If we had to pin fertility on just one factor, the most important would be age. The older you are, male or female, the more likely you and your partner are to have problems conceiving and carrying a pregnancy.
That’s true for conceiving naturally, and it’s true for conceiving with technology. As a society, our view of IVF and other high-tech fertility interventions as one giant Plan B is deeply flawed.
And so we’ve put age at the top of this list of lifestyle factors that influence fertility. Age might seem like a fertility factor you have no control over, at least if you are already in your 30s. But you can control a number of other factors that offset the effects of aging.
Speaking strictly from the “how easy or hard it will be to get pregnant” point of view, the best advice is to have children sooner rather than later (though of course that isn’t always feasible, for so many reasons). As men and women get older, both sperm and eggs decline in quantity and quality, which leads to higher rates of birth defects, miscarriages, and pregnancy risks.
The older you get, the more the lifestyle choices matter. The strategies laid out in the Making Babies program will benefit everyone, in a variety of ways, but several will specifically combat the effects of aging on fertility. When you’re 23, it will probably be a simple enough thing to get pregnant even if you party every weekend and don’t eat right or get any exercise. When you’re 38, it’s quite a different story.
Peak reproductive capacity is a benefit of youth. But peak reproductive capacity is not necessary for conceiving and bearing a child. Women under age 25 have a 96 percent chance of conceiving within a year. That figure drops to 86 percent between ages 25 and 34. The odds decrease again for women at age 35, with further drop-offs at 38 and again at about 42. However, if you group all women ages 35 to 44, statistically about 78 percent of them will be able to get pregnant within a year (weighted more toward 35 than 44, of course).
But age alone cannot account for the dramatic increases in infertility rates over the past several decades. Other aspects of people’s lifestyles and environments are contributing to this finding, and these need to be addressed. Our society often assumes that infertility is increasing because so many people are choosing to become parents at ever older ages, but research shows that this development is not sufficient to explain the fertility changes we’re seeing—and the way we’re seeing them. Even within specific age groups, the number of couples facing infertility has been increasing for years. In fact, the biggest increases in rates of infertility have occurred in the youngest women.
When age is the problem, it’s not just the woman’s age that matters. It is true that women age 35 and older do have a harder time getting pregnant (and have higher-risk pregnancies). According to figures from the American Society for Reproductive Medicine (ASRM), a woman’s chances of getting pregnant in any given cycle are 20 percent for women under 30 but just 5 percent for women over 40. Pregnancy rates fall and miscarriage rates rise with a woman’s age. The same is true for couples with a man age 40 or older, even if his partner is younger than 35. A couple in which the man is five or more years older than his partner, no matter what her age, can have a harder time, too.
A new study from France confirms this. It is the first large-scale study (more than 12,000 couples) to quantify the effects of age on a man’s fertility. In the study, pregnancy rates fell by 10 percent by the time the male partner hit 35 and by 20 percent after age 45, no matter the age of the woman. Furthermore, the study found that beginning when men were in their mid-30s, miscarriage rates started to rise, enough to double by age 45, at which point about one in three couples with men age 45 or older had a pregnancy ending in miscarriage, regardless of the women’s age.
What You Can Do About It
Men and women can combat the effects of aging on fertility by paying attention to the remaining lifestyle choices, upcoming recommendations about nutrition and supplements, and specific self-help, medical, and Chinese medical treatments later in the book. These will help to improve the development of follicles, blood flow to the ovaries, and sperm count and quality and help to manage hormonal fluctuations, no matter what a couple’s ages.
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