Age and Infertility

Most people are aware that increasing age in women leads to a decline in fertility. In fact, the relationship between age and fertility decline occurs fairly suddenly after a woman turns 37 and continues declining up through menopause. In almost any arena in which age is evaluated, advancing age leads to a decline in either fertility treatment success or ultimate pregnancy outcome. Not only does fertility decline with advancing maternal age, but miscarriage rates and risk of chromosomal abnormalities increases.

Once a pregnancy has successfully entered the second trimester, it does not appear that other pregnancy risks are increased. One test that can offer some insight into this aging process is the day 3 FSH. FSH is the pituitary hormone which is primarily responsible for folliculogenesis. As such, an increasing day 3 FSH reflects ovarian resistance to ovulation. In some studies, the day 3 FSH has been shown to be a better predictor of pregnancy success than chronologic age. A day 3 FSH greater than 15 mIU/ml places the woman in a relatively poor prognostic category, whereas a day 3 FSH less than 10 mIU/ml places the woman in a good prognostic category. Those women who fall between 10 and 15 mIU/ml find themselves in the "gray zone." It must be emphasized that the day 3 FSH value varies from cycle to cycle and that a single isolated elevated day 3 FSH is not the "final nail in the coffin" for a woman considering pregnancy. More on Age and Infertility ...