Advanced Age and Infertility
Age plays an important role in a woman's ability to become pregnant and carry a pregnancy to term.
With advancing age, many biological changes take place that work against conceiving and carrying the pregnancy to term. From age 30 to 35, there is a gradual decline in the ability of women to become pregnant; after age 40, there is a sharp decline. Also, the chance of miscarriage and chromosomal abnormalities, such as those that cause Down's Syndrome, increase with age. Even the success of in vitro fertilization and other similar procedures decreases with advancing age.
Why does age play such an important role in fertility? One reason is that as women age, they are less likely to ovulate regularly. In addition, they are more likely to have medical problems that can cause infertility, such as endometriosis. However, the more important reason relates to the condition and decreasing number of the woman's eggs. As the eggs age, they become more resistant to fertilization. Also, more of the eggs tend to have chromosomal abnormalities - oftentimes, this may result in miscarriage.
Diagnostic tests for advanced age infertility
Your evaluation is likely to begin with your medical history and a pelvic exam. However, other tests are needed to determine whether your age is affecting your fertility. You may need one or more of the following tests:
- Follicle stimulating hormone (FSH) - a blood test that measures the amount of FSH in your blood; a high level of FSH in your blood in the beginning of your cycle may mean that your infertility is age related.
- Estradiol - a blood test that measures the amount of estradiol (estrogen) in your blood; a high level in the beginning of your cycle may mean that your infertility is age related.
- Clomiphene Citrate Challenge Test - can be used to check ovarian function. An FSH blood test is taken on day 3 of the cycle. Clomiphene Citrate is then given days 5-9 of the cycle. Another FSH level is obtained on day 10. If it is significantly elevated, this may indicate problems with ovarian function.