Texas Fertility Center San Antonio

Advanced Maternal Age and Fertility

Learn more about advanced maternal age and fertility

Female fertility declines with age. As more and more women are delaying childbearing for numerous reasons, it is important to understand how advanced maternal age affects fertility. Each of our San Antonio IVF doctors is an expert on advanced maternal age and fertility, and can help you learn more about this topic.

What is the link between advanced maternal age and fertility?

Age has a much more significant impact on a woman’s fertility than it does on a man’s. Men make new sperm every day. Though quality and quantity can start to diminish in the mid-40s to 50s for men, the negative impact on women’s fertility happens much earlier.

The first thing to understand about the link between advanced maternal age and fertility is that a woman is born with all the eggs she will ever have. When a baby girl is developing in her mother’s uterus, she has about 15-20 million eggs. By the time she is born, she has about 5-6 million eggs remaining. By the time she reaches puberty, she has about 300,000 left, and by the time she is forty years old, she has fewer than 10,000.  A woman who ovulates regularly will typically release about 450 eggs in her lifetime. The remaining eggs undergo a process called atresia, or programmed cell death. That process significantly increases in the late-30s and early-40s. Thus, advanced maternal age affects fertility by impacting the amount of eggs a woman has.

These eggs also become more fragile (subject to damage) as a woman ages. The embryos that are formed from eggs of an older woman are more likely to have chromosomal abnormalities and/or result in miscarriage. By age 35, at least half of the embryos created by even fertile women are chromosomally abnormal. Fortunately, most of these abnormal embryos never implant. Those that are abnormal yet implant regardless, are usually lost to miscarriage. Despite what you may have heard or read, the percentage of pregnancies that result in a live birth of a child with a chromosomal abnormality (like Down’s syndrome) is very low.  Women who conceive at 35 years of age have a risk of delivering a baby with Down’s syndrome of only approximately 1 in 350 pregnancies.  By age 40, that percentage is still low – approximately 1%.  Our San Antonio IVF doctors know that only a small percentage of embryos result in live births, and they are therefore prepared to develop a plan that will move you quickly toward pregnancy – regardless of your age.

Advanced maternal age and fertility treatments

No one treatment is the right fit for all women. Some may only need oral medication if their primary fertility issue is that they don’t ovulate regularly. Some women may need intrauterine insemination (IUI) if there is male factor infertility or other minor fertility issues. Sometimes injectable medications are used in combination with IUI, especially in women nearing or in their late 30s.

In vitro fertilization (IVF) may also be appropriate due to poor egg quality or quantity, male infertility, tubal issues or simply a need to expedite treatment due to the effects of aging. In some cases – for example severely diminished ovarian reserve or advance maternal age – our San Antonio IVF doctors may recommend the use of donor eggs to improve a patient’s chance of conceiving a healthy child.

The link between advanced maternal age and fertility is very real. Despite this, there are excellent treatments available to help older women bring home a baby. Contact us to schedule an appointment with our San Antonio IVF doctors to learn more about fertility treatments for advanced maternal age.