Age is the single most important factor affecting the woman’s fertility and her chances of having a child. We have to understand a fact that ovaries have a life span. Women are born with all the eggs they will ever have. At birth there are about one million eggs. By puberty that number will have dropped to about 300,000. Of the follicles remaining at puberty, only about 400 will be ovulated during the reproductive years. A woman’s best reproductive years are in her 20s. Fertility gradually begins to drop in the late 20s or early 30s and falls more rapidly after the age of 35. Each month that she tries, a healthy, fertile 30-year-old woman has a 20% chance of getting pregnant. By age 40, a woman’s chance is less than 5% per cycle, so fewer than 5 out of every 100 women are expected to be successful each month. In addition today’s modern world shows a fertility decline among women has increased because of multiple factors early menarche, their life style, pollution and exposure to many environmental toxins.
The age-related decline in female fertility happens because both the quality and the quantity of eggs gradually decline. A significant increase in the rates of aneuploidy and spontaneous abortion are seen in women with advanced age. The success rate of infertility treatment including IVF is also low for the same reason. As age increases, the risks of other disorders that may adversely affect fertility, such as fibroids, tubal disease, pelvic inflammatory disease, endometriosis and others also increases. A couple who fail to conceive after one year of regular unprotected intercourse (without contraception) are said to be infertile. If the woman is more than 35yrs, the time period is limited to 6 months.
The women are advised to utilize the right age (20s) for pregnancy to prevent difficulty in conception later. It is prudent for the young women or couple to consult their gynecologist for fertility screening tests before they plan contraception to postpone their pregnancy. Fertility screening involves semen analysis of the male partner, hormonal tests and ultrasound to check the ovarian reserve of the female partner. Ovarian reserve is the capacity of the ovary to provide egg cells that are capable of fertilization resulting in a healthy and successful pregnancy. There are multiple tests to know the ovarian reserve but the most reliable ones are Baseline antral follicle count, Anti mullerian hormone and Day 3 FSH.
Ageing is not in our hands but protecting our fertility is definitely in our hands. So girls be aware and utilize the time when it is best.
Dr. Mohamad Al Halabi
Obstetrics & Gynecology/ IVF Consultant
Bahrain Specialist Hospital (BSH)