Aging and Reproduction: The Biological Clock—an Alarming Experience?

Abstract

The most significant aetiologic factor contributing to the increase in infertility, is the deferral of childbirth by couples in the reproductive age group. Couples where the female is aged 30 to 34 have a one in seven chance of infertility; between the ages of 35 to 39, a one in five chance of infertility; and between the ages of 40 to 44, a one in four chance of infertility. There is a significant increase in the spontaneous abortion rate with age, from 10 percent from age 25 to 29, to 18 percent from age 35 to 40, to 34 percent in women over the age of 40. In vitro fertilization results in a 13 percent cancellation rate, and a 22 percent delivery rate in women under 40, compared with a 22 percent cancellation rate, and a nine percent delivery rate, in women over the age of 40. A day-three follicle stimulating hormone level is a useful predictor of the potential success and cancellation rate in women undergoing in vitro fertilization. Women who have undergone premature or natural menopause can achieve a pregnancy rate of over 30 percent with oocyte donation. Older reproductive age couples require alacrity in infertility testing, diagnosis, and treatment of potential problems.