What Women May Not Know About Their Fertility

I can’t tell you the number of times women in their mid 40’s come to me and announce “Well, I’m ready to get pregnant”.  Putting off pregnancy is understandable in our times.  Women are building their careers, moving and traveling, going through a series of “Mr. Wrongs” and looking for the best baby-daddy. Women have thought that fertility was a given and they could get pregnant when the time was right.  But, sadly, what they haven’t been told is the cruel trick of nature.  Fertility doctors know…after age 29 your chance of having a baby without medical treatment is diminishing every year.  After age 40 there is a precipitous drop.

To bring that fact home, check this out.  A woman age 19-26 has a 50% chance of getting pregnant  during any one menstrual cycle if she has intercourse two days prior to ovulation.  For women age 27-34 the chance was 40% and after age 35 it drops to 30%.  And at 40 you are only 1/2 as fertile as you were at 35.  That is a sharp drop off!

Why does fertility decline with age?  There are a number of reasons that compound each other:

• Eggs- The number of egg follicles left in the ovaries declines with age and no new ones are made.


• Menstrual cycle - as women age the cycle can become irregular and shorter.


• Lining of the womb - the endometrium is thinner and less hospitable to a fertilized egg.


• Mucus secretions - the vaginal secretions can be less hospitable to sperm.


• Other diseases - endometriosis, chlamydia and polycystic ovary syndrome(PCOS) can play a role in preventing pregnancy.

The female reproductive cycle is very complex biology.  A newborn baby girl’s ovaries store a woman’s lifetime supply of immature eggs - about 400,000 - and with time, those eggs become less viable and healthy.  The hormones released during the menstrual cycle control the sequence of events that lead to pregnancy.  With age, those hormones fluctuate and cannot support a pregnancy.

Advanced fertility treatment can help many older women become pregnant.  The average cost of an in-vitro fertilization (IVF) cycle in the U.S. is $12,400.  That is after a complete (expensive) hormonal workup and exam.  For women over age 40, fewer than 1 in 12 cycles results in a pregnancy.  If a woman over age 40 is able the have a baby, the medical cost per delivery is $132,000.  About 11% of IVF pregnancies end in miscarriage.  Very few women over age 43 will attempt IVF and very few clinics will even offer it.

Bottom line is IVF cannot reverse aging.  The number and quality of eggs remaining is the major factor in women over age 40 getting pregnant and IVF cannot change those factors.

For women  over age 40 who have wanted to have children, these facts are a slap in the face.  Doctors have talked about birth control for years but few doctors gave the information about fertility and women say “Why didn’t I know this?”

And what about those movie stars who are in late 40’s having babies?  It is not their egg, or they are using a surrogate or they are adopting.  Period.