Aging And Fertility Are Frenemies
The reality is that fertility does not get better, but worse with age. Young couples have better fertility and higher rates of pregnancy. From age 30, fertility begins to decline, and from 35 and beyond, the risk of infertility increases significantly. The world has also shifted with couples declining early family planning for work or personal reasons. In vitro fertilization (IVF) treatments have risen in popularity as a result, especially with the many age-related fertility challenges that may arise. Couples are encouraged to explore fertility options like IVF as soon as possible, even if pregnancy is not an immediate goal. Understanding potential solutions to age-related fertility issues can help improve future success rates.
Age-related fertility challenges
Advanced maternal age (AMA) is a primary risk factor for infertility. Women work with a fertility timeline with peak reproductive health between 18 and 29. Women are born with a set number of follicles in the ovaries, which are released monthly via menstruation. Over time, women develop a diminished ovarian reserve, which negatively affects fertility. As egg quantity declines in the mid-to-late 30s, so does egg quality. By age 45, the average woman will struggle to conceive naturally.
Men face challenges, too
Most men can conceive without issue, but sperm quantity and quality see a noticeable decline from age 40. Men also experience decreased semen volume from as early as 35 years of age. Sperm health can show decline even earlier, with deoxyribonucleic acid (DNA) damage evident. Poor lifestyle habits, environmental stressors, and diseases like obesity directly affect male fertility, regardless of age. Failed conception, repeated miscarriages, and preterm births have all been linked to poor sperm health. Men who are struggling to conceive should consult a doctor for medical advice and to discuss treatment.
Decoding your options with initial assessments
Individuals and couples should be proactive with reproductive health, especially if starting or growing a family is a future objective. Consider an assessment if there are warning signs of fertility issues. For instance, men with erectile dysfunction (ED) challenges should see a medical professional. If past attempts to conceive naturally failed, this could be a sign of infertility. Age 35 is also a threshold where men and women should do a reproductive health check if pregnancy is a goal. Both parties can benefit from blood tests to assess hormone function. A sperm analysis will be helpful for men, while an ultrasound of the reproductive organs can help women identify any possible issues.
Age-specific IVF options
If there is evidence of infertility, doctors will typically recommend fertility treatment, with IVF considered the gold standard. IVF protocols will vary depending on age and the root causes of infertility. Couples ages 35-40 are more likely to see results with conventional IVF. Strategies like preimplantation genetic testing (PGT) can identify the highest-quality embryos without genetic abnormalities, thereby increasing success rates. Fertility teams can use additional techniques, such as embryo receptivity analysis (ERA), to determine the optimal window for embryo transfer. Assisted hatching, where a small crack is made in the outer shell of the embryo, can improve implantation rates. For men with severe sperm health challenges, intracytoplasmic sperm injection (ICSI) can use a single sperm to fertilize the egg directly. These strategies help individuals at an advanced reproductive age feel renewed hope.
Maybe you need some help?
In some age-related cases, especially beyond age 40, traditional IVF is not enough. Additional planning or strategies may be needed. The earlier couples can assess these needs, the better. Cryopreservation can be the most vital tool in fertility treatment when fertility options are discussed sooner rather than later. By freezing higher-quality sperm and eggs at a younger age, couples can attempt IVF if natural pregnancy fails. Couples can also rely on donor sperm and eggs or gestational surrogacy if there are serious fertility concerns. Discuss the many options available before making a decision.
Making timely decisions to achieve pregnancy
Age plays a significant role in fertility and IVF success. The younger a couple is, the higher the chances of success. With age, egg and sperm quality diminish, so understanding fertility options early is critical. A fertility specialist can also recommend strategies to increase success rates, including genetic testing and cryopreservation. Set personal timelines and take proactive steps about fertility and the use of IVF. Use the right balance of attempting IVF based on age, and then move to alternative options if IVF fails.
