The Fertility and Age Connection

The Fertility and Age Connection The Fertility and Age Connection

There’s a definite connection between fertility and age, especially for women. In fact, age-related infertility is an increasing problem among women who delay getting pregnant until their mid-30s.  

Age-related infertility
A woman’s fertility is at its peak in her 20s. Fertility begins to decrease in a woman’s 30s, with about 40 percent of women getting pregnant in the first year. The chance of pregnancy drops to 35 percent by 35 years old.

Age-related infertility becomes a real issue at 35 years and beyond with a sharp decline to only 17 percent of women getting pregnant in their early 40s.

Eggs decrease and decline with age
No matter how healthy you are, age-related infertility is impossible to slow down. You are born with all the eggs you will ever produce. The quantity of eggs decreases by the hundreds every month. Furthermore, as you age, so do the eggs in your ovaries. All of these factors combined make age-related infertility a serious reality for many women today. 

Ovaries stop functioning altogether at menopause. At that point, age-related infertility is present and natural conception can no longer occur. Normal menopause occurs in woman from about 42 to 58 years old. However, the influence of age related infertility may start 10 years before menopause.

The risks of pregnancy
Older women have a higher chance of having babies with severe medical conditions or birth defects and their babies are more likely to have chromosomal and genetic abnormalities. The most common genetic abnormality is Down syndrome.  

  • A 30-year-old mother has a 1 in 385 chance to have a baby with chromosomal abnormalities.
  • A 40-year-old mother has a 1 in 66 chance.

Along with the difficulties of age-related infertility, when older women do get pregnant, they have an increased risk of miscarriage. Because older women have more eggs with genetic abnormalities, the risk of miscarriage increases.

Tests may help you
Remain hopeful. A fertility specialist may be able to help you achieve a pregnancy well into your 40s. The following tests may be helpful:

  • A blood test of FSH (follicle stimulating hormones) levels taken on Day 2, 3 or 4 of the menstrual cycle can be used to assess your ovarian reserve. High levels of FSH can indicate a low ovarian reserve, which can be the result of age related infertility.
  • The Clomiphene Citrate Challenge Test (CCCT) is a common test that measures FSH and E2 levels in the blood on day 3 of the menstrual cycle. The woman then takes 100mg daily of clomiphene citrate (a medication used to stimulate the ovary and/or synchronize an ovarian follicle development) from day 5 to day 9 of their menstrual cycle. A blood test measuring the FSH and E2 levels is then repeated on Day 10.
  • Ultrasound testing can also assess ovarian reserve if there are concerns about a woman’s fertility and age. With the ultrasound, the woman’s ovary size and number of measurable antral follicles during the early follicular phase of her cycle can be evaluated. The number of antral follicles as well as the ovarian size has been found to decrease with advancing age.

Tips to increase your chance of getting pregnant
There are steps you can take that will improve your opportunity for success when trying to get pregnant after 35, including:

  • Take 400 micrograms of folic acid daily.
  • Quit smoking. Smoking increases the risk for miscarriage and ectopic pregnancy. It can also hinder conception by aging the eggs prematurely.
  • Maintain a healthy weight. Being overweight or underweight can cause ovulation problems. Being at a healthy weight can increase ovulation.
  • Don’t over-exercise. Exercising intensely for more than 7 hours per week can decrease ovulation.
  • Drink alcohol in moderation. Women who drink in excess have a greater chance of developing ovulation problems or endometriosis.
  • Go easy on the caffeine. Drinking more than 900 mg of caffeine has been shown to decrease fertility.
  • Reduce stress. Studies have found that stress may be linked to lower pregnancy success rates.

When it’s time to see a fertility specialist
If you’re under 35 years old and have been unable to conceive after more than 12 months of unprotected intercourse, you should talk to a fertility specialist.

The American Society of Reproductive Medicine recommends women over 35 consult a specialist after 6 months of having unprotected, well-timed intercourse with no success. If you’re over 40 you should seek help immediately because of the link between fertility and age.

What treatments are available for age-related infertility?
If you’re worried about fertility and age, there are treatments available. A specialist who treats age-related infertility can help to determine the right path for you.

Some treatments for age related infertility may include the following:

  • Fertility drugs
  • Artificial insemination
  • In-vitro fertilization

Older women trying to get pregnant should be aware that age does affect the success rates of most treatments.

See how age affects your chances with our fertility app

  • American Pregnancy Association: What is Infertility? 
  • American Pregnancy Association: Fertility FAQ
  • American Society for Reproductive Medicine: Age and Fertility. A Guide for Patients
  • IntegraMed: Can we wait to get pregnant? 
  • IntegraMed: Fertility over 40: Age-Related Infertility 
  • Medscape Today: Ovarian Reserve: Markers of Ovarian Reserve 
  • Female Infertility: Risk Factors; Female Infertility: Prevention