Author: Daniel F. Rychlik, M.D.
The proverbial biological clock never stops ticking. However, for women who desire a baby, the clock ticks louder with each passing year. Age is the key factor affecting fertility for women. And yes, even men’s fertility can be affected by age.
The National Center for Health Care Statistics’ annual report of fertility rates for 2000 and 2001 indicates that a woman’s fertility peaks between the ages of 25-29. It also dramatically showed that a 50% decrease in fertility rate started at age 34, and by age 40, the fertility rate decreased by 90% when compared to a 25-29 year old woman.
A woman is born with all the eggs (oocytes) she will ever have: six million at 20 weeks gestation; two million at birth; 400,000 at puberty. A total of 400 are ovulated over the course of a lifetime and, with each menstrual cycle, 1,000 eggs will leave the resting stage and start to mature.
Age affects oocyte quality. An egg mirrors the core paradigm of biological life-it doesn’t get better with age. Older eggs are not as healthy as younger ones and often lead to missed opportunities for fertilization, poor adhesion to the uterine wall or an early miscarriage. Despite the ticking of their “biological clocks,” advances in medical technology give hope to older women.
A woman who has postponed starting a family until she is in her mid-30s or older can turn to her physician or a fertility specialist to lend “Mother Nature” a helping hand if she is not able to conceive on her own. (Six months of unsuccessful trying is the accepted guideline for this age group.) Actually, a woman may call for that help even if she already has a child but is past age 34 and wants another child. The chances of success of any treatment, however, continue to diminish as a woman gets older.
Although men produce sperm throughout their post-puberty years, age can adversely impact their reproductive system, too. Couples who have been trying to get pregnant without success should not assume that the problem is exclusive to either person. A fertility work-up-basic blood tests and a semen analysis-will help to initially define the situation.
Subsequent treatment is specific to the individual couple. With information from those test results, your physician will be able to propose an appropriate treatment plan.
***Available fertility options include***
Fertility drugs may be given to a woman to trigger or regulate her ovulation, or to a man to increase his sperm count. Intrauterine insemination may be employed, giving the sperm a head start on fertilizing an egg by placing a prepared sample into the uterus. These two treatments may even be combined, further improving the chance of fertilization by increasing the number of eggs exposed to the sperm.
Another option for couples experiencing infertility is advanced reproductive therapies such as in vitro fertilization (IVF). In this procedure, egg and sperm are combined and carefully cultivated under laboratory conditions, and the developed embryos are placed into the uterus where they must implant themselves in the uterine wall. When age is a factor, donor egg IVF, where the eggs of a younger woman are used in the process, is a viable option that has been successful.
Other possibilities and combinations of treatments are also available. Although age continues to strongly impact the chances of conception, the fulfillment of parenthood is not limited to only the young; advanced reproductive medical technology may well hold the key for older parents-to-be.
Daniel F. Rychlik, M.D., F.A.C.O.G., is board certified in the sub-specialty of Infertility and Reproductive Endocrinology, and the specialty of OB/GYN by the American Board of Obstetrics and Gynecology. He is the associate medical director at the Fertility Treatment Center, an academic medical practice and one of the most comprehensive reproductive treatment facilities in the western United States with centers in Tempe, Scottsdale and Glendale. He is also a clinical instructor at the University of Arizona College of Medicine-Phoenix Campus. For more information, call (480) 831-2445 or visit www.fertilitytreatmentcenter.com.
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