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What to Know About Infertility & Risks at Every Decade

older couple looking at sonogram of their baby

No matter the patient’s age, they are not alone if they’re having difficulty getting pregnant. Although it’s true that as the patient ages their likelihood of having a healthy pregnancy decreases, it is still possible for older moms to conceive. In this blog post, we will be examining infertility at every decade, including the risks to the patient and their baby, as well as ways they can boost their fertility.

Many women are far too familiar with what it’s like to hear that their biological clock is ticking away. Knowing there is a time limit on fertility may be stressful, but knowledge is power when it comes to health care. We’ll look at the advantages and disadvantages of patients attempting to get pregnant in their 20s, 30s, and 40s.

Chances of Getting Pregnant

In their 20s – This is the best time for patients, biologically, to conceive. In fact, the odds that a woman in her 20s who is trying to conceive will get pregnant each month are around 20 – 25%, which is the highest they’ll ever be. However, this doesn’t mean that young women in their 20s can’t face fertility complications. While women in this age group generally have good ovum quality, all the other factors that can cause infertility can nevertheless occur.

In their 30s – On average, a woman in her 30s has a 15 – 20% chance of getting pregnant each month they try to conceive. However, it’s important to remember that fertility gradually declines throughout the decade, particularly after age 35.

In their 40s – By age 40, a woman’s odds of getting pregnant is less than 5% for each month she attempts to conceive. For women ages 45 – 49, those odds can dip to as low as 1%.

Patient Health

In their 20s – From a biological perspective, there are a multitude of benefits for patients who are beginning their family in their 20s. They have a higher chance of getting pregnant, and there is a lower risk of complications for both mother and child. It’s also typical that women in their 20s can handle the physical demands of pregnancy and child-rearing, compared to their older counterparts. Additionally, for patients who want a large family, this gives them more time to plan and spread out their pregnancies. This is important to consider, especially because many experts recommend that women wait at least 18 months before attempting to conceive again. Patients who want to give birth to a lot of children should talk to their doctor to find out what will work best for them and their bodies.

In their 30s – Patients who are trying to conceive in their 30s still have the stamina to handle the physical demands of pregnancy and child-rearing. Additionally, women in this age group tend to be more financially and emotionally stable compared to their younger counterparts. A mother in her 30s is likely to have a strong sense of self and a strong support system of other moms with children the same age. Although the likelihood of a healthy pregnancy declines in the 30s, they are not yet in the high-risk zone for pregnancy, particularly if they are in their early 30s.

In their 40s – Many women who are trying to conceive in their 40s feel very emotionally and financially prepared to be a mother, even though they are aware that their chances are much lower when it comes to conceiving and sustaining a healthy pregnancy. Lots of patients in this situation are hopeful but accepting of the fact that the odds aren’t often in their favor.

Risks to the Patient

In their 20s – The risk of developing preeclampsia, a pregnancy complication where the patient develops high blood pressure, swelling of the hands/feet, and protein in her urine, is highest among first-time mothers, and most pregnant women in their 20s are first-time mothers. Preeclampsia is usually manageable, nevertheless, in rare cases, it can lead to serious complications for both the expecting mother and her unborn child.

There can also be an emotional strain on young mothers, particularly if when becoming a mother she had to sacrifice her professional goals. Many young mothers feel like they are choosing motherhood over their hopes and dreams for their own life. Some young mothers will even feel like they rushed into their marriage or starting a family and this can lead to them having regrets later in life. 

Additionally, some young mothers aren’t financially stable, and adding a child into a low-income family can be very stressful for the young parents.

In their 30s – According to the American Society for Reproductive Medicine, as a woman reaches her mid-to-late 30s, she’s less likely to conceive and more like to have a miscarriage because the quantity, as well as the quality of her ovum, are decreasing.

Women in this age group are likely to be the most anxious when it comes to conceiving, particularly if they are trying to conceive their first child because many feel the pressure of their biological clock ticking and they don’t want to miss their opportunity to experience pregnancy and motherhood. 

In their 40s – All of the risks associated with pregnancy (including hypertension, miscarriage, gestational diabetes, delivery complications, the need for a Cesarean, prolonged labor, and the baby developing a genetic disorder) increases as the patient ages. This is because, in a woman’s 40s, the quality and quantity of her ovum (the key to fertility) are both rapidly declining. 

Risks to the Baby

In their 20s – All pregnancies entail risks, but many of these risks increase as the patient ages. According to the American Pregnancy Association, at the age of 20, the patient’s risk of having a child with down syndrome is 1/1600 and the risk of any chromosomal irregularity is 1/576. For patients who are age 25, the chance of having a baby with down syndrome is 1/1300, and the risk of any chromosomal irregularity is 1/476. However, it’s important to keep in mind that these are the chances at birth and the overwhelming majority of pregnancies with chromosomal abnormalities, regardless of the patient’s age, generally result in miscarriage during the first trimester

In their 30s – For patients in their 30s, the risk of having a baby with down syndrome is 1/1000 and the risk of any chromosomal abnormality is 1/384. For expecting mothers who are 35, the risk of having a baby with down syndrome is 1/365 and the risk of any chromosomal abnormality is 1/197.

