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How old is too old?

I have seen so many patients this week of age over 43 desiring fertility that I decided it would be useful to write a blog about it. Unfortunately many women as well as their primary care providers or even obgyns are unaware of the profound impact of a woman’s age on fertility. As a woman gets older, not only does the egg quantity decline but so does the egg quality. A woman is born with a finite number of eggs in the ovary which declines with increasing age. Studies have shown that the rate of decline is more rapid past age 37. Population statistics show that the chances of live birth after age 43 are <1%. Couple of the patients I saw this week had been trying to achieve pregnancy on their own for over 8 years. If only they would have sought care sooner, they would have been able to attempt conception with their own eggs as opposed to now needing to use an egg donor. Similarly I saw another patient who underwent fertility treatments for several years with her obgyn and now by the time she got to a specialist her only choice for achieving a successful pregnancy and live birth is via IVF with donor egg. So, long story short, I there is one message I could put out there it would be DON’T WAIT TOO LONG. Fertility is finite, the ovaries continue to age despite how healthy one is, how much organic food one eats or does yoga or how young one looks and feels. Women with no other known causes of infertility, if under age 35 should seek evaluation if not pregnant after one year of trying. For women over age 37 they should seek care if not pregnant after 6 months of trying. It is always okay to get tested, have all the information you need and then make an informed decision on whether or not proceeding with any treatment is right for you or you can choose to not do anything, but that would be a conscious, well informed choice.

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