Age, Does it have an impact on infertility?

There is a common question that crosses everyone's mind at some point sooner or later, which is whether age affects the fertility of both men and women? A person’s age, be it a male or female is indeed the single biggest factor that affects their chance to conceive, enabling them to deliver a healthy baby.

It is a fact that a woman’s fertility starts to decline gradually as she approaches her early 30s, thus becoming more prominent after age 35. Similarly, the risks associated with pregnancy complications increase with a woman's age.

However, in contrast to this, male fertility decline is rather subtle. A male’s age influences the chances of his female partner conceiving. When a man's age is over 45 years there is an increase in the risk of miscarriage. Studies also suggest that there is also high chance of the baby’s risk of developing mental health and developmental disorders.

In the current generation, more women are deciding to get pregnant and start a family life later in life. This means that the average age for the birth of a first baby happens only when the woman is about 28 years old. There are others, however, who choose to wait for a longer time, thus delivering their first baby well into their early or mid-30s. The birth rates for women conceiving and delivering in their 30s are increasing and are currently at an all-time high.

For couples struggling with infertility, considering IVF as an alternative reproductive procedure to overcome infertility is a good option. In-vitro fertilization (IVF) is defined as a medical procedure, where a woman’s egg is combined with a male’s sperm outside the body in a laboratory dish. This procedure results in the formation of an embryo. This embryo is then implanted into the woman’s uterus to facilitate pregnancy. The IVF procedure is carried out when natural conception has failed, and when a woman is having difficulty conceiving and pregnancy has not been possible.

One of the most frequently asked questions about the IVF procedure involves the age factor. It is therefore important to understand how this age factor can have an impact on IVF success.

On the birth of a female baby, she has a finite number of eggs that are present from birth. The egg quantity and quality however gradually decline with time. Unlike women, men continuously produce sperm throughout their lives.

A woman’s eggs age with her, with age becoming a vital factor affecting her fertility. While having good health and maintaining a healthy lifestyle thereby greatly improves her chance of getting pregnant and delivering a healthy baby, it doesn't override the effects of age on a woman's fertility.

When a woman is in her early to mid-20s, there is a 25%–30% chance of conceiving every month.

Fertility generally decreases as a woman’s age progresses and is more evident when a woman is in her early 30s, and beyond the age of 35. By the time she reaches age 40, the chance of getting pregnant in any monthly cycle is reduced to around 5%.

There is a common misconception that IVF treatment does not have an impact on age-related infertility. It has to be noted that a woman's age also affects the chance of success rate with IVF.

A woman’s risk of pregnancy complications does increase with age. A woman’s risk of miscarriage and chromosomal abnormalities in the fetus also increases from the age of 35. Most complications that have been noted among pregnant women are gestational diabetes and placenta previa, this condition occurs when the placenta covers all or part of the cervix, which causes the risk of the placenta detaching. Similarly, cesarean section and stillbirth are also common conditions that older women encounter more often when compared to younger women.

Other medical conditions that may affect a woman's fertility include endometriosis and polycystic ovary syndrome (PCOS).

Although people have understood and it has been stated that a woman's age can affect her ability to have children, recent research has shown that a male partner’s age can also impact the likelihood of pregnancy as well as determine how healthy the pregnancy is.

A man’s ability to help his female partner get pregnant decreases when he reaches around the age of 40 to 45 years as his sperm quality reduces. As a man’s age progresses and he gets older, it makes it harder for a couple to get pregnant as it takes longer for them to have a baby in comparison to a younger couple. In cases where the paternal age is higher, there is also an increased risk of miscarriage and fetal death.

Babies who are born to older fathers are at an increased risk of mental health issues and are over five times more likely to develop an autism spectrum disorder than children of fathers aged 30 years or less. It is also stated that they are at a slightly increased risk of developing schizophrenia and other mental health disorders later on in life.

To conclude, although success rates in pregnancy reduce after the age of 35, advanced ART options such as preimplantation genetic screening (PGS), a test which is a lab procedure conducted by IVF specialists check only for those embryos that are free of any genetic abnormalities. Such embryos will only be implanted in the uterus. Similarly, Pre-implantation genetic diagnosis (PGD) is a screening performed to detect genes linked to specific diseases.

Not all couples undergoing IVF would need to undertake both PGS and PGD tests. The eligibility for the test depends on several factors, such as whether or not they have had earlier unsuccessful IVF cycles, history of any past miscarriages, past and present medical history, a family history of genetic abnormalities or diseases, etc.

Thus PGD screening is done in IVF procedure to reduce the risk of passing on inherited conditions thereby increasing the chances for a successful pregnancy.