Fertility Decoded: science, timing and smart choices

In all my years practicing as a gynaecologist I have had the privilege of being able to see the complexities, the simplicity, the ease and sometimes the difficulties that nature has created in the human being . At times, fertility is as easy as falling off a log and at times it is as elusive, mysterious and confusing as the woods in a forest .One can so easily get lost if they don't have an idea of their way around . During many such session in my clinic, while I sit across couples, I have sensed their urgency, fear of unknown, anxiety, their quiet mental agony and sometimes sheer exhaustion and frustration for not being able to become parents .I have also seen how quickly these same feeling change to excitement and sigh of relief when we are able to come up with a solution. A positive pregnancy test is like a silent prayer being answered . In all these sessions, I have not been just a silent by stander, but have actually been a part of their journeys, felt the ebbs and flows of emotions and the peaks and troughs of excitement and dejection .I have realised how deeply fertility touches not just the body but the minds, psyche and families . One sentence that particularly stayed with me was that of a 38 year old lady with poor egg reserve who had gone for ovum donor cycle using IVF . I informed her during one meeting, that she would have had a chance at her own egg pregnancy -a chiId that could have been biologically hers, had she frozen her eggs in her younger days .She had said with tears in her eyes "Doc, I wish someone had told me this earlier ".She said this while holding her positive pregnancy test in her hand, and till date I'm not sure if those tears in her eyes were those of relief after a long-awaited positive test or that due to a silent regret at not being aware of her fertility options earlier. That sentence stayed with me and so did her eyes . I decided that I wanted to simplify fertility so that it becomes accessible to all those who need to understand it and help themselves . In today's world, there are many positive shifts for women. They are more educated, more ambitious, and more independent than ever before. With careers flourishing and opportunities expanding, marriages are happening later than before and babies even later .Like everything else this empowerment and freedom does have a cost -that of fertility .Because while society and priorities have changed, the biology remains the same . Fertility, depends almost entirely on quality of egg and sperm. While sperms can be regenerated every couple of months, eggs don't .Egg quality and quantity decline with age. Conditions like PCOS, endometriosis, thyroid disorders, and hormonal imbalances also become more common with advancing age and so do medical problems such as diabetes, hypertension and other lifestyle diseases .The down side is that in the midst of the struggles of getting settled in career and life the fertility awareness takes a back burner . When we do finally think about it, it is tad too late .The window of fertility has narrowed and we have no back up plans to overcome this . This book was written to stimulate thought about health and fertility. To gently nudge couples and especially women in the direction of having a plan B ready incase time is not on their side - a bridge balancing fixed biological reality and variables of modern life. The purpose is to give clarity without promoting fear mongering and to encourage informed choices -not push agenda of unnecessary treatment. This book caters to all age groups of people, those in their early twenties who just want to get ahead of their peers by getting to know their bodies better, those in their thirties and planning a family actively, newly married, career-focused, or exploring fertility treatments to understand what suits them the best -