In their 40s – The risk of having a child with down syndrome is 1/90 and the risk of any chromosomal abnormality is 1/66 if the mother is 40. If the mother is 45, the risk of down syndrome is 1/30, and the risk of any chromosomal abnormality is 1/21.

Ways to Boost Fertility

In their 20s – Younger patients may still be carrying some harmful habits which can sabotage their fertility from their days in high school and college. For instance, many women in their 20’s consume a lot of junk food and alcohol. Thankfully, patients in their 20s can still optimize their chances of getting pregnant by being proactive and aware of what factors can negatively impact their fertility. In particular, weight plays a significant role in fertility but many women in their 20s are either underweight or overweight. In addition to maintaining a healthy BMI, patients wanting to get pregnant should also eat a nutrient-dense diet, avoid tobacco/nicotine products and limit their alcohol as well as their caffeine intake. These lifestyle choices will not only help patients conceive easier, but it can also help them have a healthy pregnancy and bring their child into a healthy home.

In their 30s – Patients trying to conceive in their 30s should also try to maintain a healthy BMI, follow a preconception plan and consider the birth control they’ve been taking. For some patients who have been on hormonal birth control for a number of years, their bodies need time to re-establish a normal ovulation cycle. However, this isn’t the case for all women and the majority of women who stop taking birth control are able to conceive right away.

In their 40s – Patients trying to conceive in their 40s should adopt the same healthy lifestyle adjustments that we suggested for women in their 20s and 30s. Some experts have also recommended stress reduction techniques (like meditation, exercise, acupuncture or yoga) and having a proper sleep schedule. We suggest patients in this situation talk to their doctor about what would work best for them.

When to Seek Help

In their 20s – Typically, patients in their 20s are advised to seek help from a fertility specialist after they’ve been unsuccessfully trying to conceive for a year. However, some experts have suggested that patients should see a doctor after as little as six months of unsuccessfully trying to get pregnant or even sooner if they suspect something is abnormal, like if they have irregular periods. In fact, even if you’re not trying to get pregnant, patients who aren’t having a period or are having a cycle that lasts longer than 35 days should also seek immediate medical help. Patients should also let their doctor know if they have a family history of early menopause, pelvic abnormalities, sexual dysfunction, or any other medical conditions that have the potential to impact fertility. The patient’s partner should also be evaluated for fertility issues, like low sperm count, if the couple has been trying to conceive unsuccessfully for six months to a year. 

In their 30s – Patients in their early 30s should seek professional help after unsuccessfully trying to conceive for six months to a year and those in their mid to late 30s should absolutely pursue help after six months. If a patient has any of the risk factors mentioned above for women in their 20s, they should talk to their primary care physician about potentially talking to a specialist sooner.

In their 40s – Experts disagree on when patients in their 40s who are trying to conceive should seek help from a fertility specialist, some say three and others say six. However, there’s nothing wrong with being preemptive and for patients in their 40s trying to conceive, time is extremely precious. It’s perfectly okay for patients in this scenario to go in for basic testing even prior to trying. 

Treatment Options

In their 20s – It’s important to note that the treatment methods don’t differ significantly based on age, they just differ in their efficacy. For example, in vitro fertilization (IVF) is the most effective treatment for the majority of patients facing infertility. According to the American Pregnancy Association, the success rate of IVF is 41 – 43% for women under 35 and this falls to 13 – 18% for women over 40. However, there are outside factors like the patient’s medical history and her partner’s sperm count that impact the effectiveness of IVF.

Don’t undervalue the male partner’s role in conception. Nearly 1 out of 7 couples are infertile, this means they have been unable to conceive even though they’ve had frequent and unprotected sex for at least a year. In up to half of these infertile couples, male infertility plays a role at least in part.

In their 30s – A patient trying to conceive in her 30s has the same choices as patients in their 20s. However, the recommended approach can vary by diagnosis, the age of the patient, and other factors. For patients in their 30s, it’s better to seek infertility treatment sooner rather than later, particularly if they want to use their own eggs to get pregnant. As the patient ages, the window of opportunity for fertility is shrinking and time becomes an increasingly valuable commodity.

In their 40s – Patients in their 40s have the same treatment options as younger patients, however, their chances of success are drastically lower compared to their younger counterparts. For example, by age 44 a patient’s odds of getting pregnant via IVF is less than 10%. However, keep in mind that while it’s still true to say that fertility declines with age, it’s more Although it is true that fertility declines with age, it is more precise to say that fertility declines with the aging of a woman’s eggs. Women in this age group may want or need, to consider egg donation as a potential way to conceive. The chances of getting pregnant are based on the age of the eggs, not the age of the patient so using younger eggs from a donor greatly increases the patient’s chances of getting pregnant.

There are so many potential barriers to conception, including the patient’s age and medical conditions like PCOS, endometriosis, and more. If you want a specialist to evaluate your potential barriers to conception, schedule an appointment with Dr. Gregory Davis, a leading women’s health specialist at Mangrove Women’s Health in Chico, California. We offer specialty gynecology services and can provide a referral to a fertility specialist if needed. Our office can be reached at (530) 345-0064, Ext 281.

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