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Fertility and your age

posted by bridgid | Fertility & preconception | 7 January 2019

If you’re older and trying to get pregnant, you probably have an encyclopedic knowledge of how your age might be working against you. You’ve heard it from doctors, watched ad campaigns about ‘not leaving it too late’, and probably read multiple magazine articles, blog posts and books about the subject.

Unfortunately, buying back your fertile years isn’t an option. But don’t throw in the towel – or the ovulation sticks – just yet, because there are a lot of things you can do to test your fertility and increase your chances, even if you’re pushing 40.

Does fertility decrease with age?

Short answer? Yes. But although fertility peaks around age 22 and gradually declines after that, there is hope for women trying to conceive in their 40s, says Amanda Haberecht, naturopath at Mygen Health and Darling Health in Sydney.

“There are actually no rules with regards to that decline – your hormones, family history and genetics all play a role in your chances,” she explains. “In your mid 30s and 40s, it can be a very different hormonal picture from one woman to the next. If there’s robust fertility in your family – either male or female – you can hope you have fertile genetics on your side.”

How to test how fertile you are

Twiddling your thumbs and hoping for the positive sign on the test is one thing, but knowledge is everything. And there are lots of ways to assess where you are in your ‘fertility lifeline’. By the time a woman is 36 her chances of conceiving naturally each month is only 15 percent. And at 45 there is only a 1 percent chance per month for conception. Men’s fertility will also decline but not as steeply as women’s, but there are tests you can do for both.

“A worthwhile measurement is the Anti-Mullerian (AMH) or ‘egg-timer’ test, which can help gauge where your fertility is sitting and whether you should be fast-tracking decisions to start a family,” says Haberecht.  “The AMH test however does not test egg quality, it just lets you know whether your egg reserve is starting to decline. After the age of 35 a woman’s fertility will start to decline more rapidly.”

Should older mums go straight to IVF?

While some couples want to take the time to try everything to get pregnant naturally, others prefer to take their chances with science from the get-go – and it’s a really personal decision, says Haberecht.

“It’s one that should be based on your sense of urgency and how many children you desire – but no matter what, it’s critical to find out what is going on healthwise for you and your partner. And, to review your health and lifestyle to improve your chances. Be aware, though, that statistics suggest a woman has better chances of conceiving naturally than via IVF after the age of 43.”

How do you investigate your fertility?

You’ll need an experienced practitioner for starters, to do the right tests – which can  determine whether there are any issues with you or your partner. This is important whether you’re trying naturally or having reproductive treatment like IUI, IVF or ICSI.

“Hormonal and nutritional imbalances can be easily treated when discovered and addressed early. The women I see in practice most commonly are between 35 and 45, and our focus with this age group is to investigate any hormonal issues or deficiencies and design treatment protocols around nutrition that will both improve genetic expression and increase the function of mitochondria, which are necessary for the development of the foetus,” she adds.

Haberecht’s practice offers comprehensive preconception testing to exclude any impediments to conception, checks hormones to confirm ovarian reserve and healthy ovulation. They also conduct nutritional tests to test levels of iodine and Vitamin D.

“And if you haven’t conceived after the first few months we do an ultrasound to exclude any abnormalities and to check if your tubes are clear,” she says. “With age or a history of hormonal imbalance or polycystic ovaries, ovulation may be a bit erratic and progesterone the hormone that is responsible for maintaining pregnancy can become compromised. Naturopathic medicine utilising both herbal or nutritional medicines can all play a powerful role in re–establishing a more regular ovulation pattern and improving the health of the eggs being released.”

Are you an older woman trying to get pregnant? What have you done to try and improve your chances?

Photo: Drew Hays

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