Womens Health

40 & Hoping For Fertility

Most people know that their chances of fertility decline with age. They may not know, however, how quickly and dramatically they decline, or why they do so. A woman's fertility potential begins to decline a good deal after the age of 35, and it dramatically declines further after 40.

Why The Decline?

There are two main things that explain the fertility decline that women experience. These things are chromosomal aneuploidy and decreased ovarian reserve. There are certainly genetic issues and other factors that might influence the woman's ability to conceive. These two issues, however, are ones that researchers feel are directly tied to the woman's age and influence her fertility due to age.

Chromosomal Aneuploidy

Chromosomal aneuploidy refers to abnormal numbers of chromosomes in the egg. As the woman ages, more and more of the eggs that she produces have abnormal chromosome numbers. This abnormality leads to three consequences for women who want to conceive around or after age 35. They have a higher risk for having a baby with Down Syndrome, for spontaneous miscarriages, and for having difficulties conceiving all together.

Decreased Ovarian Reserves

Ovarian reserves in women usually start to decline about 15 years before menopause. This means that the woman will start to have a smaller supply of eggs in the ovaries. There are a number of blood hormone tests that doctors use today to evaluate the woman's ovarian reserves. These may help the woman to know if she still has enough eggs to try to conceive, and if she is at risk for having conception problems or development issues.

More on Decreased Ovarian Reserves

There is no medical treatment or intervention that can help with decreased ovarian reserves. Although doctors are constantly making medical advances, they have not, yet, figured out a way to reverse the inevitable decrease in ovarian reserves. The options that are available are as follows: The woman can take high doses of gonadotropins to stimulate the ovaries. She may also use novel protocol strategies such as oral contraceptive pills, diluted dosages of Lupron, and other ideas. If none of these strategies prove helpful, then the woman will need to either use a donor egg, a surrogate, or think about adoption.

Today, there are more and more women who are only beginning to consider conception after the age of 35 or 40. While work, social factors, age at the time of marriage and other issues are certainly at play, it is important for women to understand the risks that they may be taking by waiting to have a child. Their timeline can't always be prevented, but if it can be, it is always better to start earlier rather than later.


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