Age and fertility

Age and fertility

 

The age is an important factor in conception, especially the age of the mother. Over 70% of the ovules of women past 35 years old generate abnormal embryos, which do no get implanted, eliminate through miscarriage or generate genetic abnormalities at the fetus. These risks increase significantly after the age of 40. The complete exhaustion of the ovules marks the start of  the menopause. There are women with a reduced ovarian reserve from young age.

 

Factors that influence fertility are:

  • The age of the reproductive system, 30% of women past 35 years old are infertile, 50% of women past 40 years are infertile;
  • The increase of spontanous miscarriage 10%>30 years old, 18%>35 years old, 34%>40 years old;
  • Modifications of the masculine reproductive system.

 

After the age of 40, the risk of the conception product deficiencies increase by 20%, the testosterone decreases, the hypophyseal gonadotropin increases and the production of sperm decreases. The follicles loss is accentuated  in the period 10 to 15 years before menopause, the inhibin decreases and the FSH increases, the quality of the follicles decreases and the follicular phase decreases. The FSH is increased, the LH is normal, the lutheal phase is normal, the cycles shorten initially, then they increase before menopause. The incipeint ovarian failure is characterized by: increased FSH, normal estradiol, decreased inhibin (inh. B involved in the premature folicular phase). An ovarian volume which is estimated  by means of ultrasound to be under 3 cm cube indicates a weak response to the ovarian stimulation. The ovarian reserve can be estimated through dosing the FSH in day 3, the normal values being <10IU/L, through the increase of the estradiol in day 3, over 80pg/ml thorugh the test of clomiphene citrate day 5 and day 9 and the FSH is dosed in day 3 and day 10, the normal sum of which being  over 26UI/l).

 

The screening of the ovarian reserve is indicated for: infertile women past 30 years, in case of  infertility for unexplained cause, in case of nonresponse to ovarian stimulation. Over 40% of the assisted human reproductive techniques are used for older couples. The increased dose of progesterone 100mg/day decreases the deficiency in the lutheal phase. The rate of spontaneous miscarriages is related too to the age of the oocytes donor. The uterin factors are not involved however in the decrease of the fertility rate.