Does Fertility In Women Decline After The Age Of 35? What Couples Must Know

When considering starting IVF treatment, both the partners have to be in the best shape. They must prioritise reproductive health, especially in their 30s, when fertility rate tends to decline. Read on.

Age-related fertility issues in women: Doctors warn that fertility in women declines after the age of 30, and further declines sharply after the age of 35. It is, therefore, crucial for couples to undergo tests and screenings for fertility if they have tried to conceive naturally for over a year when the age of the woman is less than 35 years. According to health experts, after the age of 35, the quality and quantity of eggs start to decline. Chances of chromosomal abnormalities like Down syndrome also increase, besides the risk of miscarriage. Lifestyle-related disorders like pregnancy-induced-hypertension, diabetes, and risk of preterm deliveries are more prevalent in older mothers. These complications, however, are also commonly seen in the younger population, says Dr Shweta Ashok Harnal, fertility specialist, GarbhaGudi IVF Centre, stressing on the importance of timely screenings.

Screening Tests Before Starting IVF

According to Dr Shweta, routine tests are performed to rule out disorders like that of the liver and kidneys, hypothyroidism, diabetes, hypertension and any other physical or mental health problems before starting IVF treatment. It is important to take into consideration any known genetic disorder, detailed medical and surgical history.

These general checkups and tests can help optimise health, the doctor says.

Preimplantation Genetic Testing For Aneuploidy

The fertility specialist says in the case of chromosomal abnormalities, preimplantation genetic testing for aneuploidy (PGTA) is performed, wherein the screening of embryos is done to exclude the embryos that are ‘genetically abnormal’.

“This could be either invasive or non-invasive, where selected embryos that are genetically normal are transferred. This test can help in lowering the risk of miscarriage and result in a healthy pregnancy.”

Lifestyle Changes Before IVF

According to the doctor, here are some lifestyle changes to make before undergoing IVF procedure:

Stress: Stress must be reduced. For couples undergoing work and personal stress, counselling is recommended.
Yoga and physical activity: It is important to practise yoga or engage in simple physical activities such as a 40-minute walk daily.
Diet modification: If the BMI of the patient is on the higher side, there has to be an increase in protein intake and reduction in carbohydrates to maintain optimal weight. Supplements such as antioxidants or other health supplements can be taken.
Water intake: Water or fluid intake should be adequate for bodily functions.
Medical conditions: Health conditions such as thyroid, diabetes and high blood pressure levels should be optimised before IVF treatment with the help of dietary intake.
Things to avoid: Smoking, alcohol and recreational drugs should be avoided to enhance the quality of the egg and sperms.

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Role Of Male Partner’s Health

The doctor points out that men, too, need to undergo blood tests to assess their sugar and thyroid levels. If these levels are on the higher side, it can impact their semen parameters. General screening tests or blood tests for male partners play an important role in IVF treatment.

“In men, the quality of sperm starts to decline at a slightly later age — the decline is seen around 40-45 years. Sperm motility, structure and DNA fragmentation index parameters, however, start deteriorating sooner. General or age-related conditions must be optimal before the treatment. Lifestyle factors remain the same for both partners.”

The doctor adds that tests like sperm DFI (DNA fragmentation index) can be considered if the age of the male is advanced. This test can help detect DNA damage that can affect fertility. It is especially recommended if the male partner is exposed to toxic chemicals and heat, smokes and drinks regularly, and if there is a history of pregnancy losses, recurrent implantation failures.

Genetic Testing

As far as genetic testing is concerned, advanced tests like whole exome sequencing can help couples, or the partner whose family is affected by known genetic disorders, or has a history of pregnancy losses. In case of a medical disorder or pre-existing cardiac, kidney or renal disease, the current status must be considered before proceeding; opinions of other health experts are recommended.

Egg freezing can be considered if women want to delay pregnancy.