Frequently Asked Questions on Female Fertility

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Is the birth control pill still considered safe? What about the extended pill — does it carry any extra health risks?


Most birth control pills in use today are far safer than those used in the past — mainly because they contain far lower levels of hormones. In fact, the pill has been shown to help protect women from ovarian and endometrial cancers. While numerous studies have looked at the relationship between the pill and breast cancer, there is no conclusive evidence of a link. However, if you smoke, the pill may increase your risk of high blood pressure, blood clots, and blocked arteries. If you are over age 35 and smoke, or if you have a history of blood clots or breast, liver, or certain gynecological cancers, the pill may not be the best choice for you. Ongoing research is being conducted on the safety of birth control pills containing drospirenone (such as Yaz and Yasmin) due to a possiblity of an increased risk of blood clots. There are no extended health warnings associated with continuous birth control pills like Seasonale, which provide for one menstrual cycle every few months.


With all the advances in fertility treatments, how old is too old for a woman to try to get pregnant?


All women see a decline in their fertility beginning around age 35, making it far more difficult — but not impossible — to conceive naturally. Note, however, that the risk of birth defects, including Down syndrome, increases as a woman ages, as does the risk of an ectopic pregnancy, which can be life threatening.


Treatments such as in vitro fertilization have extended the window of fertility significantly, making it possible to conceive well into the mid-40s. For many doctors, however, the cutoff point is around age 45, a time when many believe a woman’s eggs are no longer healthy enough for a normal conception — although normal pregnancies can and do occur at this age.


Moreover, with the inception of donor eggs — those produced and provided by a younger, more fertile female — a woman could actually carry a child and give birth well into her 60s and beyond, depending on her individual health status. Although this is possible, it is not necessarily a recommended or accepted practice.


How often should a woman be tested for a sexually transmitted disease (STD) and what tests does she need?


If you are sexually active, you should be tested for chlamydia every year until age 25. Between ages 26 and 39, testing should be based on your risk profile — the more partners you have, the greater your risk. Regardless of your age before starting a new relationship both you and your potential partner should be tested for all major STDs including chlamydia, gonorrhea, HIV, genital herpes, syphillis, and HPV (human papilloma virus), a sexually transmitted cancer. You should also be tested anytime symptoms arise, including genital itching, burning or pain, abnormal and particularly odorous discharge, or the presence of any lumps, bumps, or rashes.

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