Age alters the chances of conceiving because our hormones and sexual structures change over time. This is true for both sexes, and for most women, there’s a gradual fall in their fertility from their late teens to about 32, as egg numbers fall. From about 35, the monthly decrease accelerates, which is why egg numbers are so important for older women. i
Less well-known is that male fertility falls predictably with age, although the changes tend to happen a bit later than for women. When men reach 40, their age is having a similar impact on fertility as reaching 35 has on women; for more on this, see eggs and age and age and male fertility.
Age is usually THE biggest fertility issue for couples who leave it later in life to start or extend a family, and many people simply underestimate when age becomes important or overestimate how effective IVF is. Surveys suggest that:
- 20% of women are unaware of how age affects fertility ii
- Most women overestimate when age affects their fertility by 10 years iii
This can be a big blow for anyone who had expected to have children in their 30s and 40s without any problems! Being older makes it harder to conceive and avoid miscarriage. Understanding the effect of age on fertility could help avoid the financial and emotional burdens that many couples experience with IVF.
Recommendations
The approach from most fertility experts is that women:
- Should be told how age affects fertility in their 20s and 30s as part of their primary “well-woman” care
- Should be told that fertility falls from their late 30s (except with egg donation)
- Over 35 should have a fertility “work-up” after 6 months of trying for a baby
- Over 35 (or younger women likely to have a low ovarian reserve) should consider ovarian reserve testing iv
Positive action
While we can’t get any younger, it’s possible to reduce the impact of ageing on the body. It’s also important to remember that the quality of eggs and sperm is more important than their quantity:
- Women usually ovulate one egg each cycle, which is the best quality egg each cycle
- Men usually make sperm until they’re really old, but sperm quality is falling in a man’s 20s
It’s possible for couples to improve the health of their eggs and sperm by optimising their health and wellbeing. This approach is different to IVF, which tries to retrieve as many eggs as possible from a single cycle. While IVF increases the number of mature eggs in a cycle, it doesn’t actually increase the number of eggs that were in the cycle or improve the quality of the eggs in it.
A baby comes from one egg being fertilized by a single sperm
- The quality of the egg and sperm determines the health of each pregnancy and baby
- Falls in fertility with age reflect a reduction in both the quality and number of eggs and sperm
- Quality is often confused with quantity as numbers are easier to monitor, and the assumption is they go together
- For older couples, the most successful approach focuses on egg and sperm quality (and the health of the ovaries and uterus) rather than chasing numbers
How to improve egg and sperm quality
The way to improve the fertility of older couples is to improve health generally, and we strongly recommend following the Morefertile Fertility Profile (PFP) advice. It’s also important to reduce eggs and sperm’s exposure to damaging substances. Women have all their eggs when they’re babies, and they are inactive and protected in the ovaries until puberty (eggs and follicles). After this, eggs in the recruitment process to ovulation are exposed to an environment that can damage them, and why only a small fraction of the eggs reach the last stage.
Egg numbers that reach the ovulation stage reduce as women age, partly due to accumulations of toxins, but our ability to cope with oxidative stress and repair damage also falls with age. However, changes to lifestyle and diet can reduce the damage to eggs and sperm, which varies from person to person, as the morefertile PFPs reveal.
Improve reproductive function
Improving the health of sex organs is possible with herbal combinations, and for women, research shows: v
- Lower follicle-stimulating hormone (FSH) levels each cycle
- Better the blood supply to the ovaries and uterus
- More eggs and follicles in cycles
- Healthier luteal phases
- Thicker womb linings
These changes fundamentally alter fertility levels and improve pregnancy rates for all ages. Herbs are also about 10x more effective than lifestyle changes at improving semen parameters for men.
