First Gynecologist visit: When and Why?

When should you see an OBGYN?

There isn’t one perfect time for everybody to go see a gynecologist. But women should not wait until after they get married to have this checkup. Visiting a specialist to do a gynecological check-up is fine at any age, and whenever there is an issue related to periods or reproductive health. For example, if a 14- or 15-year-old girl didn’t have her period yet, or if a girl who reached puberty has irregular periods her mother must take her to see the gynecologist for a checkup.

Is a visit to the OBGYN necessary when there are no issues?

The answer depends on several factors; a woman’s age, and whether she is married or not. For married women, it is clearer; they can see the gynecologist about irregular periods, choosing a contraceptive, fertility treatments, and other issues.

For unmarried ladies who are not facing any issues, should they see a gynecologist? I recommend all women to see a gynecologist and a fertility specialist even before they get married, or face any issues related to their period. To increase awareness of fertility, which declines over time, and discuss fertility preservation. When visiting the gynecologist, and the fertility specialist they will run tests to check on the woman’s reproductive health, her fertility levels, and suggest a fertility preservation solution if needed, in cases where the ovarian reserve is declining due to various reasons, which affects the chances of conceiving.

 

Visiting the fertility specialist

A fertility specialist performs an ultrasound test to check the ovaries, the uterus, and the ovarian reserve. They will also check the levels of the AMH hormone and other hormones through blood tests. All these tests will give an idea and some understanding of ovarian reserve and the chances of getting pregnant. The ovarian reserve usually starts to decline when a woman is in her thirties, the decline is more after age 35 to reach its peak when the woman is in her forties. But, in some cases, this decline happens earlier, and then an intervention to preserve fertility is necessary. One of the signs that might indicate an acceleration in the ovarian reserve decline is the shorter interval between periods, in addition to some cycle irregularity. In some cases, there is a genetic cause for premature ovarian insufficiency (POI) or otherwise known as early menopause. In all these cases visiting the OBGYN and the fertility specialist is recommended. It’s important to avoid online forums and blogs that are not medically certified as they may offer incorrect or misleading advice. It is noteworthy to say that unfortunately, no test can tell us how long a woman’s ovarian reserve is going to last and despite the early tests there are cases where the ovarian reserve diminishes very early without any known reason.

Fertility preservation

If a married woman wishes to delay getting pregnant for any reason, she can preserve her fertility by freezing her eggs or embryos to be used later. For unmarried women, they can have their eggs frozen when they are in their twenties or thirties, as this is when the ovarian reserve has the highest quantity and quality. The frozen eggs can then be used when needed when the quality and quantity of her eggs have declined and with it her chances to conceive either naturally or through assisted conception treatments such as IVF.

Unmarried, single, or virgin Should they visit a gynecologist?

There is a lot of embarrassment and many social and cultural question marks around an unmarried woman’s visit to the OBGYN. This stands in the way of raising awareness, and the resolution of many issues related to reproductive health. There shouldn’t be any embarrassment in visiting a gynecologist and a fertility specialist before marriage to do a fertility assessment and to choose a fertility preservation method if needed. We also need to bear in mind a single woman may be divorced, separated, or a widow.

Eggs freezing before marriage

There are two commonly used methods for egg retrieval, vaginally, which is commonly used with married women. The alternative route is abdominally through laparoscopy to retrieve the eggs transabdominal. This method is usually in a lower yield. Occasionally the transvaginal method is used in single women who are virgins after their approval. In this case, we offer a medical certificate to state that we performed a medical intervention to extract the eggs through the vagina that might have interrupted the hymen. In some situations, it is to perform the procedure and keep the hymen intact. There is no reason to worry about fertility preservation before marriage as quite a few options are available.

Another less common method is the transrectal route after enema preparation of the bowel and recently although confined to specialized centers is the option of ovarian tissue cryopreservation.

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