Age and Fertility- Written by a specialist.

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Age and Fertility- Written by a specialist.

According to research over the last 40 years, a healthy 30 year old woman has about a 20% chance of getting pregnant each month. A healthy, ovulatory 40-year-old woman’s chance per month is 5% (1,6). The decline is slow and steady up until the age of about 35. After that the decline becomes steeper. These ranges and time frames have been established through multiple studies and have been consistent for the last 30+ years. The decline in fertility is attributed to depletion of ovarian oocyte (eggs) reserve and is determined by genetic, environmental, and lifestyle factors.(2).

Now, for the good news. Age at conception does have bearing on time to pregnancy in a healthy, ovulatory woman. In general, fecundity (a woman’s physiological ability to have a child) is reported as age ranges because it is difficult to correlate a specific age to a specific chance of success. There are also factors that can affect reproductive aging. These include other medical conditions that can have an effect such as endometriosis, fibroids, genetic conditions (errors in number of chromosomes), environmental influences, obesity, smoking, thyroid gland dysfunction, history of sexually transmitted diseases (STDs), and ovulatory dysfunction, to name a few (2,3).

PCOS stands for Polycystic Ovarian Syndrome, it is the most common form of ovulatory ovarian dysfunction.  The pathology of PCOS makes ovulation irregular and unpredictable, making the timing of intercourse for conception difficult. 

There could also be issues with male fertility such as erectile dysfunction and sperm quality issues. Male evaluation initially consists of a semen analysis and potentially other endocrine blood testing to evaluate any severe sperm abnormality.

HOW CAN ASSISTED REPRODUCTIVE TECHNOLOGY HELP?

Most of the factors other than extreme reproductive age are usually treatable. When you get started, the first step is a comprehensive evaluation of both you and your partner (if applicable). We test your ovarian reserve to gauge likelihood of adequate number of eggs produced per cycle, prolactin levels since the elevated levels can affect regularity of ovulation, and PCOS testing. If there are any positive findings, we can offer prescription medications or supplements beneficial for conception (5).

There are supplements that both partners can take that have been shown to be beneficial for conception.  Lifestyle modification and diet changes (such as following the Mediterranean diet) can also positively impact your chances.  Controlling your stress and regular moderate exercise also confer benefits (3,4).

Please click the link below for a consultation with an experienced Reproductive Endocrinologist. You can also follow us on Facebook or return to our website for updated information about your fertility journey.

References

1.   Menken J, Trussell J, Larsen U. Age and infertility.  Science. 1986;233:1389-1394.

2.   Utting, D., & Bewley, S. (2011). Family planning and age-related reproductive risk. The Obstetrician & Gynaecologist, 13(1), 35–41. https://doi.org/10.1576/TOAG.13.1.35.27639

3.   Collins GG, Rossi BV. The impact of lifestyle modifications, diet, and vitamin supplementation on natural fertility. Fertil Res Pract. 2015 Jul 25;1:11. doi: 10.1186/s40738-015-0003-4. PMID: 28620516; PMCID: PMC5424364.

4.   Dimitrios Karayiannis, Meropi D Kontogianni, Christina Mendorou, Minas Mastrominas, Nikos Yiannakouris. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Human Reproduction, 2018; DOI: 10.1093/humrep/dey003

5.   Unfer, V., Nestler, J. E., Kamenov, Z. A., Prapas, N., & Facchinetti, F. (2016). Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials. International journal of endocrinology, 2016, 1849162. https://doi.org/10.1155/2016/1849162

6. Sozou PD, Hartshorne GM (2012) Time to Pregnancy: A Computational Method for Using the Duration of Non-Conception for Predicting Conception. PLOS ONE 7(10): e46544. https://doi.org/10.1371/journal.pone.0046544

How to get pregnant with Unexplained Infertility.

Our hearts melt when our patients text us: “We did it! I can’t believe it.” We want to share a story of one of our patients who underwent IVF and other procedures and lost her hope. However this story does have a happy end.


“Alice tried everything and her hope was lost…”

By Dr. Gary Levy

(Board-Certified Reproductive Endocrinologist, Chief Medical Officer of Fertility Cloud)


I would like to introduce to you the story of Alice (name changed for the purposes of this blog post).

Alice is a patient that came to us with the diagnosis of unexplained (undiagnosed) infertility. Alice had an evaluation that demonstrated normal ovarian reserve, her AMH was 3.58 ng/mL (the lab norm is from 1 to 7.6 ng/mL), her fallopian tubes were open as documented by a hysterosalpingogram test and her spouse’s sperm evaluation was completely normal. In addition, her male partner had two prior children from a previous relationship. Alice had been trying to conceive for over fourteen months prior to seeking care with us. She underwent a few cycles of letrozole and then underwent IVF and did not get pregnant with a frozen embryo transfer.

After seeing her through our, always accessible, telehealth platform, we realized that Alice likely suffers from LPD. We discussed additional testing for PDG monitoring and confirmed our suspicions.

We discussed her treatment options, and she underwent ovarian stimulation and progesterone support and got pregnant on her second treatment cycle. She was ecstatic, as her experience at FC allowed her to be successful and receive an answer to the question that has been unanswered for a long time providing much needed closure in a much more affordable manner.”