In our Austin Fertility Center, we see age as the number one reason for Female Infertility.
Many women are delaying childbearing. It is estimated that approximately 20% of women are waiting until after the age of 35 to start a family. This can be due to many factors, including the availability of effective birth control options, the desire to succeed professionally prior to beginning a family, and the fact that women are marrying at an older age. There are many stories in the media which can suggest that fertility treatments can help to overcome this delay in childbearing successfully. However, successful fertility treatments depend upon a reasonable amount of ovarian function — which may or may not be available for women who choose to wait to begin a family.
It is important to remember that the decrease in fertility with age becomes more pronounced after the age of 35.
Even with the advances of modern medicine and the fact that many women are healthier and taking better care of themselves, this does not offset the natural decline in fertility with age. This is because women are born with all the eggs they will ever have and are unable to make any new ones. Even before puberty occurs, they have lost all but approximately 500,000 eggs. Though a woman ovulates (releases) approximately 300 eggs during her reproductive life, many more are lost through the natural aging process of atresia. The eggs that are remaining in the later 30s and early 40s are older eggs and have a higher chance of having developed genetic mistakes. This can lead to a decreased risk of pregnancy and an increased risk of miscarriage if pregnancy does occur.
An option for women whose ovarian function has significantly deteriorated is donor egg IVF. The chances of a successful pregnancy can be very high using an egg from a donor in her 20s or early 30s, and the miscarriage rate is very low. The high success with egg donation confirms that the egg quality is a significant barrier to pregnancy in older women.