To wonder about people's awareness of fertility decline

[Orangeblossom78]

decline I mean, in late 30s/40s. I know someone who on trying to get pregnant for the first time in their early 40s is shocked and devastated to be told of their fertility being low at this stage. AIBU but is is not usually apparent that our fertility declines after mid 30s and you can't just expect to have an easy time getting pregnant in early 40s.

I had my dd at 37, pregnant in two months.

I'm now 42 and had one instance of unprotected sex recently. I figured it was unlikely to result in pregnancy, given my age. I've just had a medical termination.
The nurse at the clinic said she had seen other 40 plus women think they were probably too old.

Hmm.. you don’t stop ovulating until you’ve been through the menopause.

I’m 49 and still ovulating.

No, sadly, that's not true.

Many women who experience fertility issues will be having what are known as anovulatory periods. It's increasingly common as women age.

I’m not talking about women with fertility issues. I’m saying you can’t count on age to protect you from pregnancy. If you’re still ovulating you can get pregnant. Even when you’re not ovulating every single month.

Erm, but that's kinda the point, isn't it?

At 49, many women who have periods will not be ovulating. They won't be likely to think they have 'fertility issues'. They probably just think they are 49!

The issue is that the biology we were taught in school is too simple. You can have a period when you didn't ovulate; you can ovulate when you've not had a period in months.

Isn’t it that even though we ovulate, our eggs are basically old, they don’t grow new eggs, so they aren’t usually very ‘viable’.

Hence older women 45+ especially often use another woman’s eggs. They can carry the baby okay. Just not have the good eggs.

No, it's not that.

There is no reason for eggs to 'grow new eggs'. What does happen is that older women's eggs sometimes don't develop well into embryos. But this is not to do with making new eggs.

Aside from issues with egg quality, older women (and sometimes younger women) can find they are having what look like periods, despite not ovulating. This is known as being anovulatory. Your body thinks you're having a period, and expels the womb lining, but you never actually had an egg in there in the first place. It's not so unusual.

Apologies if this is boring, but here's what happens in a (simplified) explanation of normal pregnancy and fertility treatment, in case it's useful:

1. A baby girl is born. She has all the eggs she will ever produce, there inside her ovaries.
2. During any menstrual cycle, follicles start to grow in one or other ovary - or both. Often, several follicles develop, but only one or two become mature - and generally, this development happens in one ovary or the other.
3. The mature follicle releases an egg, which travels down the fallopian tube.
4. It fertilises with a sperm.
5. If the fertilised egg implants into the womb lining, it results in a pregnancy.
6. With luck - and a lot of things can still go wrong here - the implanted embryo develops into a healthy pregnancy.

In the case of IVF, the process is different. The woman takes drugs that stimulate her egg production cycle, and these eggs are extracted. Then, doctors check to see which eggs are mature, fertilise them with sperm, and watch to see which eggs develop. Those eggs that develop into embryos may be re-implanted. If you use a microscope, you can see the fertilised eggs dividing, and can therefore see which ones are doing best.

I hope this is useful, especially for posters who had been told IVF is not good for people will low-quality eggs (in fact it is ideal for them).

At 49, many women who have periods will not be ovulating. They won't be likely to think they have 'fertility issues'. They probably just think they are 49!

They may not be ovulating or they may be sometimes ovulating in which case they can’t rely on being 49! My point stands that until you’re done with ovulation completely you can still get knocked up.

And you can’t use periods as a guide because you can’t tell whether you’ve ovulated or not.

Yes, sorry, you're not wrong there! I only took issue with the statement that you're not done ovulating until you've gone through menopause - which is wrong. Of course it's equally important to recognise that many women will ovulate well into peri-menopause.

We're just emphasising the opposite ends of a spectrum - in my case, pointing out that you cannot be sure you're ovulating just because you have a period.

It’s not wrong that menopause is the end of ovulation.

As ovulation stops, periods gradually stop too over time. For some women it happens quickly and for some it’s slower and more gradual.

The menopause happens when egg production is no longer possible and ovaries stop releasing oestrogen.

No, sorry, it doesn't actually work like that. People think it does.

'Menopause' means 'cessation of periods'.

People imagine (as you say) that 'periods' mean 'ovulation'.

However, you can have a period - or indeed regular periods - without ovulating.

You can also find that your periods seem to have stopped, but you are in fact still ovulating.

Egg production has nothing to do with either process. We don't actually produce eggs - we're born with them already produced.What's actually happening is that eggs are released.

I have never thought that periods = ovulation. But at menopause ovulation and periods end.

