As female patients age, their ability to produce healthy eggs declines. If you are over 35 years old, we recommended undergoing testing to determine the state of your ovarian reserve. You can expect state-of-the-art care at Reproductive Medicine Institute.
Many women come to us with this question and ask us is there anything they can do to extend the life of their eggs. In general, for women, age is the most critical factor that reflects on the egg supply and the egg quality. For some reason, we don't fully understand it, women release the best eggs younger in life. And when time goes by and women get older than 30 and older than 35 and older than 40, the egg supply goes down and the proportion of abnormal eggs goes up. Age is the most critical factor to reflect on the egg supply and egg quality. Having said that, for each particular patient, we usually have a set of tests that can tell us specifically what the situation is. Usually, what we would do is a pelvic ultrasound, where we look at the ovaries and count the antral follicles in the ovaries. In general, the higher the number of antral follicles, the better the egg supply, and usually the proportion of the good quality eggs might be higher. Having said that, age is the most critical factor to reflect on the quality of the eggs. The other test we usually do, we look at some specific hormones. We look at the hormone called AMH, anti-Müllerian hormone, which is produced by the small preantral follicles. In general, the higher is the level of this hormone, the better is the egg supply. The other hormones that we sometimes consider are also FSH and estradiol. If the FSH level becomes high, that is a concern where we might be worried about abnormal egg supply or higher percentage of abnormal eggs. In general, there are some women that might be able to conceive naturally at 45, 48 and even 50, but that's kind of like winning the lottery. The chances for that are probably one in a million, so you can't quite count on that. For most women, the chances to get pregnant go down after 35, more significantly after 38 and after 40. Most women have trouble conceiving, because of the abnormal egg quality, after 43 years old. Well, in general, infertility is defined as inability to conceive for 12 months for women that are younger than 35 and the inability to conceive for 6 months for women that are older than 35. Having said that, if we know that there is a specific issue with this particular woman or in the family, women might seek help sooner. For example, if you have uterine fibroids or you have family history of early menopause or you have irregular menstrual cycles, you might want to approach your physician sooner. Well, in general, until about 10 years ago, we didn't have any options. Lately, with advancement in technology, we figured out that we can freeze mature eggs. So, theoretically, what you can do is you can freeze the eggs, and later on, when you get married and ready to start the family, you can use frozen eggs, and that approach is quite successful. Well, in the early 40s, a lot of women will be able to conceive naturally. Having said that, probably after 45 most women are not able to conceive with their own eggs. So until recently, until we figured out how to freeze eggs, most of the situations are the situations where the couple uses donor eggs. So, in general, when women get older, older than 35 and older than 40 and older than 42, 43, the chances to conceive become lower, the chances to have a miscarriage become higher, and the chances to have abnormal baby with chromosomal abnormalities become higher. Well, again, with the advancement of technology, now what we can do, we can create the embryos and screen the embryos for all the chromosomes, and then, in the future, only use normal embryos. And if we do that, the chances for the embryos to implant become much higher even for older women, the chances to have a miscarriage become much lower, and the chances to have abnormal babies become extremely low for those abnormalities explained by chromosomes. Well, in general, life is not fair. And for women, the egg supply is going to run out at some point, but men constantly produce new sperm. Over a period of about three months, a new generation of sperm is usually being produced. So for most men who are healthy, there is no age cutoff at, you know, and usually men are able to have children almost at any age if they're healthy.