10 Things Doctors Want Women in Their 30s to Know About Their Fertility
For the first time, women in their 30s are having more babies than women in their 20s, according to Centers for Disease Control data. In part, that’s encouraging — women are investing time into their careers and independent lives. (Interestingly enough, research also suggests women who have their first child in their 30s tend to live longer.) But if you’re past 30 and want kids, the thought can still be daunting. We spoke with a handful of doctors about what women in their 30s should know about their fertility.
“In the field of fertility, female age trumps everything,” Dr. James Nodler, a Houston, Texas-based reproductive endocrinologist at fertility center CCRM, tells SheKnows. “The quantity and quality of a woman’s eggs will never be better than they are today.”
After all, women are born with all of their eggs and — unlike men, who make new sperm all the time — over time, both number and quality decline. And as you age, risk of miscarriage as well as maternal risk rises too.
Sailed past 30? No need to be a naysayer. Keeping a healthy weight, eating nutritiously and exercising regularly all play a role in a healthy pregnancy too, Dr. Mary Jane Minkin, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, who had her first child at 36, tells SheKnows.
Being informed with good, quality info helps too. Here, what top doctors want you to know about your fertility as you age.
1. At 30, your chance of pregnancy every month is about 20 percent
And by age 40, it drops to 5 percent. “Large studies suggest the miscarriage rate below age 35 years is about 15 percent, but this rate rises progressively to 25 percent by age 39 and 50 percent by age 44,” Dr. Paula C. Brady, a reproductive endocrinologist at the Columbia University Fertility Center, tells SheKnows. It’s an important figure to know so you don’t freak out after one unsuccessful month at 31, but also so you know your chances as the years tick by.
2. Pick up an ovulation kit
They help you know when you should be trying. “The First Response kits do a good job on pinpointing ovulation to make sure couples hit their most fertile times for having sex,” Minkin says.
Peak fertility is usually two days pre-ovulation, says Brady, but you could try anywhere between Day 12 and 18 of your cycle (with Day 1 being the first day of your period). “Sperm must be present before ovulation, after which cervical mucus thickens and no sperm can get into the uterus,” Brady says. A kit turns positive 24 to 36 hours before ovulation.
Also, “Don’t bother with cervical mucus and basal body temperature; they only change after ovulation, when it’s too late, and are not terribly reliable,” Brady says.
3. Get tested!
“Gonorrhea and chlamydia can cause serious damage to the fallopian tubes, which is a common cause of infertility or ectopic pregnancy — pregnancy outside the uterus, usually in the fallopian tube, which can be life-threatening,” says Brady. Both infections often come without symptoms but can cause inflammation in the fallopian tubes, called pelvic inflammatory disease — each episode of which doubles the rate of infertility, she says. The good news is both can be treated with an antibiotic.
4. Conception isn’t always so straightforward
Public figures including Michelle Obama, Chrissy Teigen and Gabrielle Union have shed important light on fertility issues and in vitro fertilization. Nonetheless, it’s easy to see a celeb get pregnant at 40 and think you’ll be able, to too.
“I worry that women lose track of the importance of age for fertility when they see public figures having babies in their late 40s and early 50s without any discussion of how those children may have been conceived,” says Brady. IVF, egg freezing and donor eggs can all come into play with these pregnancies.
5. Make an IRL appointment for fertility issues
If you’re under 35 and have been trying for a year, between 35 and 40 and been trying for six months with no such luck or want to have a kid at 40, a reproductive endocrinologist can help pinpoint any issues and a face-to-face meeting beats out OTC tests.
“Over-the-counter fertility tests are not proven to be accurate by well-designed clinical trials, and when done without a full evaluation with a reproductive endocrinologist can provide either a false sense of security or alarm women unnecessarily,” Dr. David Ryley, a reproductive endocrinologist at Boston IVF, a fertility center in Boston, Massachusetts, tells SheKnows.
A specialist will look at all aspects of your overall reproductive health: a pelvic ultrasound (which could ID endometriosis or ovarian cysts), potential partner infertility, root causes of irregular periods and even your partner.
6. Half of infertility cases are due to male infertility
Another reason to make an appointment: “Heterosexual couples need to assess a man’s semen analysis,” says Ryley.
Research from the Ilam University of Medical Sciences suggests male-factor infertility accounts for 40 to 60 percent of infertility cases. Usually, male infertility has to do with changes in sperm concentration, motility (how well the sperm move) and morphology (the size and shape of the sperm). Everything from lifestyle to certain medications and prolonged heat exposure can negatively impact a man’s sperm quality, potentially impacting fertility. A semen analysis can provide a better look at what’s going on.
7. See a doc if you have irregular periods
“Periods should be 21 to 35 days apart from the first day of bleeding in one cycle to the first day of bleeding in the next,” says Brady. “Period intervals consistently in that range indicate that a woman is ovulating.” Intervals that are consistently shorter or longer may indicate you’re not ovulating and should see a doc, she notes.
8. Research freezing your eggs
“Women in their early 30s who are not ready for pregnancy and don’t plan pregnancy soon should consider oocyte cryopreservation (aka egg freezing),” says Nodler. “Freezing eggs pauses the progression of chromosomal abnormality and allows a woman to use much higher-quality eggs with a lower risk of miscarriage and Down’s syndrome when she is ready to be pregnant.”
9. Choose your birth control carefully if you want kids back-to-back
The IUD is a particularly great option, Brady says, because it’s easy to forget a birth control pill when, you know, you’re chasing around a toddler.
One that should definitely give you pause is the birth control shot. It may take up to 18 months for ovulation to resume once you stop injections, says Brady. “All other forms of birth control are essentially immediately reversible and should not delay conception of the next child.”
10. Don’t believe fake news
“The internet has a lot of good medical information, but there is a lot of misinformation out there regarding fertility,” says Brady. Both The National Infertility Association and The American Society for Reproductive Medicine provide accurate insight into the issue.
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