How age affects fertility

When you age, your chances of getting pregnant decline, while the chances of having a miscarriage and pregnancy complications increase. This decline is usually due to various reasons including egg quality, implantation issues, and an increased risk of miscarriage. This process begins earlier than most suspect—between 30-35 years of age. Older and bad-quality eggs make getting pregnant more difficult and can increase the risk of a miscarriage. Getting pregnant by using reproductive technology and IVF, or with an egg donor can increase your chances of having a baby, however, this process also becomes more pronounced as a woman reaches 35 years of age. If you are over 35, seek an infertility workup after 6 months of trying to get pregnant or earlier if there are known medical issues.

What’s your peak reproductive stage?

From ages 20 to approximately 35, you’re in your peak reproductive stage. This means you are at your most fertile during this time period. Key reproductive hormones (such as follicle-stimulating hormone (FSH) and estrogen tend to be within the normal range. Plus, menstrual cycles have locked into a regular pattern and that makes getting pregnant easier. 

Fertility testing

Fertility testing can help you identify if there is a problem keeping you from getting pregnant. The basic fertility tests include:

• History and physical examination for him and her
• Diminished ovarian reserve testing (anti-mullerian hormone and/or inhibin-B; follicle-stimulating hormone, FSH)
• Progesterone (ovulatory dysfunction testing)
• Thyroid function (problems with the thyroid may cause infertility)
• Prolactin levels (high levels can disrupt ovulation)
• Ultrasound for count of antral follicles
• Tubal factor and uterine factors (uterine sonography; sonohysterography; hysteroscopy; hysterosalpingo-contrast sonography, (hysterosalpingogram)
• Semen analysis

How common is infertility, and how is it diagnosed?

Many couples have trouble getting pregnant and are considered infertile. Many more are subfertile and take longer to get pregnant. The causes of fertility issues are about equally divided between men and women. Many couples don't know whether they are fertile, infertile, or subfertile, or if their difficulty in getting pregnant can be easily treated. There are medical treatments, lifestyle changes, nutritional improvements and other changes that can improve fertility. Getting the right tests, such as a sperm analysis or ovarian reserve testing, can help pinpoint specific problems that can be addressed. 

Primary causes of infertility

While the causes of infertility are varied from couple to couple, there are a few main causes affecting both men and women. 

Ovulation issues: If you don't ovulate, you can't get pregnant. Anovulation is the term for not ovulating, and the main causes women do not ovulate are polycystic ovarian syndrome (PCOS), poor egg quality, and advanced maternal age.

Poor quality or quantity of sperm: Male infertility contributes to about half of all infertility. In fact, twenty-five percent of infertility is caused by a lack of sperm, decreased motility (movement), or abnormal morphology (shape).

Fallopian tube dysfunction: Fallopian tubes need to be open to allow the egg to easily move throughout. The most common causes of fallopian tube dysfunction are endometriosis, adhesions, and infections.

Timing sex can improve your chances of getting pregnant

Tracking your menstrual cycle and period helps to identify when you ovulate, which will help you determine your fertile window. This is vital for knowing exactly how to time sex for your most fertile days. Each month, you have 5-6 fertile days: the 4-5 fertile days before ovulation and the day of ovulation.

Want more personalized fertility and pregnancy guidance? Our new app Obie takes the guesswork out of getting pregnant. Download the app.

About our online female fertility test

Dr. Amos Grunebaum developed this online female fertility test as a first step to help you quickly find out if you may have fertility problems. It takes less than 3 minutes to complete, it's private, and it's free! Once you get your personalized report, you can make an action plan based on our recommendations. Then take our male fertility test to find out if your partner has fertility problems.