Age & Infertility
In recent years, women / couples in western cultures decide to become parents when they are older, when they have a stable marriage/relationship or a favorable financial situation. Also, more people marry at an older age or for a second time.
We all have heard of women who had children when they were older, e.g. at the age of 42. These are rare cases. In most women, fertility (the ability to achieve a pregnancy) is diminished with age. This happens gradually: decline starts after the age of 30 and is more evident over 35. Fertility is significantly compromised after the age of 40, while over 45, it is practically impossible to conceive. Unfortunately, some women experience menopause earlier than expected (before the age of 40).
The risk of miscarriage also rises with age. At the age of 25-29, the risk of miscarriage is 10%, while at 40-44, it reaches 34%. The risk of chromosomal abnormalities rises with age, too. So, a woman’s age is a very significant factor when trying to achieve a healthy pregnancy.
The actual issue is oocyte number and quality, which decline with age. This affects embryo quality (following oocyte fertilisation ). For all these reasons, many couples need to have a fertility treatment, such as in-vitro fertilisation (IVF), in order to overcome all such issues. Embryo quality is a critical factor when trying to achieve a healthy pregnancy.
A man’s age does not seem to be equally important for various reasons (listed below). However, sperm quality is compromised after the age of 55.
• Oocytes are produced in the ovaries when a woman is still a fetus; this means that her ovarian reserve is determined. When this reserve is depleted, there is no way it can be replaced. On the contrary, sperm in men is constantly produced.
• Oocytes ‘grow older’ with age, while sperm stays ‘fresh’ because it is constantly produced.
• Embryo quality mostly depends on the oocyte, not on sperm. The critical factor defining sperm quality is its ability to fertilise the oocyte. In older men, sperm might have reduced ability to fertilise the egg.
• Sometimes, older men have reduced libido. This is also very important when trying to conceive.
It is evident that achieving a pregnancy mostly depends on the woman’s age when she is using her own oocytes. If using oocytes from a donor, then one should consider the donor’s age, while the recipient’s age is not relevant. In short, what matters is the age of the oocytes, not of the uterus that will carry the baby to term.