Age Related Infertility: Women’s fertility gradually declines as they get older.

The decline in fertility with increasing age is a result of fewer eggs as well as the quality of their eggs. This decline in fertility starts gradually in the early thirties and more rapidly in the late thirties and early forties. It is rare for women in their mid to late forties to conceive naturally.

Some younger women see a decline in their fertility if they have medical conditions or treatments that may have affected their ovaries and the number and quality of their eggs. These conditions include a family history of early menopause, history of chemotherapy or radiation, surgical removal of an ovary or part of an ovary due to ovarian cysts or endometriosis, or heavy smoking.

There are a number of tests that your doctor can perform to see if you have had a decline in your fertility due to age or a medical condition. These include counting the number of small follicles seen in your ovaries with an ultrasound (antral follicle count). There are also several blood tests that are good indicators of your fertility. Follicle Stimulating hormone (FSH) goes up as your fertility declines. Antimullerian Hormone (AMH) goes down as your fertility declines.

If you are older it is more important to be seen earlier by a fertility specialist if you are having difficulty conceiving.

The American Society for Reproductive Medicine recommends that women older than age 35 should receive evaluation and treatment after 6 months of failure to conceive. There are effective treatments that can help women with age related infertility conceive. These treatments include ovulation induction medications to stimulate egg development with or without intrauterine (artificial insemination) or in vitro fertilization (IVF). For women who have a low chance of conceiving with their own eggs due to their age, they have very high pregnancy rates using eggs from a younger donor in a procedure called donor egg IVF.