I’m assuming most people don’t know much about fertility issues, mostly because my wife and I were clueless when we started learning. She is a psychologist like I am, and we decided to focus on building our life together before having children. We got through years of schooling, started saving money for a house and finally got to a point where we felt we could start thinking about kids. She was 36, and I was about 44 at the time.

Fertility doctors will almost always start you on medication-assisted treatment designed to help increase the chances of being successful, in addition to helping you get the timing right regarding when to have intercourse. If you’re not successful after a few cycles, they might suggest that you consider something called in vitro fertilization (IVF). This involves giving a woman a bunch of medication (some injected) designed to improve the maturation process of a woman’s eggs during their monthly reproductive cycle and having a doctor “harvest” their eggs at the right time. Those eggs may be fertilized immediately (if there is sperm saved or someone special “in the picture”) or frozen for later use.

Here’s what they don’t tell you right away. Most of a woman’s eggs will not produce a genetically viable embryo. For a relatively young person (younger than 30), an average of one out of six eggs will be viable (if all is well with the sperm donor, who also should be medically evaluated for potential fertility issues). Once a woman hits the age of 35, the viability of eggs declines rapidly. This does not mean it’s impossible to have children through intercourse (unaided by medication), but it becomes much less likely. It also, unfortunately, means that it is also much less likely that a woman’s eggs will be viable when going through the IVF process.

Why am I telling you this? If you were like me, with a relatively young wife (36 at the time), knowing we were both healthy (we had been “checked out” medically), we assumed there was a “good chance” that we would be able to conceive a child naturally. I wish someone would have talked with me the way I am talking with you.

Today, as a psychologist with LASD who sees you and your partners on a daily basis, I ask more questions than I used to. I don’t just ask about spouses and children; I now ask about any plan(s) that my patients have regarding having children. I pay attention to age, because there are real medical issues that could negatively affect a person’s (or couple’s) chance of being able to conceive a child.

Humor me for a minute and pretend you’re in my office for an intake. I’m going to ask you some questions; please answer them honestly (only you will know your answers).

1. Are you currently in a romantic relationship?
2. Do you have children (even if you’re single)?
3. Do you want to have children (or more children)?
4. How old are you?
5. How old is your partner/spouse/dating partner (if they exist)?
6. Have you been trying?
7. If so, for how long?
8. Have you ever consulted a fertility specialist?

This is not one of those tests you take from a social media website like Instagram or Facebook; there are a billion factors that make everyone different, and your situation is different from anyone else’s. If reading this article or answering these questions concerns you, talk with someone about it. It could be your partner, your primary care physician or anyone at Psychological Services Bureau (including me) by calling (213) 738-3500 for a consultation or to make a confidential appointment. To obtain additional information, you may visit our intranet site (http://intranet/intranet/ESS/Index.htm).