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Age and Female Infertility

Studies of pregnancy rates and age support the idea that female fertility declines with age. If you have not considered age as a factor in your infertility, you may be unaware of these pregnancy trends.Ageing of the ovaries is the most prominent factor and is part of the normal ageing changes that effect all organs and tissues. Most women have about 300,000 eggs in their ovaries at puberty. For each egg that matures and is released [ovulated] during the menstrual cycle; atleast 500 eggs do not mature and are absorbed by the body.
Pregnancy rates begin to decline slowly, beginning in the early 30s. Throughout the late 30s and early 40s there is an even greater decline in pregnancy rates.

• Few pregnancies are recorded after the age of 45.
• By the age of 30, 7% of couples are infertile.
• By the age of 40, 33% of couples are infertile.
• Fertilization is associated with a higher risk of genetic abnormalities eg. Chromosomal abnormalities such as down syndrome with increasing age. The risk of a chromosomal abnormality in a woman age 20 years in 1/500 while the risk in woman age 45 is 1/20.
• Gynecological problems such as Pelvic infections, tubal damage endometriosis fibroids, ovulation problems etc tends also to increase with age. As the woman gets older, she has more time to develop these conditions, which will adversely affect her fertility.
• Sexual function is also decreased with ageing eg. Libido frequency of intercourse etc.
• The effect of ageing in endometrial receptivity [ability of the endometrium to receive the embryo] is controversial. There is increasing evidence that the receptivity decreases with age.
• Ageing does not just affect women, but also men to a much lesser degree. It affects sperm and coital frequency. There is no maximum age at which men are not capable of conceiving a child.
• Advanced maternal age increases the risk of autosomal dominant diseases such as Marfans syndrome, neurofibromatosis and achondroplasia.

Chart: The effect of age on fertility

Age-related decline in female fecundity

• Delaying pregnancy until careers are established
• Waiting for sound financial security
• Being unsure about the desire of parenthood
• Late marriages

with advancing age, many biological changes take place that work against conceiving and carrying the pregnancy to term. It is estimated that the chance of becoming pregnant in any one month is about 20% in women under 30, but only 5% in women over 40. After age 40, there is a sharp decline, also the chance of miscarriage and chromosomal abnormalities increases with the age. Even the success of IVF and other similar procedures decreases with advancing age. There are several explanations for this change in fertility, including medical conditions, changes in ovarian function and alterations in the eggs released by the ovaries. Aging does not just affect women, changes in fertility and sexual functioning do occur in men as they age. The tests tend to get slightly smaller and softer with Age. Sperm morphology (shape) & motility also tend to decline. Despite these changes, there is no age limit at which men are not capable of conceiving a child. Sexual functioning in men may also change with aging and decrease in libido may be due to decrease in 'testosterone' level, monotony, mental tension, overburdened with work , lack of time, etc.

Treating Fertility Loss as You Age

If you are having difficulties getting pregnant and fear that your infertility may be due to the aging process, you do have some options.

Fertility Drugs

Fertility drugs can help to increase the number of eggs that your ovaries release every month. This can help to increase your chances of becoming pregnant. There are a wide variety of fertility drugs available through your fertility clinic.

In-Vitro Fertilization

In-vitro fertilization can be used to help retrieve viable eggs from your ovaries and implant them in your uterus. A number of eggs will be surgically aspirated from your ovaries. These are then fertilized using your partner's sperm. Once fertilization has taken place, a number of embryos are implanted into your uterus.