Education. That is one of our main tasks. We have to share our medical knowledge with the rest of the society. If that occurs, prevention will be easier and health problems will be less usual.

The American Society for Reproductive Medicine (ASRM) has just published a new document explaining that fecundity of women decreases gradually but significantly. It is slow at around 30 years old, and more rapidly after 35-37 years old.

Number of oocytes (eggs) decreases from fetal life (6-7 million) to birth (1-2 million). There are only 300,000-500,000 at puberty, 25,000 at 37 years old and 1,000 at 51 years old. How is it translated in terms of fecundity?

Pregnancy and live birth rates decline not only in spontaneous sexual intercourse but also in IVF cycles. In American registries (similar as our program results), success rates are 41% for women below 35 years old, 32% for women at 35-37 years old, 22% in those aged 38-40, 12.4% for women at 41-42 years and less than 5% for those aged 43-44. Egg donation, as it is expected, maintain similar high success rates in everybody, because it depends on the oocyte age and not on the uterus age.

Aneuploidies (abnormal number of chromosomes) and spontaneous miscarriage increase with age.  Pregnancy loss before week 7 occurs in 10% of women below 35, 20% in women of 38-40 years old and more than 35% of women over 42.

If we, as society, know about these facts, we will be able to choose better. Most scientific societies suggest to consult after one year of failed attempts to conceive in women below 35, after 6 months in women over this age, and ASRM recommends immediate evaluation and treatment in women older than 40 years. On the other side, options like egg freezing are now available for those young women not willing to conceive soon.

Information means more educated decisions. Let´s give our society better information.

P.S.: this is not new information. But, sometimes, this kind of old information is more important than the last new about a new molecule.