Age-Related Infertility at Fertility Institute of Texas
Age-related infertility has become more common in this country as more couples wait longer to start a family. One of the first questions asked in a female fertility consultation with Dr. Susan Hudson is the effect of maternal age. Evaluation protocols can vary based on age and health history, but for most women in their 30s and 40s, Dr. Hudson will order tests to assess egg quality and ovarian reserve.
What is ovarian reserve?
Simply put, ovarian reserve is the egg supply. A woman is born with a finite number of eggs -oocytes—generally about 1 million. By the time she reaches puberty, this number declines to 300,000. Each month, hormonal signals cause one or more follicles to grow, mature and release an egg from the ovary into the fallopian tube. Pregnancy results when a single sperm fertilizes that egg. Of the 1 million eggs she is born with, a woman will ovulate about 450 of those during her reproductive years.
As a woman ages, her egg supply dwindles each month in a process called atresia, and the remaining eggs are more likely to have chromosomal abnormalities. This means that getting pregnant becomes more difficult with age, and the chances for miscarriage increase.
A woman’s fertility window
Dr. Hudson prefers to break down female fertility by decade to demonstrate the impact that age can have on fertility. American Society for Reproductive Medicine (ASRM) statistics state the following chances for getting pregnant, when no infertility factors exist:
- In her 20s: A woman’s prime time for getting pregnant
- In her 30s: 20 percent chance of getting pregnant each month
- In her 40s: Less than a 5 percent chance of getting pregnant each month
- Read more about age and fertility here:
Testing for ovarian reserve
At Fertility Institute of Texas, we evaluate ovarian reserve through blood testing and ultrasound. Dr. Hudson is looking for three indicators of reproductive health:
- A follicle-stimulating hormone -FSH- level in the normal range, usually less than 10 mIU/mL
- Anti-mullerian hormone -AMH- above a certain level, 1ng/mL
- Antral follicle count -AFC- greater than 10 follicles
Dr. Hudson will also perform a vaginal ultrasound to assess the number of follicles -antral follicle count- that develop in the course of a normal menstrual cycle, and to check for fibroids, polyps and other physical abnormalities.
Fertility treatment options for women of advanced maternal age that are experiencing infertility include:
- Ovulation induction and intrauterine insemination – IUI
- In vitro fertilization – IVF
- Preimplantation genetic diagnosis
- Donor egg IVF
- Blood testing and preconception genetic testing
Male age and infertility
Sperm production continues throughout a man’s lifetime, and men generally don’t see a decline in their ability to reproduce until age 50. However, certain health factors can worsen over time and affect sperm health. A semen analysis can confirm the existence of male infertility.
Knowing the facts about age and infertility can help you make decisions about when to start trying to get pregnant, and how quickly to seek treatment. Contact Fertility Institute of Texas to schedule a consultation with Dr. Hudson today.
New Braunfels 830.608.8004