US women need to be better educated on age of fertility decline

A survey conducted in the US has found that nearly 40 per cent of women over 35 who didn’t get pregnant at a younger age would have tried sooner had they known about age-related fertility decline

Based on the results of the research, conducted by the Harris Poll on behalf of the American Osteopathic Association, Americans appeared overly optimistic about their fertility.

“Conversations about family planning should shift from birth control to pregnancy planning around age 32,” says Ellen Wood, DO, a Florida-based fertility specialist. “Thirty-five is not the new 25 when it comes to fertility.”

According to fertility specialists, egg quality starts to decline at age 32 and decreases rapidly after 37. Advanced maternal age also heightens the risk of birth defects. Only 28 per cent of women, and 35 per cent of men, believe age is the number one contributor to female infertility, the AOA survey found.

With women in their early 30s now having more babies than younger moms, osteopathic OB/GYNs hope to promote better education before patients reach their mid-30s. Postponing pregnancy attempts until after 35 will, for many women, limit the ability to birth a healthy child.

“Men are not immune,” says Dr Wood. Western nations are witnessing an unprecedented fall in sperm count that is not disputed, but has not been explained.

Options

In vitro fertilization or IVF, typically the final treatment for infertility, is considered the most effective method of assisted fertility. For women age 38 to 40 using their own egg, IVF results in approximately a 40 percent chance of eventually birthing a healthy baby, according to the Society for Assisted Reproductive Technology. The success rate drops to about 23 percent after age 41.

Freezing eggs and potentially sperm at a young age greatly improves the chance of a healthy pregnancy later in life, but can be prohibitively expensive. The time, cost—typically between $5,000 and $50,000 depending on insurance and number of attempts—and emotional toll can be extensive.

“While IVF can create miracles, for many it’s also an emotional rollercoaster and brings significant debt,” says Dr Wood. “It’s why so many of my patients who require IVF because of maternal age wish they had better understood the risks.”

In many cases the cause remains unexplained, even when a patient is successful

“The advances in fertility techniques and technology are incredible,” says Dr Wood, “But the most simple and effective tool we have as OB/GYNs is to communicate with our patients about the testing and preservation options available, which can have has the greatest impact on family planning success.”

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