Each year, there are thousands of women in their mid to late 30’s that naturally conceive and have healthy babies, starting their families and beginning an exciting new journey in their lives. If you are over 35, getting pregnant is not impossible or something to be afraid of. While there are some additional challenges that pregnancy later in life may present to you, being aware of them will help you navigate issues that may arise as you start trying to conceive.
For women who are trying to get pregnant or thinking about building a family in the future, there is often a fear that waiting too long to have a baby might hurt their chances of conception or put their pregnancy at risk. But what are these risks, and what can we do to help overcome them?
Out of all the obstacles that we may face as women, some of the biggest ones are that as we age we will experience a diminished number of eggs resulting in inadequate egg health and sometimes less frequent ovulation.
There is a common misconception that a woman’s fertility does not begin to decline until she starts menopause, but in fact, our egg reserve is naturally decreasing throughout our entire lifetime, and our reproductive capabilities begin to slow down much earlier than we think. We actually begin losing a significant amount of our eggs even before we are born. All women are born with the total amount of eggs that we will ever have, and once they have been formed, we do not create more.
Before birth, both women and men have germ cells that turn into either sperm or eggs. A man’s germ cells in the testes don’t start producing sperm until puberty, which is when germ cells continue to divide over and over producing more and more sperm. For women, our eggs are formed when we are still in our mother’s uterus. In a female fetus, germ cells in an ovary begin to turn into immature eggs right away. A 20 week old fetus has about 7 million of these immature eggs, but by the time she is a newborn, there are only about 1 to 2 million left. When puberty hits and these eggs begin to be released and start to mature, there are only about 300-400,000 left in our body. At that point, a single egg is released every month while many other eggs die at the same time. At age 37, a woman is down to about 25,000 eggs, only 2.5% of her starting count, and by the time she is 50, she is pretty much completely out of eggs. And even though it seems like we have a large egg reserve, in a woman’s lifetime only 300 eggs will ever be released and mature during ovulation.
After women start puberty, they are fertile for approximately 30 years. Fertility actually peaks in our early to mid 20’s and usually begins declining from there. This occurs because our ovaries start to become less effective at producing and releasing healthy and mature eggs. When we hit menopause, our ovaries stop producing hormones entirely. Not only does a woman’s egg reserve decrease with age, but occasionally, during an ovulation cycle, an egg may not be released at all, meaning that we are unable to get pregnant during that cycle. This becomes more frequent the older we get and can be another reason why older women generally have a harder time getting pregnant and may face lower odds of conceiving naturally. Even if we live the healthiest life possible, fertility decline is inevitable, and is a naturally occurring process that arises as we age.
Of course health is still very important for fertility. Even though this fertility decline is bound to happen, living a healthy life and maintaining healthy habits can help to increase your egg health and longevity. Bad health habits such as smoking are associated with an increase in the fertility aging process. Smoking damages the eggs in the ovaries and increases the risks of miscarriage and having blocked fallopian tubes. A healthy diet will also help keep your eggs healthy and your body well prepared for a successful pregnancy. The better care we take of our bodies, the better chances we will have at maintaining a well functioning reproductive system.
Although we often try our best to live our healthiest lives, as we begin to advance in age, so do our eggs, and if we do get pregnant when we are older, the older eggs have a higher chance of having abnormal chromosomes. These abnormalities can increase the risk of miscarriages or birth defects. One of the more common chromosomal abnormalities is Down Syndrome which is caused by having a single extra chromosome. 25 year olds have a 1 in 885 risk of having a child with Down Syndrome; 30 year olds have a 1 in 641 risk; 35 is 1 in 237; 40 is 1 in 69. Miscarriage rates increase as well, going from 20 percent in the 20’s to 30 percent in the 30’s to 40 percent for women in their 40’s.
The chances of natural conception drops the older we get. Women in their 20’s usually have about a 1 in 4 chance of conceiving during a menstrual cycle, meaning that for every 100 women trying to conceive about 25 will get pregnant per month. But by the time we are about 40 years old, the rates drop down to a 5% chance of getting pregnant in a cycle. Women over 35 are also more likely to have issues like endometriosis, a disorder that occurs when the tissue making up the uterine lining becomes present on other organs inside your body. They are also more likely to have uterine fibroids, small growths of uterine muscle that can distort the uterus which can block the fallopian tubes or make the cavity unable to accept an embryo. Fibroids and endometriosis can make conception more difficult, but are not untreatable, and can often be helped with proper care.
