Female Fertility: What’s age got to do with it?

Age is one of the most important factors that affect a woman’s ability to conceive and to successfully carry a pregnancy to term. In today’s modern world, many couples delay starting a family, often unaware that what is called ‘advanced maternal age’ is one of the common causes of fertility problems.

In this article, we look at how age affects fertility in women and what to do if you are having concerned about your fertility.

For diverse reasons, many women delay starting a family – perhaps due to their careers or other commitments or perhaps they were not ready to settle down or had not yet met a suitable partner.

However, as women age, they have fewer eggs and the percentage of those eggs that are genetically normal also decreases. As a result, many more women are struggling to fall pregnant due to what the medical profession calls ‘advanced maternal age’.

The age at which fertility begins to decline is sooner than most people realise: in fact, woman’s fertility begins to decline as soon as the age of 30! And after the age of 35, a woman’s fertility reduces rapidly.

In layman’s terms, this relationship between age and female fertility is often referred to as a “biological clock”, and you may have heard people say a woman’s “biological clock is ticking”, referring to the fact that the time period during which a woman is most fertile is drawing to a close. This is one of the most common fertility issues in today’s modern world.

Advanced maternal age not only makes it more difficult to conceive, but it also increases the risks of miscarriage and chromosomal abnormalities such as Down syndrome.

How age affects fertility

There are several changes that take place in a woman’s body as a natural part of aging that also affect fertility.

The most crucial in terms of fertility is the number and quality of eggs a woman produces each month, called her ovarian reserve.

A woman’s ovarian reserve decreases naturally and progressively from the time she is born until menopause, and the rate of the decrease is genetically predetermined.

At birth, all women have a finite number of eggs, usually as many as 1 million.

However, when puberty is reached at around the age of 12, this number is already reduced by half. Thereafter and until menopause, which is usually at age 51 or older, both the number and quality of the eggs in the ovaries continue to decline. This reduced ovarian reserve translates into lower reproductive potential and fertility challenges.

Of course, not all women are the same: some may experience a significant decline in the quantity and quality of their eggs after the age of 40, while for others it may happen even earlier.

Generally, however, fertility peaks in most women in their 20s. Before the age of 30, healthy women have a significantly larger number of eggs in their ovaries than older women, and a greater percentage of these eggs are genetically normal. This ensures both a particularly good chance of conceiving naturally and an improved possibility of a successful pregnancy. In fact, women in their 20’s usually have a 25% chance of pregnancy each month, and the chances of a genetic abnormality such as Down syndrome are about 1 in 1200. In a woman’s late 20s, this peak fertility begins to decline gradually.

In their early 30s, many women will experience a more marked decline in their fertility and the pregnancy rate per month will drop. The risk of miscarriage at 30 is about 20%, and the risk of genetic abnormalities is slightly higher than for women in their 20s.

However, after the age of 35, this decline occurs at a much more rapid pace. This is because a woman’s ovaries respond less well to the hormones responsible for ovulation as menopause comes closer. After the age of 35, the chances of conceiving drop to 18% per month. The pregnancy risk for women older than 35 is also much higher than for younger women, with an increase in the miscarriage rate and a higher rate of genetic abnormalities. After age 35, the chance of a miscarriage goes up to 25% and the risk of Downs syndrome increases to about 1 in 350.

After the age of 40, a woman’s ability to fall pregnant declines sharply because the number of genetically normal eggs in the ovaries are substantially reduced. The fertility rate per month is only about 5%, and even with IVF the pregnancy rate is only about 10%. At the same time, the pregnancy risk is again much higher, with women in their early 40s facing miscarriage rates at roughly 35% and the risk of Downs syndrome increases further to about 1/38.

After the age of 45, achieving a pregnancy naturally is very difficult, because the majority of a woman’s remaining eggs are genetically abnormal. In fact, women over 45 have a less than 1% chance of falling pregnant with their own eggs. In addition, these women face a pregnancy risk of 50% and higher, as well as an increased risk to their own health due to higher blood pressure, heart disease and diabetes. Furthermore, the incidence of a genetically abnormal pregnancy is 1 in 12.

Is it never too late

Usually, visiting a fertility specialist is advised for couples who have unsuccessfully tried to fall pregnant for more 12 months when the female partner is younger than 35. A consultation with a fertility specialist is also recommended if the female partner is older than 35 and the couple has unsuccessfully tried to fall pregnant for 6 months.

However, at Medfem Fertility Clinic we recommend that you don’t wait: speak to us without delay if you are concerned in any way about your fertility.

This is because while advanced maternal age is a common cause of infertility, it is still only one of the many possible causes of infertility among women. There are many other possible causes affecting a woman’s fertility, ranging from lifestyle to medical conditions such as endometriosis and Polycystic Ovarian Syndrome (PCOS). In addition, a couple’s infertility may also be affected by a problem with the male partner’s fertility.

Furthermore, there are also many treatments, options and solutions available to couples struggling with infertility, whether it is caused by advanced maternal age, or any other factors affecting one or both partners. You can read more about the options for treating infertility caused by advanced maternal age here: Advanced Maternal Age – What Are My Options?

However, the only way to know for certain what is causing infertility in a couple – and how it can be treated – is a consultation with a fertility specialist.

We invite you to meet one of our fertility specialists at Medfem Fertility Clinic, where we believe in helping you reach your family dream through:

* World-Class Fertility for Everyone – we believe in making world-class fertility treatments available for everyone
* A Positive Fertility Journey – It is our joy and commitment to give you a positive outcome to your fertility journey
* Delivered With Empathy & Caring – So you may have a fond memory, of a feeling of empathy, caring and being part of the Medfem family

Simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.

We look forward to meeting you at Medfem Fertility Clinic!



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