For many young adults, conversations around fertility begin and end with whether they have access to contraception or Plan B and STI testing and treatment. Some of this comes from school-provided education, which puts the emphasis on those topics. Some adults find, when they do start to seriously consider family planning, that they don’t know what questions to ask, let alone whether their practitioners provide services they may need.
The Sopris Sun interviewed Mountain Family Health Center’s Dr. Matt Percy to help publicize what is available to patients in the Roaring Fork Valley and what local health professionals recommend. Preliminary tests that individuals may be interested in are blood tests for women and men, and semen analysis for people with testes.
A typical baseline blood test for women tests anti-Mullerian hormone (AMH) levels, a reliable indicator of remaining eggs. Results are given in nanograms per milliliter. For women 35 and below, results below 1 ng/ml are considered low, between 1.5-4 ng/ml as normal range, and 4 ng/ml or above is high. High AMH results can be an indicator of polycystic ovarian syndrome. Median AMH levels are between 2-3 ng/ml up to the age of 25, when levels start to decline for most women. On average, after 30 years of age, AMH levels fall by 1 ng/ml every five years until menopause. AMH is affected by lifestyle and stress levels; it is possible for it to increase without medical interventions, depending on the circumstances.
Per Dr. Percy, Mountain Family Health Centers (MFHC) can order basic blood labs like AMH alongside recording basic fertility history through interviews with the patient. No prerequisites are necessary for this. “[We] strive to welcome all regardless of gender/sexual orientation/relationship status,” he said. The medical professionals in the organization individualize care based on patient desires and history. “That said, there are general guidelines from experts that for women under 35 we should consider infertility workup if unable to achieve pregnancy after trying for 12+ months, between 35-40 years old after trying for 6+ months and over 40 at any time if trying and unsuccessful.”
For men, MFHC also recommends starting with a basic fertility history interview. They can order basic blood labs to check testosterone and follicle-stimulating hormone (FSH), and order labs for semen analysis if indicated.
When asked whether patients need to request labs in advance of appointments, Dr. Percy said it isn’t necessary. “We can usually do labs at any visit,” he offered, but noted “there are a few exceptions for certain lab types if seen toward the end of the day after our lab courier picks labs up. Certain labs can’t wait for the next day.”
Asked about the cost of labs and baseline testing, Dr. Percy explained that it depends on each patient’s insurance or lack thereof, and on income. “MFHC accepts most insurances and works to provide services for all regardless of ability to pay as part of our mission,” he said. “For uninsured patients, we have an income-based sliding fee scale that goes up to 400% of federal poverty level and lab fees for those on the sliding fee scale range from $20-70. For self-pay patients who do not qualify for sliding fee scale, they will be billed the cost of the lab by the lab vendor and the price varies for each lab. Our prices are generally some of the cheaper options around for people.”
MFHC makes referrals for patients who come in for fertility support, Dr. Percy said. “A rough estimate would be that half of patients are able to see local specialists while the other half end up needing to go to the Front Range for at least some visits.” He considers local specialists to be those within 30-90 minutes driving distance. “In most cases, the first step is often to refer to local OB/GYN providers (for women) or urology (for men). We have good referral partnerships with all our local hospital partners, including Grand River, Valley View, Aspen Valley and Vail hospitals.” Patients requiring in-vitro fertilization and other infertility treatments are referred to specialists on the Front Range.
Dr. Percy recommends that all patients of reproductive age discuss family planning with their primary care practitioner, whether they plan to have children soon, someday, or never. Specifically, “for women attempting to get pregnant, it is important to be taking a prenatal vitamin containing folic acid and avoid alcohol. If taking any medications I would also recommend reviewing these with a healthcare provider prior to becoming pregnant.” Percy elaborated, “another important aspect of family planning is choosing when to become pregnant and preventing unintended pregnancies. MFHC offers a broad range of contraception services from free condoms for patients to prescription birth control to long-acting reversible contraception for women to vasectomies for men.”
The Sopris Sun contacted All Valley Women’s Care (AVWC) and Aspen Valley Hospital for comment on this article. Neither organization responded. Per their website, AVWC offers basic OB/GYN care, contraception, STI testing and pregnancy care. The site mentions “comprehensive testing” but does not provide specifics. AVH’s website states they offer well-woman check-ups and obstetrics care. Valley View Hospital’s website states that they offer ovulation tests and transvaginal ultrasounds in addition to standard well-women services and obstetrics.
Do you know what fertility support you can access in the Roaring Fork Valley?
