The war has reshaped the plans of millions of Ukrainians: some strive to have a child as soon as possible, while others postpone parenthood due to instability, separation from a partner, or uncertainty about the future. At the same time, reproductive health requires attention regardless of external circumstances. Specialists from the Dakhno Institute of Reproductive Medicine, who prepared a practical guide for Wave RBC.UA, emphasize that understanding how age, the condition of both partners, and lifestyle affect fertility makes it possible not to miss the window of opportunity and consult a reproductologist in a timely manner.
Female Fertility and the Age Factor
One of the key factors in female fertility is age. Unlike men, whose sperm are produced throughout their lives, women are born with a limited supply of eggs. Over the years, their number gradually decreases, and their quality changes. The decline in fertility becomes especially noticeable after the age of 35, and after 40 the chances of natural conception drop even more significantly. However, age is not the only determining factor: endometriosis, polycystic ovary syndrome, thyroid diseases, ovulation disorders, previous surgeries, and the condition of the fallopian tubes all affect the ability to get pregnant. "I recommend thinking about your reproductive health for the first time around the age of 30 — especially if parenthood is currently being postponed," advises Andrii Serbin, medical director of the Dakhno Institute of Reproductive Medicine, obstetrician-gynecologist, and reproductologist.
Ovarian Reserve: What It Shows and What It Doesn't Show
An important concept that patients of reproductologists regularly encounter is ovarian reserve, meaning the supply of eggs in the ovaries. It is assessed using ultrasound with an antral follicle count and a blood test for anti-Müllerian hormone (AMH). However, as specialists clarify, these indicators are not a test capable of accurately predicting natural conception or determining the age of menopause onset. They help the doctor assess the condition of the ovaries, particularly before using assisted reproductive technologies. "It's simply harder to help achieve pregnancy with age, so it's better to know your capabilities in advance," adds Andrii Serbin. At the same time, pregnancy remains possible even after 40: the main thing is to take into account individual bodily characteristics and consult specialists in a timely manner. "Fertile age is only a part of life, a real window of opportunity, and it is not infinite," notes Vira Sirenko, PhD in Medical Sciences, reproductologist at the Dakhno Institute.
The Male Factor: Hidden Causes and the Role of Lifestyle
When pregnancy does not occur for a long time, attention is often focused exclusively on the woman's health. However, the male factor plays a significant role in conception issues. Sperm quality is affected by hormonal disorders, inflammatory processes, varicocele, past injuries, and certain diseases. Lifestyle also matters: smoking, excessive alcohol consumption, obesity, and the use of anabolic steroids can worsen reproductive parameters. At the same time, a man may have no complaints and may not even suspect any impairment. "However, spermatogenesis disorders mostly have no symptoms and only manifest in test results," explains Anton Kutsenko, PhD in Medical Sciences, urologist-andrologist, and general director of the Dakhno Institute of Reproductive Medicine.
Diagnostics and Treatment: From Spermiogram to Correction
That is why one of the first stages of diagnostics is a spermiogram — a laboratory study that makes it possible to assess the sperm count, motility, and other characteristics. If necessary, the urologist-andrologist prescribes additional tests: hormone analyses, ultrasound, or genetic tests. "A spermiogram is a fast, non-invasive, and highly informative study," notes Anton Kutsenko. According to the doctor, many male fertility disorders are treatable: sometimes a lifestyle change is enough, while in other cases medical or surgical treatment is required. "Many conditions affecting sperm quality are treatable through hormonal correction, surgical treatment of varicocele, or lifestyle changes," the andrologist adds.
Preparing for Pregnancy: What Truly Matters
Preparing for pregnancy does not mean needing to take dozens of tests. First of all, it is important to assess the overall health of both partners, rule out chronic diseases, and undergo targeted diagnostics if necessary. Specialists at the Dakhno Institute emphasize that early consultation with a reproductologist is not a sign of pathology, but a conscious step that allows you to save time and chances for natural or assisted conception. In conditions where future plans can change unpredictably, knowing one's own reproductive health becomes not a luxury, but a practical tool for decision-making.
