Infertility by the Numbers
“You’re as young as you feel.”
“40 is the new 30.”
“Age is just a number.”
While these days women are often looking and feeling much younger than their chronologic age, unfortunately all of the above clichés do not apply when it comes to ovarian function and fertility. In fact, a woman’s age is the single most important factor affecting her ability to conceive, and advancing age can significantly reduce the chance of getting pregnant and having a healthy baby.
Why does fertility decline as women get older? Women are born with all the eggs they will ever have, and as a woman ages her eggs diminish in both quantity and quality. There is a constant gradual process of egg loss that occurs called atresia, which begins before birth and continues until menopause. Additionally, over time, women have an increasing proportion of genetically abnormal eggs (typically having extra or missing chromosomes) in the ovaries. As a result, the monthly chances of conception decline and the rate of miscarriage increases. For example, a healthy, fertile 30-year-old woman has a 20% chance of conception each month. By age 40, the monthly pregnancy rate decreases to less than 5%. Furthermore, women under 35 have roughly a 10-15% risk of miscarriage between 6 and 12 weeks, but this rate increases to almost 50% in women over 40.
Given these changes, when it is appropriate to pursue a fertility work-up? We generally recommend fertility testing after 12 months of unprotected intercourse for women under age 35, or after 6 months for women older than 35. Couples who have pre-existing medical issues that put them at higher risk for infertility or who have a history of multiple miscarriages should pursue an evaluation sooner. A typical fertility work-up may include a semen analysis, a hysterosalpingogram (a pelvic X-ray to determine if the fallopian tubes are open), and hormonal testing, including evaluation of ovarian reserve (egg quantity).
While it can be more challenging for women to conceive as they get older, fortunately there are many options for treatment which can enable women of all ages to successfully expand their families. From medicated intrauterine insemination cycles to IVF to treatment with donor eggs, there are a variety of treatments available to help maximize a woman’s chance of achieving a healthy pregnancy.
If you and your partner are experiencing issues with conceiving, contact the fertility specialists at Greenwich Fertility today for a consultation!