Age alters conception rates because hormone levels, sexual reserves and structures change over time. This is true for both sexes, and most women experience a gradual fall in fertility from their late teens to about 32 as egg numbers fall. This trend escalates from about 35, as egg numbers become increasingly important. i
However, male fertility also falls predictably with age, although the changes usually happen slightly later, and for men of 40, their age is a similar fertility issue as reaching 35 is for women; see eggs and age and age and male fertility for more on this.
Age is usually THE biggest fertility issue for couples who leave it later in life to start (or extend) a family, with most people underestimating when age becomes important or overestimating how IVF success rates:
- 20% of women are unaware of how age affects fertility. ii
- Most women overestimate when age affects their fertility by 10 years. iii
This can be crushing news for couples who had expected children in their 30s and 40s without any problems. Being older makes it harder to conceive and avoid miscarriage. Understanding how age affects fertility could help many avoid the financial and emotional burdens experienced with IVF.
Recommendations
The fertility expert’s advice is that women should:
- Be told how age affects fertility in their 20s and 30s as part of their primary “well-woman” care.
- Know fertility falls from their late 30s (except with egg donation).
- Have a fertility “work-up” after 6 months of trying for a baby when over 35.
- Consider testing ovarian reserve if they’re over 35 (or younger but likely to have low ovarian reserve). iv
Positive action
While we can’t get any younger, it’s possible to reduce the impact of ageing and remember that egg and sperm quality is more important than their quantity:
- Most cycles result in a single egg being ovulated, which is the best quality egg in that cycle.
- Men make sperm until they’re old, but sperm quality falls from a man’s 20s.
Couples can improve egg and sperm health by optimising their health and wellbeing, which is a different approach to IVF, which aims to retrieve as many eggs as possible from single cycles. While IVF increases the number of mature eggs in a cycle, it doesn’t increase egg numbers in the cycle or improve egg quality.
A baby comes from one egg that’s fertilized by a single sperm
- The quality of the egg and sperm determines the health of each pregnancy and baby.
- Falls in fertility with age reflect reductions in both the quality and quantity of eggs and sperm.
- Quality is often shorthand for quantity as numbers are easier to monitor, and the assumption is they go together.
- The most successful approach for older couples is to focus on quality (and reproductive health) rather than chasing numbers.
How to improve egg and sperm quality
Older couples are advised to focus on improving their general health by following Fertility Profile (PFP) advice. It’s also crucial to reduce exposure to damaging substances which reduce egg and sperm health. Once eggs join the recruitment process, they’re exposed to environmental damage, which is why only a small fraction reach the last stage, especially as women age. This is partly due to accumulations of toxins, but our ability to cope with oxidative stress and repair the damage it causes also falls with age. However, proactive lifestyle and diet changes (including de-toxification) can reduce the damage to eggs and sperm, and this is best done alongside the morefertile PFPs advice.
Better reproductive function
Sex organ function can be improved with herbal combinations, with women having: v
- Lower follicle-stimulating hormone (FSH) levels each cycle
- Better the blood supply to the ovaries and uterus
- More eggs and follicles in cycles
- Healthier luteal phases
- Thicker womb linings
These changes fundamentally alter fertility levels and improve pregnancy rates for all ages; plus, herbs are also about 10x more effective than supplements and lifestyle changes at improving semen parameters for men.
