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Impact of Age
Generally, age and fertility are inversely
related, and aging of the reproductive system plays a key role in
female infertility.
The most rapid decline in fertility potential in any single year
has been found to occur at age 35, a finding confirmed by the
American National Bureau of Health Statistics in studies performed
between 1965 and 1988. Each study used the 12-month threshold as
the definition of infertility, and all showed that by age 35 over
one third of women would not be able to conceive within a year. A
woman’s 35th year, therefore, serves as the horizon beyond which
reproductive function is irreversibly lowered.
In the 10 to 15 years before menopause, there is a gradual
acceleration of follicular loss that correlates with an increase in
follicle stimulating hormone (FSH) levels. Together, these changes
reflect the reduced quality and capability of aging follicles, the
most sensitive follicles having already responded. At about the
same time that these changes are taking place, a major alteration
in the menstrual cycle is also occurring. While the menstrual cycle
may remain regular in the years before menopause, a reduction of
the cycle length takes place due to a shortened follicular phase. A
gradual shortening of cycle length by an average of 3 to 4 days
compared to the cycle length a woman had in her late 20s has been
found to be a useful predictor of a decline in fertility
potential.
Impact of age on the quality of
eggs
 The decline in fertility also seems to be a direct
result of the age-related decline in the number of healthy eggs in
a woman's ovaries. A woman is born with all the eggs she will ever
have – about 400,000. Each month, during her reproductive years,
usually only a single egg matures. The quantity of eggs starts to
diminish in childhood and continues into adulthood. Ovulation
contributes to the decrease, but the majority of eggs are slowly
absorbed by the body. By the fifth or sixth decade of life, most
women will have depleted the egg supply they were born with.
Ovarian failure occurs when a woman's follicles and eggs are
depleted and when the production of the hormones oestrogen and
progesterone ceases.
Other age related factors
Other factors can also affect reproductive
functioning in older women. These include:
Frequency of intercourse, which may decline with increasing age and
the duration of a couple's relationship; irregular ovulation, which
occurs as a woman's hormone levels change with age; and luteal
phase deficiencies, which occur when too little progesterone is
produced to maintain a sufficient uterine lining for a fertilized
egg to implant into.
On the whole, age (in its association to the female reproductive
system) is linked to a variety of physiologic dangers:- Spontaneous abortion: the
risk of which rises in women over the age of 40.
- Exposure to diseases that can affect
the reproductive system: including endometriosis and
sexually transmitted diseases such as pelvic inflammatory
disease.
- Ectopic pregnancy: other
than women between the ages of 15 and 19, women 40 and older have
the highest incidence of deaths related to ectopic
pregnancy.
- Mortality: although not
high, the risk of death associated with pregnancy and childbirth
increases with age.
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