The American Society for Reproductive Medicine (ASRM) has just tweeted some myths about infertility. I found them very useful to reproduce here and remind about relevant issues regarding the fertility and the infertility.

MYTH #1: “I don’t feel 35. Age won’t affect my fertility.”

Fact: Healthy living can boost your fertility potential, but it cannot reverse the effect of age on eggs and sperm.

Age is a critical determinant of fertility potential. Although, in women, fertility gradually declines in the 30s, particularly after age 35, obviously, this is not true for everyone. There are some women who have a declination before (i.e. low ovarian reserve or ovarian insufficiency) and there are some that, even when they are around the 40s, still get pregnant easily. The most important concept is that age impacts on women’s fertility; and that the slope of decreasing fertility gets usually more pronounced between 35 and 40, and even more afterwards.

Some numbers for spontaneous pregnancies: for every 100 fertile 30-year-old women trying to get pregnant in one cycle, 20 will be successful. In 40-year-old women, fewer than 5 out of every 100 women are expected to be successful each month.

Some numbers for IVF cycles with own eggs: for every 100 fertile 30-year-old women trying to get pregnant in one cycle, 40-45 will be successful. In 40-year-old women, around 20 out of every 100 women are expected to be successful each month. Of course, it depends on the clinic´s characteristics and its success rates.

The fertility decline observed in the above mentioned results are not only due to a lower ovarian response (number of eggs retrieved in an ovarian stimulation) but also (and mainly) due to a lower egg quality. One of the most important reasons why egg quality decreases with age is because the rate of chromosomal abnormalities increases, leading to lower live birth rates, higher miscarriage rates and higher rates of newborn chromosomal abnormalities (i.e. Down syndrome).

Unlike the early fertility decline seen in women, a man’s decrease in sperm characteristics occurs much later and it is not that determinant. Although we can see some characteristics in sperm from men over 45 years old (i.e. increased DNA fragmentation), these alterations are more subtile and men could get a pregnancy at older ages.

Fortunately, currently we count with several options to better treat couples where women´s age could have some impact, going from different types of ovarian stimulation protocols, the option of embryo banking, the use of comprehensive chromosomal screening with PGS and, eventually, egg donation. With all these in mind, chances of not being successful became very low. And, of course, the option of egg freezing (vitrification) in those cases when not ready to have a baby now, but in order to preserve the current fertility for the future.