Does Age Matter in Fertility and Pregnancy?

Menopause is a state when the ovaries stop producing eggs and reproductive hormones completely. Perimenopause is said to begin 13 years prior to the actual menopause due to the fluctuating reproductive hormones and occasional egg formation. So if the average age of menopause in India is 47years, perimenopause will start at 34-35 years for most women! Unfortunately, this is also the age where most of the urban girls are considering starting their families! Premature ovarian aging is, therefore, a cause for worry for the woman of this generation since she becomes biologically inadequate very early in life ! The cause of this early menopause is not known.

Is there a test for checking premature aging?

• There is no specific test for aging, however, a combination of tests can be used to determine how many eggs are there in a woman’s ovaries. While these tests may be useful for determining whether a woman can use her own eggs for achieving a pregnancy, they are not very reliable in predicting pregnancy.

What about fertility treatments?

• • There are several medical technologies that can help some women get pregnant even at an older age although they cannot make up for age-related fertility decline. These are called assisted reproductive technologies or ART. These technologies can be expensive and are not covered by insurances in India.
  • Controlled Ovarian hyperstimulation: Medication is used to stimulate the ovaries. This will make the body make more than one egg thus increasing chances of pregnancy
  • This is usually the first treatment that an infertile woman would try. However, the older a woman is, the lower her chance of pregnancy with this method. Older women, particularly those over 40, should consider IVF after one or two unsuccessful cycles of ovarian stimulation.
  • In vitro fertilization (IVF):
  • Multiple eggs are made by giving injectable medicines. Eggs are removed from the ovaries and are fertilized with the husband’s sperm in a laboratory. The resulting embryos are then transferred to the uterus, with the hope that one or two will implant.
  • IVF offers higher pregnancy and live birth rates than ovarian stimulation. However, like ovarian stimulation, the chances of success diminish with age.
  • Oocyte donation:
  • Eggs are provided by a female donor, usually in her early thirties or younger. Once her eggs have been fertilized in a laboratory, the embryos are transferred to the older woman’s uterus, with the hope that they will implant successfully.
  • Pregnancy rates with oocyte donation are significantly higher than those with ovarian stimulation or in vitro fertilization alone. For a woman without many eggs left, this may be the only effective treatment.

Can I do something to preserve my fertility?

• • Social egg freezing is becoming popular now. Women who are entering their 30’s and are single or wish to delay child bearing have the option of freezing their eggs or embryos as the case maybe. The pregnancy rates are comparable to fresh embryo transfers. This is better than oocyte donation since it gives a chance to have your own genetic child.

Age is an irreversible factor for declining fertility. Women must try to complete their families before it is too late.