is likely that you have not considered having any check-ups. Not even if you have it in mind unless you have had a problem. This is normal, as most of us take it for granted that we are fertile from the moment our period first comes. But having a period is not a guarantee that our reproductive system works well. In fact, the only way to know for sure is to have a fertility test, something that no one considers unless instructed by an expert.
However, there are many factors that can compromise fertility – and that can go unnoticed – such as the presence of fibroids, a uterine malformation, a thyroid problem, or hormonal imbalances, to name a few examples. For this reason, coinciding with June being the month of fertility, we indicate some situations in which it is convenient to visit the gynaecologist for a check-up. Dr. Claudia Forteza, gynaecologist specialized in reproduction at our centre explains why.
- Menstrual irregularities. Having irregular cycles does not mean that you cannot get pregnant, but the cause must be studied. One of them may be polycystic ovary syndrome (PCOS). It is an ovarian dysfunction that may cause alterations at hormonal and metabolic level. In general, the first option to control the PCOS is the introduction of a series of guidelines in lifestyle (weight control, regular exercise, reducing the intake of sugar, etc.) Many times, these measures together with a regular medical follow-up can be enough to keep it under control.
- Feeling generalized tiredness or having symptoms of hyperactivity. They are symptoms that may indicate alterations in the thyroid gland. The function of the thyroid gland is to control metabolism. Thyroid problems are divided into two main groups: hypothyroidism and hyperthyroidism. The first occurs when the thyroid gland does not produce enough thyroid hormones to meet the body’s needs. This causes the metabolism to slow down. In hyperthyroidism, on the other hand, the thyroid gland produces excessive amounts of thyroid hormones and causes the metabolism to accelerate. These alterations are common in young women between the ages of 25 and 45 and can affect fertility, since thyroid hormones interact with female sex hormones – oestrogens and progesterone – to maintain the normal functioning of the ovaries and the maturation of the ovules. The important thing is to make the diagnosis, since these thyroid alterations can be controlled with medication.
- Painful periods. If your periods are painful, it is important that you inform your gynaecologist, as they may indicate the presence of a fibroid or other uterine problems, such as ovarian cysts. They can also be a symptom of endometriosis, a benign disease that occurs when endometrial tissue grows outside the uterus. It is estimated that 50% of women with endometriosis may have fertility problems. In all these cases, it is essential to make a diagnosis as soon as possible to start a treatment and, at the same time, find out what options you have in case you want to be a mother.
- History of hereditary diseases or infertility problems in the family. There are genetic alterations that lead to hereditary diseases. The problem is that these do not always manifest themselves, but they can make a pregnancy difficult, especially when both you and your partner are carriers of the same disorder, a fact that can lead to repeated abortions. Therefore, if there is a history of repetitive abortions, infertility problems, or the birth of children with a genetic defect in your family or that of your partner, it is important that you consult an expert. In our centre we have a Genetic Unit that offers counselling.
- Having been looking for a pregnancy for more than 6 months without success. In general, if you have already reached 35 years of age and have been looking for a pregnancy for more than 6 months, it is recommended that you consult a specialist for a check-up (you and your partner, because in more than 50% of cases the cause of infertility is a male problem). If you are younger, that period can be extended to 12 months, since getting pregnant the first time is not so easy. Each month, under ideal conditions, a young, fertile, healthy couple who have sex has a maximum 20% chance of achieving a viable pregnancy, so you have to give yourself a certain margin. But, after that period, it is important to consult a specialist.