Age And Fertility In Women: Here's All You Need To Know About Age-Related Fertility Decline
With age fertility in women declines. Read here to know the expert the link between ageing and fertility in women. Also, know how it can be tackled.
There are a variety of reasons that can lead to delayed pregnancy
- Age-related decline in fertility is natural
- These days fertility issues are common even in young women
- Egg freezing is one the ways to deal with age-related fertility
Fertility tends to change with age. One's peak reproductive years are between the late teens and late 20s. By age 30, it starts declining. Moreover, this decline becomes more rapid in the mid-30s. By 45, fertility has declined so much that getting pregnant naturally is difficult than usual for most women. It is imperative to acknowledge and understand that fertility declines as a woman ages due to an age-related decrease in the number of eggs in her ovaries. Age-related infertility is becoming more common for a variety of or if they suffer from certain medical conditions. All these factors play a role in the delay of pregnancy, further affecting one's fertility.
Know about the fertility problems linked with ageing
Ovarian reserve is affected when there is an increased age factor in women. Women are born with a finite number of eggs, and few eggs are lost every month through a woman's menstrual cycle. A woman is born with 2 million eggs and by the time she gets her first periods, she has only 20,000 eggs left. As she keeps menstruating every month, the ovarian reserve keeps declining. As she gets older, it's not only the number of eggs that get affected but even the quality of the eggs gets compromised. As the number and the quality of the eggs decrease, the capacity or the potential of the woman conceiving also decreases affecting her chances of conceiving with her own egg.
As women age, there are certain metabolic diseases or changes like diabetes or hypertension that occur in the body. These factors hamper one's chances of conceiving and carrying forward the pregnancy along with increasing the complications.
As women age, the chances of chromosomal abnormalities occur in the unborn baby, such as Down Syndrome. So, the ones who conceive with their eggs, have to undergo various tests during pregnancy to detect these chromosomal abnormalities. Should a couple opt for ART treatments, the women will also be recommended to do Pre-implantation Genetic Testing (PGT.) Here, the embryos are created and screened for genetic abnormalities. If any abnormalities are present in embryos then those embryos are not transferred inside the woman's uterus. Transferring good embryos only can increase the woman's chance of getting pregnant and making sure that the baby doesn't have chromosomal abnormalities.
Fertility problems in young females
Often it is seen that women in their late 20s or in their early 30s can also have decreased or declining ovarian reserve. So, if a woman is trying to conceive for more than a year and unable to do so, she should not take this issue lightly dismissing the problem with the pretext "but I am young, I will conceive sooner or later, only women who are older need help to conceive". If she fails to visit a fertility consultant at the right time, then she will only be further delaying and reducing her chances to conceive with her own eggs. It is recommended that irrespective of your age if you have been trying to conceive for more than 6 months to a year and are not successful you should take up the Anti-Mullerian Hormone (AMH) test to analyse the ovarian reserve and get an idea about the fertility reserve. This can help a woman decide about when and how to plan her pregnancy.
Other factors that play a role in declining ovarian reserve apart from age are stress, genetics, pollution, smoking, and lifestyle habits.
The treatment: As a woman, if you are planning to postpone childbearing by a few years then it is a good idea to get your AMH test done to know where you stand with respect to your fertility potential. If it is on the lower side and you still want to postpone your pregnancy, then you can consider egg freezing (if you are single) or embryo freezing (if you already have a partner) as fertility preservation. Once you have frozen your egg/embryos you can plan your pregnancy anytime, all you have to do is thaw those eggs/ embryos if eggs are thawed you will need to create embryos using your partner's sperms and conceive without the effect of age on it.
For example- If your eggs /embryos are frozen at the age of 28 and you plan your pregnancy when you are 35, your fertility potential and pregnancy outcomes would be that of a 28 year old. Once you freeze your egg/embryos they are frozen in time with no deterioration happening over time. If you have a declined or a declining ovarian reserve then it is better to plan your pregnancy with an IVF cycle to minimise your time to conception and to exploit your fertility potential to the maximum.
To conclude, it is time we acknowledge that fertility is like any other normal medical condition, and with a rise in fertility problems across all age groups and the country, it is extremely important that an individual, male or female, be made aware of their fertility potential and the various options available out there, thereby empowering them to make important decisions pertaining to their fertility timeline without having to regret later owing to the fact that they were not aware, and this can be done without actually compromising any other life decisions or goals that they may have in life. Should anybody be keen to start a family at any given point in their lives, they should consult with a fertility specialist, understand where they stand in terms of their fertility and plan their future accordingly.
(Dr. Ritu Hinduja is a Fertility Consultant at Nova IVF Fertility, Mumbai)
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