01 May AGING AND FEMALE FERTILITY
A woman’s age is the best marker of her fertility potential. Every woman is born with a fixed number of eggs which she exhausts during the reproductive age and ends up in menopause.
Data from various studies reveal that fertility in women peaks between the ages of 20 and 24, decreases relatively little until approximately age 30 to 32, and then declines progressively.
Variations in fertility rates among different populations could reflect differences in genetic factors or socio-economic conditions (lifestyle factors).
Success rates achieved with infertility treatment also decline as age increases. The number of eggs produced and embryos formed are lesser, abnormalities in embryos are more and pregnancy rates are lower in older than in younger women.
The age- related decline in live births reflects not only decreasing fertility, but also increasing pregnancy losses. Miscarriage rates in natural conception cycles are generally low before age 30 (7-15%) and rise with age, only slightly for ages 30-34 (8-21%), but to a greater extent for ages 35-39 (17-28%) and ages 40 and older (34-52%). This is attributed to increase in the proportion of abnormal oocytes (eggs) in an aging and shrinking follicular pool.
Societal trends toward delayed childbearing and age- related decrease in female fertility have focused a great deal of attention on reproductive aging.
To know the size and quality of the remaining ovarian follicular pool at any given point of time, we have Ovarian Reserve Tests. The purpose of ovarian reserve testing is to correctly identify women with diminished ovarian reserve and accordingly guide them for fertility treatments. We know we cannot prevent aging, but now can better help women to set and to realize their reproductive goals.
Most commonly used ovarian reserve tests include basal FSH, AMH and a baseline ultrasound.