Age affects everyone’s fertility, and for women there’s generally a gradual fall in their fertility up to the age of 32 as a natural result of fewer eggs remaining in the ovaries after each cycle. From about the age of 35 the monthly drop in egg numbers increases, and from 37 this monthly decrease becomes more rapid.i What’s less well known is that men also experience a measurable fall in their fertility with age, and although the significant change starts later for them than for women, the age of 40 has roughly the same sort of impact for men as 35 has for women; eggs and age and age and male fertility explain this is in more detail.
Being older is a major fertility issue for the many couples who leave it later in life to start (or extend a family), and there are lots of reasons why people do this. Often it’s simply because they underestimate when age starts to really affect fertility, and people tend to overestimate how effective and achievable IVF is, as surveys suggest that:
- 20% of women are unaware of the impact of age on fertilityii
- Most women overestimate when age affects their fertility by 10 yearsiii
This has serious consequences for those people who fully expected to have children in their 30’s and 40’s without any problems. Being older makes it harder to conceive and to avoid miscarriage, and it’s become a major reason so many couples wanting a family choose (or feel a pressure to have) fertility treatment. If there was a better understanding of how age affects fertility it might reduce the significant financial and emotional burdens that couples often experience when trying for a baby in their 30’s and 40’s, and fertility experts recommend:iv
- Women in their 20’s and 30’s should be advised about age-related infertility as part of their primary ‘well-woman’ care
- Women should be advised that fertility (both natural and assisted) is much lower in their late 30s and 40s (except with egg donation)
- Women over 35 should be referred for a fertility ‘work-up’ after 6 months of serious trying for a baby
- Testing ovarian reserve is a consideration for women at 35, or for younger women who’re likely to have low ovarian reserve
While we can’t get any younger, there are things that can reduce the impact of the ageing in the body, and when considering the relationship between age and fertility it’s important to remember that egg and sperm quality remains more important than their quantity:
- Women continue to ovulate an egg each cycle (until the menopause) and this egg is usually the best quality egg in that cycle
- Most men produce sperm until they’re really old, but there are reductions in quality even in their 20’s
Couples wanting a baby can change things to create as healthy an environment for their eggs and sperm as they can, by focusing on supporting and optimising their health and wellbeing, rather than trying to force the body to ‘produce’ more eggs as IVF appears to do (it actually doesn’t; it just stimulates more eggs in a given cycle to reach maturity, rather than creating more).
A baby comes from one egg being fertilized by one sperm
- The quality of the particular egg and sperm that join determines the viability of the pregnancy and the health of the baby
- The reduction in fertility with age very closely reflects a reduction in both egg and sperm quality and numbers
- Quality is often confused with quantity as it’s much easier to monitor quantity and because of the link above there’s an assumption they to go together
- The best approach to raising older couples fertility is to focus on the quality of the individual’s eggs and sperm (and the health of the ovaries and uterus), rather than quantity
There are two ways to improve the quality of eggs and sperm:
- Reduce the impact of ageing on the developing egg and sperm
At birth a woman’s eggs are already formed, and they stay protected and inactive in the ovaries until some of them start getting ‘woken up’ after puberty (eggs and follicles), from this point the eggs become exposed to toxins and oxidative stress which can damage or kill them. This is a significant factor and just a small fraction of any eggs that start the recruitment process reach the last stage, and the proportion of eggs that reach the ovulation stage reduces with age. There are a number of reasons for this; it’s partly because toxins build up over the years, and as we age our natural protection from oxidative stress and our ability to repair damage in cells reduces. However it is possible to reduce damage to eggs and sperm by making dietary and lifestyle changes. Which changes will work best varies from person to person, as the morefertile fertility ‘types’ describe in detail, but it their aim is to reduce damage to cells and increase the body’s natural protective functions.
- Improve reproductive function
Choose a way to increase the function of the testes, ovaries and the uterus; Chinese medicine (especially herbal medicine) is excellent at this, and research shows it can:
- Reduce follicle stimulating hormone (FSH) levels each cycle
- Increase the blood supply to the ovaries and uterus
- Increase the numbers of follicles in a cycle
- Promote the health of the luteal phase
- Increase the depth of the womb lining
These profoundly improve fertility and increase the pregnancy rates for women of all ages, as well as being able to improve the semen parameters for men. When looking for a practitioner, remember that professional members of morefertile.com have access to a unique range of treatments for all areas of fertility.