An advanced reproductive age in women is very important when evaluating couples with infertility conditions or decreased fertility.
Fertility and Infertility
Infertility is defined as an absence of achieving a pregnancy after 12 months of sexual intimacy without using any contraceptive methods. This medical condition affects 15% of couple during their reproductive age. Trying to conceive with an advanced reproductive age not only decreases 30 to 50% the chances of getting pregnant (fertility) but it also increases other medical risks during pregnancy, for example pre-eclampsia, gestational diabetes mellitus, chromosomal abnormalities of the fetus, stillbirth, among others.
Decreased fertility starts at age 30 for all women and is markedly decreased to less than 50% chance of achieving a pregnancy after age 40 adding also a 2 to 3 increase fold on having an spontaneous abortion or miscarriage. The quality of the ovum and the embryo formed after achieving a pregnancy is adversely affected by the women’s reproductive age ( when decrease fertility is encounter). On the contrary, the age of the male partner does not affect the sperm quality (male fertility) nor the capacity to fertilize the ovum. The growth of the embryo or chances of implantation into the uterus is not either affected by the reproductive age of the male partner. This is because the male partner is constantly producing new spermatozoids contrary to the female where she already has an established amount of ovums/eggs in her ovaries after birth. The ovums with the most reproductive capacity are those released early during a women’s reproductive age and those of lesser quality and fertility potential are those released during the last couple of years of the female reproductive cycle.
Reproductive options and Fertility
Most common alternatives for women with an advanced reproductive age (Decreased Fertility)are the following:
1) Ovarian hyper-stimulation with intrauterine insemination of spermatozoids: (Optimizing Fertility)
With this technique physicians stimulate the ovaries to produce more than one ovule per reproductive cycle thus increasing the fertility potential. Through artificial insemination physicians deposit a larger amount of spermatozoids close to the fallopian tubes , where fertilization occurs. By stimulating more than one ovum release per menstrual cycle the chances that one of better quality is ovulated increases, offering a better physiological environment for a pregnancy to occur and an increase in fertility rates. A note to remember is that the ovum’s of a patient with advanced reproductive age carries a higher risk of chromosomal abnormalities and increases the chances of having a fetus with a chromosomal disease.
2) In-vitro fertilization (IVF):
The ovaries are hyper stimulated and the fertilization occurs inside a laboratory ( ovums extracted before natural ovulation occurs ). Once a pre-embryo is formed, it then gets transferred to the uterus for implantation to occur. In those cases that a patient has poor quality ovums, there is the possibility of ovum donation from another patient or family member, thus increasing their fertility potential.
Our recommendation at Pink Women’s Center is to not delay pregnancy after 35 years or older due to decreased ovule quality and decrease fertility potential. Patients older than 35 year old with infertility concerns, who think they have decreased in their fertility potential because of existing medical conditons or who have more than 6 months trying to conceive or any other couple with more than a year being unable to conceive must seek professional help to improve their chances of achieving a pregnancy. At Pink Women’s Center we help patients achieve their reproductive goals and help co-manage patients with this condition. Fertility and infertility is a very popular topic now a days since women are waiting longer to conceive due to their professional lives or prior pregnancy history. A personal history of decreased fertility capabilities or infertility must raise a red flag in couples trying to conceive, as you should not wait after turning 35 y/o to find medical help.
Pink Women’s Center is a board certified OBGYN group in Katy Tx and west Houston Tx. We care for normal and high risk pregnancies, gynecologic and menopausal problems, including abnormal vaginal bleeding, abnormal pap smear, stress incontinence, osteoporosis, sexual dysfunction, endometriosis, fertility issues and much more. We are a certified menopause OBGYN group, the only one in Houston Texas.
Fertility and Infertility Joel Rivera MD
OBGYN Katy Texas Fertility Center
Joel Rivera on Google+!