From the Guidelines
Female fertility begins to decline significantly after age 32 years, with a more rapid decline after 37 years. This decline is attributed to the gradual decrease in both egg quantity and quality over time, making it more challenging for women to conceive as they age 1.
Key Factors Influencing Fertility Decline
- The decline in female fertility is a natural process that accelerates in the mid-30s, with fertility dropping more steeply after 37 and becoming markedly reduced by age 40.
- The accumulation of genetic abnormalities in eggs as they age leads to higher rates of chromosomal issues, miscarriage, and difficulty conceiving.
- Conditions like endometriosis or fibroids, which become more common with age, can also potentially affect fertility.
Considerations for Family Planning
- Women concerned about future fertility should consider discussing family planning with healthcare providers earlier rather than later, as age is the single most important factor affecting a woman's natural ability to conceive and have a healthy pregnancy.
- The importance of this discussion is underscored by the fact that an increasing proportion of couples in developed countries choose to have children later in life (≥35 years), which can compromise fertility due to delayed childbearing 1.
From the Research
Female Fertility Decline
- Female fertility begins to decline at approximately 32 years of age, with a more rapid decline after 37 years 2, 3.
- The decline in fertility is associated with a decrease in the frequency of ovulation and an increase in the risk of pregnancy loss 2, 3.
- Women's fertility begins to decline in the late 20s, with substantial decreases by the late 30s 4.
- The most fertile age for women is generally considered to be between 20-24 years old, with a slight decrease in fertility at 25-29 years old and a marked decrease at 35-39 years old 5.
Age-Related Fertility Decline
- Age-related fertility decline (ARFD) knowledge is essential for women who desire pregnancy, as it can help them make informed decisions about their reproductive health 2, 3, 5.
- Education and awareness of the effect of age on fertility are crucial in counseling women who desire pregnancy 2, 3.
- Women older than 35 years should receive an expedited evaluation and undergo treatment after 6 months of failed attempts to conceive, or earlier if clinically indicated 2, 3.
- Men's fertility is also affected by age, with significant declines by the late 30s 4.