This fact sheet explains a little about age and fertility. Please remember that you are an individual not a statistic and we can give you a clearer understanding of your situation when you come for a consultation and assessment.
Why does age affect my chance of getting pregnant?
More and more women are delaying the start of a family until their thirties and over 20% of women in Australia now have their first child after age 35.
The chance of having a baby decreases 3-5% for every year after the age of 30 and at a faster rate after 35. Some women over age 40 find it straightforward to achieve a pregnancy, but many do not.
The reason for these changes is primarily because at birth, a woman has all the eggs she will ever have and from puberty through to menopause her ‘ovarian reserve’ of eggs declines. This decline can be particularly steep for women in their late thirties and forties. Importantly too, eggs are increasingly affected by abnormalities in their chromosomes as women get older and this can make it harder to achieve a pregnancy and a live birth even when a woman is still producing eggs.
What about the man’s age?
In contrast to menopause, which marks the point where ovarian function and egg production cease in women, sperm production in men continues throughout their life.
It’s not completely clear, but there is some evidence that semen characteristics, embryo development and IVF outcomes may decline slightly as men get older. There have also been some reports that certain genetic disorders and conditions such as autism may increase in the children of older men.
While these are certainly issues to be aware of, as far as we know, the changes are not significant enough to prevent older men from having IVF treatment or fathering children1.
When should I seek help?
If you are female and over 35 and have been having regular unprotected sex for a year without becoming pregnant, you should consult Life Fertility Clinic. The younger you are when you come in and see us, the better the chances are that we will be able to help you.
If you are female and over 40, it is wise to take action sooner and to only give yourselves six months of trying to get pregnant naturally before having a full fertility evaluation and considering treatment.
What are the risks of female age?
The number and quality of a woman’s eggs deteriorate with age and this makes it harder to get pregnant.
There is also an increased risk of miscarriage. A woman in her 20s has only a 12-15% (1 in 6 or 7) chance of having a miscarriage each time she becomes pregnant. A woman in her 40s faces on average a 50% (1 in 2) risk of miscarriage.
As women get older their eggs are more likely to have abnormalities in the number of chromosomes they contain. Eggs that are abnormal in this way can still be fertilised and the embryos can implant, but most pregnancies from these embryos will miscarry. At least half of all miscarriages are due to abnormal chromosomes, so the rates of miscarriage are higher in older women.
A recent large study for example found that the proportion of embryos that had an abnormal chromosome number was about 25% for women 26-30 years old, but the rate rose steadily to 85% of embryos for women 43 or older2.
Chromosomal abnormalities also cause conditions like Down’s Syndrome, which is why older women have a higher chance of having a child affected by such conditions.
How does Life Fertility tell if I have age-related infertility?
At Life Fertility Clinic, we undertake a range of diagnostic tests and physical examinations for all patients. If you have a partner, his semen will also be tested.
The routine tests include a laparoscopy to check to see if your pelvis is normal and whether your fallopian tubes are open and able to carry the egg from the ovary to the uterus.
Most importantly, to assess age-related changes to ovarian function, we will do a blood test to measure a hormone called Anti-Mullerian Hormone (AMH). The AMH assessment can show if you are approaching menopause or have a diminishing ovarian reserve.
What treatment might I need?
If female age is a factor in your infertility, your doctor is likely to recommend you undertake treatment as soon as possible.
There are simple approaches to treatment such as fertility medications to try to increase the likelihood of ovulation every month. However, while these simple fertility medications on their own can offer some hope, the older you are, the more likely it is that your doctor will recommend treatments like IVF.
IVF can be an effective approach for many women who are still producing eggs, but the overall pregnancy rates per cycle for women over 40 do still remain comparatively low so it can take a few cycles to get pregnant.
We can also use a technique called Preimplantation Genetic Screening (PGS) to check the chromosomes of your embryos if you have had miscarriages, or have not had success from IVF despite producing good embryos.
If you are approaching 40 or over; have consistently low AMH levels, poor response to medications or have had recurrently poor embryo quality when you have had IVF, you may need to consider using a donated egg.
At what age does Life Fertility Clinic no longer offer fertility treatment?
Whether you are considering treatment using your own or donated eggs, there are other health and lifestyle factors to consider, in particular the health of the potential mother.
While some fertility clinics have achieved pregnancies for women in their 50s, 60s and 70s, and Life Fertility Clinic does consider each situation carefully, we do not normally treat women beyond their 50th year.
In short:
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- Women’s fertility declines from the age of 30 and does so significantly after 40.
- Miscarriage rates are higher for older women, especially over 40.
- In women, age related infertility and increased miscarriage rates are largely due to diminishing ovarian reserve and increasing numbers of eggs with abnormal chromosome numbers.
- If you are over 35 and have not become pregnant after one year of regular unprotected sexual intercourse, come and have a fertility check up.
- If you are over 40, don’t wait a year, come for a fertility check if you are not pregnant after six months of regular unprotected sexual intercourse.
- The sooner (and younger) you have fertility treatment, the more likely it is to be successful.
- There have been no known IVF births in women aged 47 years or older who have used their own eggs in treatment.
- IVF Treatment through our Bulk Billed Program is only available to women who are under 45 years of age or younger (at the time of egg collection).
- We do however have Donor Egg and Surrogacy Programs associated with our Full Service Fertility Treatment Program. If you want to consider these alternative options, and find out if they are medically suitable for you, we recommend you book in for a consultation with our Medical Director Dr Glenn Sterling or one of our other Brisbane or Melbourne Fertility Specialists.
- For many women over 40, egg donation and IVF are the most likely ways to achieve a pregnancy.
Contact Life Fertility Clinic
The friendly and professional team at Life Fertility Clinic are happy to answer any other questions you may have about age and infertility.
1 Ramasay et al (2015) Male Biological Clock: a critical analysis of advanced paternal age. Fertility and Sterility, 103, 1402-1406.
2 Franasiak, J.M. et al (2014). The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive tropehctoderm biopsies evaluated with comprehensive chromosomal screening. Fertility and Sterility. 101. 656-664.