A study published in the Human Reproductive Medical Journal found that women who were between the ages of 19 and 26 had a higher chance of conceiving, around 50 percent, on their most fertile day than that of older women who were between the ages of 27 and 34, who had less than a 40 percent chance of conceiving on their most fertile day. But once a woman is over 35, her chances dropped to less than 30 percent chance of conceiving on their most fertile day. Women between the ages of 35 and 39 had the least likelihood of getting pregnant per month out of all of these age groups.
If you are under 35 and are not having success after 1 year, then it is a good idea to consult your doctor. If you are 35 or over, then it is more important to get a head start on looking into potential fertility problems. If you have not had success conceiving after 6 months of trying, then you shouldn’t delay seeking help. As a woman ages, her ovaries do not respond as well to treatments. This includes not only the natural hormones released but also hormones that are present infertility drugs used to treat fertility issues, making fertility treatments for older women less successful, especially when they have lower egg counts. Even though there are many women who conceive naturally over 35 within a year or two, if there are fertility issues, waiting a year or two may make it more difficult to be successfully treated and become pregnant. Getting fertility testing done after six months for both you and your partner if you are over 35 is a precaution that can help get a jump on any fertility problems that may be found. Remember, if an issue is discovered earlier on in a woman’s life, the chances of successful fertility treatments is higher, so the sooner you consult your OBGYN or a fertility doctor, the better.
Usually, fertility testing includes several basic procedures. For men, a semen analysis will be done to determine the number and quality of sperm in his sample. If there are any issues, doctors can begin making a course of treatment for his specific condition. For women, there is blood testing to evaluate hormones and an ultrasound to look at the ovaries and uterus. There is another test called a hysterosalpingogram (HSG) which will evaluate whether the fallopian tubes are open. This test uses X-ray images to track dye as it goes through the fallopian tubes. Sometimes an HSG can also pick up any defects in the uterus that an ultrasound may have missed. If any of these issues are detected, your doctor can proceed with specific treatments.
Reproductive Health and Wellness Center is a fertility clinic that is here to help. There are a variety of medicines a woman can take that will increase the chances of a successful pregnancy. If a woman is over the age of 35 and has been trying to conceive for 6 months, a doctor may recommend fertility treatments using medications to help stimulate egg production, intra-uterine insemination (IUI), or In Vitro Fertilization (IVF). If a woman has other medical issues that will affect her chances of conceiving, a doctor may suggest more targeted treatments to help amend any problems that may arise.
For single women who know they may want to have a baby in the future but are not yet ready, a great option is to freeze and store the eggs to keep them reserved for the future. The quality of these eggs will be at its peak if they are collected close to our most fertile years, and this will help increase the chances of a successful pregnancy later in life if natural conception becomes difficult. For woman who don’t have viable eggs, she can use eggs donated from a younger women, fertilize those eggs with her partner (or a donor’s) sperm, and then have it implanted into the uterus as it would be during a regular IVF procedure. Even though eggs age, it has been shown that a woman’s uterus does not seem to suffer quite as much as she gets older, meaning that if a healthy egg is used, she still has a high chance of carrying a healthy pregnancy to term.
Thankfully, fertility treatments continue to advance. Now more than ever before, there are solutions to the issues that may arise when it becomes hard to make our dreams of family come true. Each year, we learn more and more about how to overcome the difficulties that fertility issues present, and success rates are climbing as we usher in a new era of reproductive health and treatment.
At Reproductive Health and Wellness Center, we are always waiting with open doors to help you with your reproductive needs. We care about you during this delicate time, and we understand how deeply personal fertility problems are. We want you to have as much information as possible so we can help you make the right choices to build your happy family. We have cutting edge fertility treatments but also focus on education, personal guidance, and whole body health and wellness to try and give you the best care possible. If you have questions or want to schedule a consultation, you can contact us at (949) 516-0606.
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