While it may be considered inappropriate to ask someone their age, we are faced with the reality every day that our age impacts us. There are age requirements to begin school, age requirements to obtain a driver’s license, legally vote, and age recommendations to receive senior citizen discounts. It should come as no surprise that age is integral for reproductive success as well. With the rising prevalence of infertility (nearly one of six couples are impacted by this disease), age is one of the most important aspects, and one of the most significant factors, in success.
Understanding the correlation of age and reproductive success begins with education and growing awareness, well before one ever considers starting (or even growing) their family. Most people don’t routinely think about it, but have you considered that peak fertility occurs between the late teens and late 20s, and by the age of 30, fertility rates begin to decline? Many individuals, or couples, are choosing to postpone the start of their family until later ages, specifically into their 30s or 40s.
As you age however, so do gametes (eggs and sperm) of both women and men. While you often cannot see or feel any of these changes, they are happening faster than one realizes. In fact, in the mid-1960s, the mean age of mothers giving their first birth was around 23, and that age has progressively risen, currently closer to 29 years of age. Several factors are contributing to this trend, including persons postponing significant or long-term relationships or marriages, in lieu of furthering careers, education, travel, job advancement, access to care, or even considering remaining childless. As women age, the eggs in the ovary are aging faster, and the quantity and quality of those eggs are declining. This leads to increasing infertility and miscarriage rates.
“I wish I had known this {the association of age and fertility} sooner,” is a statement echoed repeatedly from women who were not aware of how age would impact fertility success. From the famous, such as actress Jennifer Aniston, who shared with the world in November of 2022 how she tried for nearly a decade to start a family, yet was unsuccessful, to local Mississippians who have encountered the same fate. Age does not discriminate and unfortunately is not modifiable, so what options do people have when not quite ready to start a family, but also not conceding to becoming an infertility statistic?
While modern science has not yet found the ability to turn back time, in the field of reproductive medicine, we have been able to successfully assist both women and men in preserving fertility at younger and much healthier ages. Assisted Reproductive Technology (ART) provides for fertility preservation for medical (non-elective) and elective reasons.
Prior to 2013, oocyte (egg) cryopreservation was an option for women mostly facing gonadotoxic therapies, such as chemotherapy for treatment after a cancer diagnosis. However, just over 10 years ago, the experimental label was lifted by the American Society of Reproductive Medicine and elective oocyte cryopreservation became available for women desiring to preserve their fertility at a younger age.
Whether completely elective or for medical reasons, the earlier a woman chooses to cryopreserve (or freeze) eggs, the more likely she will have success. The rate of women electing to preserve fertility by freezing eggs is rapidly growing locally and nationally. Based on national data for 2021, the number of egg-freezing cycles reported by IVF clinics increased by over 31% from the previous year, from 16,786 to nearly 25,000 which confirms a marked increase in fertility preservation treatments in the United States.
Now that we have reviewed age as a non-modifiable factor, other things to consider and remain vigilant about are modifiable factors that contribute to overall health, wellbeing, and successful family planning. There are numerous studies that have drawn conclusions about modifiable risk factors, shown to impact (both positively and negatively) reproductive success.
A well-balanced nutritional plan, including the addition of specific supplements and multivitamins, has been correlated with improved success. Reduction or elimination of caffeine, tobacco, alcohol, marijuana, improvements in BMI (body mass index - whether over or underweight), reduction of stress (including oxidative-stress, state and trait anxiety, perceived and real stressors), improvement in psychological wellbeing, appropriate activity and exercise (not too strenuous), and even the effects of the environment (exposure to endocrine-disruptors) are all areas to become more aware of while preparing for successful family planning opportunities.
So where do you start from here? You may be reading this article and thinking of yourself, your daughter, your sister, your friend, or your aunt. Maybe this information pertains to you or you may want to share it with someone else, either way, my hope is that you are more aware of our population growth through reproduction – both through our natural fecundability and, when appropriate, through the use of Assisted Reproductive Technology. I hope you are more aware of modifiable and non-modifiable factors that impact pregnancy success, and how you can make changes or interventions for successful family building and planning.