I’m perfectly well aware that you can have a period without ovulation or indeed ovulate without a period, I have never said otherwise.

I’m also aware that we are born with our eggs, that’s very basic stuff. Egg ‘production’ in that context simply meant release.

No, I'm sorry, you're still not quite getting it.

Menopause literally means 'end of periods'.

But, as it happens, that doesn't invariably mean a women hasn't ovulate. It is relatively common that a women finds she has stopped menstruating, but then does ovulate.

I'm in my mid 30s & all my peers seem aware. However there does seem to be less knowledge of how the fathers age & health can affect the baby.

Ah that’s a different point.

Yes it’s true some women can get knocked up post menopause as the end of their periods haven’t meant the end of their eggs. That happened to my grandmother with my father who was a late ‘surprise’. Menopause is normally diagnosed when you’ve not had a period for a year.

Equally, a friend of mine was diagnosed with premature ovarian failure or ‘premature menopause’ as it’s colloquially known In her 30s, but she did occasionally ovulate. Until eventually she had no more eggs.

But for the vast majority of women ovulation and periods end at menopause.

I got pregnant easily in my late 30s/ early 40s. Not the same for everyone but there is plenty evidence that the fertility stats are based on older evidence. As a pp posted earlier women in their 30s have a good chance of getting pregnant on each cycle. I was worried about abnormalities but tests showed no issues and as a pp said, these can happen at any age. My dr noted that the tests showed no issues which was to be expected in the majority of cases at any age.

There are good reasons for women (and men) to leave childbearing till their 30s and 40s. I know very few who had children any earlier because few people are emotionally and financially ready.

I don’t think anyone is unaware of the fertility drop off - like a pp said I was shocked to be pregnant as I thought (due to years of daily mail indoctrination) that my ovaries were spitting out dust.

In the past lots of women had babies in their 40s but just not their first.

The issue isn't really statistics being out of date. For each individual woman, she will have fewer viable eggs at age 40 than she did at 35. It is a fact of how our bodies function. That doesn't mean Jane has no chance of conceiving or carrying a pregnancy to term at 40, but she certainly has a lower chance than she did when she was younger.

Only a fertility check can determine the situation for you personally at any given age but the trend is the same for every woman.

Zsa- you may know very few who had children efore 30 but as has been said thats demographics.

The average age for first time child was v close to 30 last time I looked so HALF of all first time mums are under 30. That youve only met a few doesn't make it less true.

In my area (v w/c) people that dont go to uni are keen to get on and have kids (rightly or wrongly) as they do believe its best to have them young and that 30 is "old" to have kids etc etc.

As a professional graduate Ive had chidlren later and most of my uni friends did, but I live in an area where thats very much not the norm.

Older fathers are responsible for nearly all of a child’s random genetic mutations - a father’s age at conception may account for 97% of the new mutations.

Most famous case of this is of course haemophelia in the European royal families, blamed on poor Victoria (who had her children in her 20s and 30s) but was probably her father's fault (he was in his 50s when she was born).

There is a lot of pressure on women to have children. Firstly it is worth remembering that the baby boomers were unusual in having their children so young (average age to have a first child in the 70s was 25), their parents and children both had children later. There may be double the number of women having children in their 40s in comparison to the 90s but the eate is half what it was in the 30s. Historically it was only the richest in society who married off their daughters young to have children, marriage records show most people got married around 30 (with no contraception best form of preventing multiple pregnancies was abstenance while young). In addition there are very few useful statistics on birthrates, most research on fertility is conducted on infertile couples so the experts see a skewed version of life.

Additionally risk. Sure there is an increased risk you might have a child with Downs (but 99% of 40 year olds won't) or have a miscarriage (but there is significant risk of miscarriage at all ages) or a drop in fertility (but as the Danish study show the major decline is after 40) but as a PP said the real risk is having a child with a feckless father or losing your job or career due to your pregnancy/childcare issues all more likely as a young mother. Age generally brings greater security and so the balance of risk changes making motherhood a more attractive prospect.

I’m aware but also wary tbh - I know a fair few mums who have quite easily become pregnant in their mid and late thirties. Age is obviously a factor - but I think many women who struggle to become pregnant in their late thirties shouldn’t just blame their age, plenty of other factors can play a role too and due to those there’s a good chance they would have struggled the same if they’d TTC earlier.

Age is obviously a factor - but I think many women who struggle to become pregnant in their late thirties shouldn’t just blame their age

When it's secondary infertility then age is certainly likely to be the main factor. It's the only thing that has usually changed between pregnancy 1 and TTC 2.