Age and Infertility
A woman’s age can affect her ability to get pregnant. Age-related infertility starts to affect women in their mid 30’s and by their 40’s it becomes extremely difficult to conceive. In your 20’s you have about a 25% chance of conception each month. By the time you are 40, this chance decreases to 5% each month.
Currently, we believe that women are born with all the eggs they will ever have.
As a woman ages, the number of eggs she has declines. Hundreds of eggs are lost every month when they compete to become the “dominant egg.” This dominant egg is the one egg that will ovulate that month. The other eggs go through atresia, a process whereby they are no longer usable. These eggs are lost every month regardless if she is on a birth control pill, or pregnant, or is not actually ovulating.
+ You should seek an infertility evaluation after 1 year of trying to conceive without success if you are under the age of 35.
+ Once you are 35, you should seek an evaluation after 6 months of trying to conceive without success.
+ If you are 40 or older, you should consider having a consultation as soon as possible.
By the time a woman is 40 years old, her chances of becoming pregnant are greatly reduced because of the fewer number of available, good quality eggs. The reduction in quality reduces the chance for normal fertilization, and increases the chance of miscarriage or chromosomal defects. This does not mean that a woman over 40 cannot be helped by aggressive fertility treatments. However, there comes a time when even aggressive fertility treatments are not effective. At that time, the best treatment may become the use of donor eggs.
As a woman ages, her hormone levels change. These changes indicate that the number of eggs is declining. Markers for how many eggs you have left, or your ovarian reserve, include follicle stimulating hormone (FSH) and antimullerian hormone (AMH). These hormone levels will be tested early in your evaluation and they will help determine the chance for pregnancy with various treatments.
For more information on how age affects infertility, visit ASRM’s booklet HERE.