Fertility Over Forty

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Infertility on the rise

Infertility is increasing in every age group. About 15% of couples have difficulty conceiving. That means 1 in every 8 couples. That is the same statistic for breast cancer occurrence. But we acknowledge and talk about breast cancer openly, while fertility struggles remain quiet. Fertility doesn’t get the attention it deserves, especially when we’re talking about fertility over forty. It’s time to change this paradigm.

Am I too old to be fertile?

For women over forty, this is the only age category in which birth rates have doubled and continue to rise. This is the new normal. Consider our celebrity scene: Tina Fey pregnant at 40, Mariah Carrey with twins at 42, Kelly Preston pregnant at 48, and Susan Sarandon had 3 children at ages 39, 42 and 45. While there are some risks having a child later in life, there are benefits too. Women usually have higher rates of education and are more likely to read to their children, they are 58% less likely to get ovarian cancer (even if child-bearing in their 40’s), and the “wage-penalty” is less, as women have a bit more tenure and security in their careers.

Why does fertility decline with age?

A woman is most fertile during her late teens to 30 and then there is a slow and gradual decline in fertility from 30-40. Then fertility can decline rather sharply at peri-menopause, here’s why:

  1. Decreased Ovarian Reserve. Egg quantity and quality is the biggest factor. Women are born with a certain number of eggs, which are released with every cycle, so the number in the pool declines. Quality of eggs is critical. The percentage of genetically normal eggs declines with lifetime environmental exposures and age.
  2. Hormonal Changes. Hormone imbalance or decline cause lower cervical mucous, among other factors. Consider levels of estrogen, progesterone, DHEA, testosterone, thyroid & adrenals, FSH, LH, AMH, and melatonin.
  3. Mitochondrial Defects and Oocyte telomere shortening.
  4. Free Radical Damage from Reactive Oxygen Species (ROS) in Carbonyl Stress and Oxidative Stress.

Positive antioxidant results

There are many antioxidants that we use to fight ROS and preserve ovarian cell health. Green Tea, glutathione and melatonin are just a few. But let’s highlight some research on just one antioxidant, melatonin. An Italian-based study looked at 65 women undergoing IVF who were randomized to receive myo-inositol and folate, or the same combination plus melatonin. There was a significant number of mature oocytes and decreased number of immature oocytes after GnRH stimulation in the melatonin group. There were also positive trends in the clinical pregnancy rate and implantation rates. Another study with 115 women with a history of failed IVF and low fertilization rate (<50% in previous IVF Cycle), took 3mg melatonin daily or no intervention. Fertilization rates significantly improved in the melatonin group only.

If you’re trying to conceive and would like to improve your chances of pregnancy, give us a call at Mind Body Soul Integrative Clinic.

We offer evidence-based effective support to improve your chances of getting & staying pregnant, whether you choose an all-natural approach or you want to maximize your success with assisted reproductive techniques such as IVF or IUI.

Courtesy of Dr. Emina Jasarevic, ND

* References available upon request.

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