One of the questions I hear every day in my clinical practice is, ‘how much will my age affect my chances of conceiving?’.
And it’s understandable given the huge focus placed on this topic by the media and many fertility clinics.
The problem with making sweeping statements about a woman’s ability to conceive once she is past a certain age, is that it takes no account of her individual situation. We know from the medical literature that a person’s chronological age may have little bearing on his or her biological age. In other words, you might be a 40-year-old woman, but you could have the organ and hormone function of a woman ten years younger.
What does it mean exactly, when we talk about age affecting a woman’s fertility?
The egg follicles are with us since birth and the many thousands of egg follicles we start out with slowly decline in quantity over the course of adolescence and throughout our 20s and beyond. The reason age affects female fertility is that with the passage of time, the egg follicles are exposed to free radical damage, which can alter how the genetic material within the egg is expressed during conception. This means that rates of miscarriage or failed conception tend to increase as we get older. The good news is that the egg follicles go through a maturation phase in preparation for ovulation that lasts approximately 90-120 days, which means there is a decent window of opportunity to influence the quality of your eggs.
‘A healthy body, is a fertile body’
Whether or not you are able to conceive during your reproductive years (between 25-45 years old) hugely depends on your overall health and that of your partner.
I recall one patient who had been trying to conceive for most of her late 20s and early 30s with no success. At that time she was working flat out in a very stressful job, was about two stone overweight and was the first to admit that her diet and lifestyle was far from healthy. She came to me first, aged 36 and was convinced that IVF would solve the problem.
I explained that the odds of success with IVF are greatly diminished when a woman is overweight and has secondary health problems, which were evident in her case. We decided on an acceptable time-line of six months to prepare for IVF, by improving her diet and lifestyle with the aim of losing weight and reducing her health symptoms. Just four months into the new regime, having lost at least a stone in weight and feeling in much better health she conceived naturally and is now the proud mum of a baby boy.
I appreciate that this story won’t reflect every woman’s situation. Nor should it. Every case is unique and should be treated as such. You might be trying to conceive your second or third baby and are finding it trickier this time around, or you might have found your partner later in life, so this is the first time you have ever thought about having a baby.
Whatever your situation, make sure you are receiving the appropriate care for your particular needs.
Here are some of the factors to be aware of:
1) Are your ovaries functioning properly?
Are you ovulating each month and are your ovaries responding properly to hormonal messages? This may be checked via ultrasound scanning and testing your hormone levels via blood samples.
2) Ovarian reserve
This is a somewhat controversial area given the AMH test has been discredited in a number of countries because of its unreliable results. I have seen this problem with AMH reliability with my own patients – women are told they had a low AMH (five or less) and yet when re-tested the AMH had ‘miraculously’ increased. As a result, I always advise women to view their AMH results in the context of the overall health picture to ensure a more informed decision may be made about what the next steps should be on the journey to conception.
3) Are your tubes and uterus healthy?
If there is a blockage in your fallopian tubes this would make natural conception very difficult. If you have any scarring due to infection or endometriosis in or around the womb, that could greatly impede your chances of pregnancy. A HSG test would usually be recommended to check that the uterus and fallopian tubes are in good health.
4) Secondary health issues
If you have been dealing with menstrual problems for a while or have a chronic health condition, make sure to address these complaints before trying to conceive as it could greatly impact your chances of success.
5) Don’t forget your partner
Older women trying to conceive tend to have partners who are the same age as them, if not a few years older than they are. Men are also vulnerable to the passing of time and the sperm are especially vulnerable to damage because they are made on a daily basis. It would be wise to insist on a DNA fragmentation, as well as semen analysis, so you can get the full picture of your partner’s sperm quality before trying to conceive. This advice would especially apply if you have been trying to conceive for a long time or have experienced recurrent miscarriage.
If you want to improve your diet to support the development of the egg follicles prior to conception then you may wish to check out my piece on fertility diet here. I’ve also written a detailed article on what to consider if you have experienced recurrent miscarriage, which is a common problem for women trying to conceive over 35.
With almost a decade of experience in the field, Jessica Bourke has gained a reputation for helping women conceive where everything else has failed. For more from Jessica, visit jessicabourke.com.
