What is the effect of our age on fertility?

Abstract:

In industrialized countries worldwide, women are delaying childbearing for a variety of reasons, including pursuit of career, greater financial independence, improved and more accessible contraception and longer life expectancy. In terms of fertility and maternity, those aged >= 35 years are considered to be of advanced maternal age and there are usually marked reductions in both the fecundity rate for spontaneous conceptions and the success rates with assisted conception. These decreases are thought to be due mainly to oocyte ageing, and the established success of oocyte donation from younger individuals to older recipients supports this contention. For those who achieve a pregnancy at an advanced maternal age there is a greater likelihood of aneuploidy (assuming conception with the woman's own oocytes), hypertensive and other medical disorders, birth by Caesarean section and maternal mortality. However, most of the complications associated with advanced maternal age are caused by age-related confounding variables, and older premenopausal women in good health should not require special attention. The data on perinatal mortality rates are encouraging and in the absence of congenital abnormalities perinatal mortality is probably not much increased, if at all, in older mothers. Pregnancy is now possible for postmenopausal women with the application of oocyte donation, but these individuals have a significantly higher likelihood of cardiovascular ageing and should be considered at increased risk of vascular complications during pregnancy.

Please click on the required question.

• 1 What is infertility?
• 2 How prevalent are infertility problems?
• 3 What are the main causes of infertility?
• 4 What are the objectives of our infertility investigations?
• 5 Have there been any noticeable changes in fertility requirements in recent years?
• 6  What is the effect of our age on fertility?
• 7 I smoke cigarettes. Can this have an effect on my fertility?
• 8 Does my weight influence fertility?
• 8A Obesity! How can I lose weight?
• 9 I have fibroids. Could these reduce my fertility?
• 10 I have been told that my womb has an abnormal shape and that was the way that I was born. Could this reduce my fertility?
• 11 I have endometriosis. Could this reduce my fertility?
• 12 I have been told that I have cervicitis or a cervical ectopy (erosion). Could this impair my fertility?
• 13 My doctor tells me that my womb is retroverted (tilts backwards). Could this reduce my fertility?
• 14 I have had an ectopic pregnancy. Does this affect my future fertility?
• 15  We are worried that we may have a fertility problem. What should we do?
• 16 How will our doctor be able to identify the cause of our infertility?
• 17 How can we tell if I am releasing my eggs (ovulating)?
• 18 Investigations have shown that I have a problem releasing my eggs (anovulation). What could be the cause of this?
• 19 How important are my Fallopian tubes in fertility?
• 20 How can we tell if my Fallopian tubes are functioning?
• 21a What are the causes of male factor infertility?
• 21 How can we assess male fertility?
• 22  What is the purpose of a post-coital test (PCT)?
• 23 We have had our infertility investigations and our problem remains unexplained. How can this be?
• 24 What are our chances of achieving a pregnancy?
• 25 Where can I obtain more information?
• 26 Could we have some recommended infertility support groups?
  

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.