Age affects fertility in women
Women are born with all the eggs they ever have. Women are most fertile between the ages of 18 and 31. When women are getting older, their egg quantity and quality are declining. They become less fertile. There is clear evidence of an age-related decline in female fertility. By the time women reach 35 years of age, their fertility is declining markedly. This presents that the number and quality of eggs decrease; also genetic abnormalities and spontaneous abortion increase noticeably with female age. A study involved in 1000 women in pregnancy showed that 71% of women aged 30 conceived within 3 months whereas only 41% of women aged 36 conceived within 3 months. A negative effect of increasing male age particularly in the late 30s was also found. A study involved 2112 women in pregnancy showed that increasing age for both men and women take longer time to conceive. There were some other studies presented similar results.
There is a significant decline in clinical pregnancy rate, implantation rate and delivery rate per embryo transfer associated with increasing female age in assist reproductive treatment. A recent study of all IVF clinic in Netherland found that the overall live birth rate per cycle decreased by 2% for each additional year of female age. Another study involved in 36483 treatment cycles in assist reproductive treatment reported that women aged 25-29 achieved a live birth rate of 25.9% while women aged 40-44 only achieved 6.1% live birth rate. The poor live birth rate in older women greatly attributes to spontaneous abortion
What is the best marker of reproductive age in women?
Research suggested that genetic factor contributes to women’s fertility. Women whose mothers had an early menopause had much fewer eggs in their ovaries than those mothers had a later menopause. These women with fewer eggs have fewer chances to conceive. At present there is no test that can predict women’s fertility accurately. There are many tests that are used to measure ovary function. What is the best marker to measure reproductive age? GJ Scheffer et al compared several markers. These include that antral follicle counts (2-10mm), total ovarian volume, total follicular volume, mean follicular volume, and volume of either the smallest or largest ovary; FSH, estradiol and inhibin B and the response of estradiol and inhibin B to exogenous GnRH agonist. They tested these markers on 162 healthy female volunteers aged 25-46 years. These women were proved with normal fertility and regular menstrual cycles. All marker tested excerpt inhibin B were correlated with age, but the number of antral follicles was highly correlated with age. Their conclusion is that the number of antral follicles has the closest association with age in normal women with proven fertility.
How old a woman can be to achieve pregnancy with assisted conception approach?
Check JH reported a case that a 46 year old woman with high day 3 estradiol and FSH. She conceived on her third IVF-ET attempt. She delivered a healthy full term baby girl. This was believed to be the first case report of a successful pregnancy in a woman of such an advanced age with diminished ovary reserve using her own eggs. This report showed that pregnancy is possible in similar circumstance.
Fertility declines with aging in men as well
Women are born with all eggs in the ovary which cannot be divided into other cells. The egg numbers are only declining with age. On the contrary, there are gonocytes or primitive germ cells in the normal men’s testes. These cells can split without limitation. The cells split can become another gonocytes which could further divide; or they can become mature sperm cells. Gonocytes supply within testes can be last very long time and mature sperm cells can be produced. This is the main reason why a man’s fertility does not decrease significantly with age as women’s.
However, fertility in men decreases when they reach certain age. In men semen parameters could begin to decline as early as age 35. Semen volume and motility would decrease and morphology could gradually become abnormal. After age 40, there could be notably DNA damage in their sperm; motility and viability continues declining. With an increase in age in men, the time to pregnancy for their partner increases.
Acupuncture can help both men and women to improve their fertility. As a result, this improves their chance to get pregnant.
Check JH Clin Exp Obstet Gynecol (2011) 38:209-10
Check ML Clin Exp Obstet Gynecol (2004) 31:299-301
Fotrman EJ et al Maturitas (2011) 70:216-21
GJ Scheffer et al Human Reproduction 18:700-706
Homan GF et al Human Reproduction Update (2007) 13:209-223
Welcome to my blog, discover acupuncture with Dr Maggie Ju
Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.
Friday, 2 March 2018
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