Key Takeaways

• Age is one of the largest factors affecting people’s ability to conceive, especially females.
• Women and those assigned female at birth begin to see a gradual decline in fertility in their early 30s, with a more pronounced drop-off starting shortly around age 37.
• Assisted reproductive treatments involving egg donation, embryo adoption, and gestational carriers provide alternative pathways for patients to become parents, especially when fertility is diminished.

Age and Fertility: What You Need to Know

As individuals enter their 30s and beyond, a common concern arises: When will my fertility potential begin to decline? 

Studies consistently reveal that older patients face more fertility challenges than their younger counterparts. In our society, where individuals often balance careers with family planning, deciding when to have a baby can be daunting. The ticking “biological clock” also adds pressure to this important decision.

Insights from ACOG

The American College of Obstetricians and Gynecologists (ACOG) reaffirmed its committee opinion on female age-related fertility in 2022. Here’s what we know:

• Age MattersFertility gradually decreases around age 32 and declines more rapidly after 37. Women over 35 should seek expedited fertility evaluation and treatment after six months of unsuccessful attempts to conceive. For those over 40, immediate evaluation and treatment are recommended.
• The Fertility CurveWhile there’s no single “fertility deadline,” data shows that pregnancy chances are linked to age. The decline is relatively modest until the early 30s. Why? Maternal age affects both egg quantity and quality.
• Understanding Ovarian ReserveAn evaluation by an infertility expert sheds light on your “ovarian reserve”—the number of available eggs each month. This assessment can also identify other non-age-related factors affecting fertility.

The Odds of Getting Pregnant by Age

Women are born with a fixed number of oocytes (commonly known as eggs). Unlike men, who continuously produce sperm, women do not generate additional oocytes throughout their lives. At birth, each female carries approximately six to eight million eggs. This initial abundance diminishes over time. Many oocytes are lost during childhood, and by the time of her first period, a woman typically retains only 300,000 to 500,000 eggs. As time passes, these precious cells become more susceptible to chromosomal abnormalities. These tiny DNA mistakes can impact their ability to fertilize and develop into healthy babies. Here’s what you need to know by decade:

• In Your 20sAt this stage, about 90% of your eggs are genetically normal. A healthy couple under 30 has an impressive 95% chance of getting pregnant within a year of unprotected sex. Barring specific health conditions, such as endometriosis or polycystic ovarian syndrome (PCOS), conceiving in your 20s is relatively straightforward.
• In Your 30sFertility begins to decline after 30. By age 35, your chances of pregnancy drop by about 3% each year. At 37, you’re left with just 25,000 eggs (a mere 2.5% of your initial count). The risks of miscarriage, complications, and genetic issues also increase.
• In Your 40sBy 40, your monthly pregnancy chances plummet from 25% to 10%. On average, the last successful pregnancy occurs around age 41.

Other Options: Egg Donation, Embryo Adoption, and Gestational Carriers

Thanks to huge advances in fertility treatment technology, other options exist even when ovarian reserve has diminished. 

Egg Donation

Since female fertility declines with age, egg donation becomes a valuable option. Women over 35 may have fewer high-quality eggs, but their uterus often remains capable of carrying a pregnancy. With Donor Egg IVF, a healthy young donor provides eggs, which are then fertilized with a partner’s sperm or a donor’s sperm. The embryos that result are transferred to the patient’s uterus, allowing her to experience pregnancy. 

While donor eggs are not genetically related to the birth mother, the very process of pregnancy allows for special bonding between the baby and mother. Additionally, emerging science shows that some programming of the baby’s genetic material (a phenomenon known as epigenetics) is influenced by the mother. So, the birth mother can play a role in the genetic development of a baby even when donor eggs are used. 

Embryo Adoption

Embryo adoption uses frozen embryos from other couples who have undergone IVF. These embryos are ready for transfer. For older women, this option provides a chance to carry a pregnancy without relying on their own eggs. It’s a way to create a family and give a loving home to embryos waiting for their chance to thrive.

Gestational Carrier / Surrogacy

When patients cannot carry a pregnancy due to medical reasons or age-related factors, the use of a Gestational Carrier or GC (also referred to as surrogacy) offers hope. A GC carries the pregnancy on behalf of the intended parents. The embryos can come from either the intended mother’s eggs or a donor’s eggs. GCs allows older women to experience the joy of parenthood while entrusting the physical aspect of pregnancy to a surrogate.

Age and Male Fertility

Men typically experience a more gradual decrease in sperm quality as they get older when compared to women. Typically, this decline doesn’t become problematic until a man reaches his 60s. Although the changes are less abrupt than those seen in women, men do undergo alterations in fertility and sexual function as they grow older. However, there’s no set age at which men cannot father a child. We often hear reports of celebrities who’ve been able to have children later in life, such as NBC’s story about actor Al Pacino fathering a child at age 83 (similar to actor Robert DeNiro at age 78.)

According to the American Society for Reproductive Medicine, as men age, their testes can become smaller and less firm, with sperm shape and motility declining. Additionally, there is a slightly elevated risk of genetic defects in their sperm. Some aging men may also develop medical conditions that impact their sexual and reproductive function. However, not all men go through major changes in fertility or sexual function as they get older, especially if they’re healthy and have stayed in good shape. If a man faces issues related to sex drive or erections, seeking treatment from a health care provider or urologist is advisable, as decreased libido could be linked to low testosterone levels.

Taking Control of Your Fertility Journey

Knowledge empowers you. If you’re considering family planning, reach out to our board-certified fertility specialists at San Diego Fertility Center. We’re here to guide you, answer your questions, and provide personalized care. Contact us at (858) 794-6363 to schedule an appointment.

Remember, your unique story deserves compassionate support. Let’s navigate this journey together.The information provided here is for educational purposes only. Consult with a healthcare professional for personalized advice.