Female fertility is a topic of great importance, especially as more women delay pregnancy until later in life. While age is just a number in many aspects, it plays a crucial role in determining a woman’s reproductive potential. The biological clock affects the health of the reproductive organs and the overall ability to conceive naturally. Dr Poonam Agarwal, Principal Consultant Obstetrics and Gynaecology at Sri Balaji Action Medical Institute shares her inputs with Zee News Digital.


How Age Affects Female Fertility


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A woman is born with all the eggs she will ever have. This is known as her ovarian reserve. With each menstrual cycle, the number of available eggs decreases, and their quality declines over time. By the age of 35, fertility begins to drop significantly, and by the age of 40, the chances of natural conception are considerably lower.


Oocyte (egg) quality is another key factor impacted by age. As women age, the likelihood of chromosomal abnormalities in eggs increases, leading to higher rates of miscarriage and conditions such as Down syndrome.


Why Does Fertility Decline with Age?


The decline in female fertility is largely linked to changes in the hypothalamic-pituitary-ovarian axis, which controls the release of reproductive hormones. As women age, follicle-stimulating hormone (FSH) levels rise, indicating that the body is working harder to stimulate the ovaries to produce eggs. Additionally, the hormone anti-Müllerian hormone (AMH), which reflects ovarian reserve, decreases as women get older.


Aging also affects the uterine lining, making it less receptive to a fertilized egg, further reducing the chances of successful implantation. This combination of factors leads to a natural decline in fertility with age.


Who Is More Prone to Fertility Decline?


Women who delay childbearing until their late 30s and 40s are most affected by age-related fertility decline. Additionally, those with pre-existing conditions such as polycystic ovary syndrome (PCOS), endometriosis, or ovarian cysts may experience reduced fertility earlier in life. Lifestyle factors such as smoking, obesity, and poor diet can also accelerate the decline of reproductive health.


Reproductive Organs Affected by Aging


The ovaries, as mentioned, experience the most significant changes with age, as egg production slows. However, other reproductive organs are also impacted. The fallopian tubes can become less efficient in transporting eggs, and the cervix may produce less fertile cervical mucus, which is essential for sperm movement. The uterus can undergo changes that make it harder for an embryo to implant, and the risk of uterine fibroids also increases with age, which can interfere with pregnancy.


Prevention and Steps to Maintain Fertility


While ageing is inevitable, certain steps can be taken to maintain fertility for as long as possible.


1. Healthy Lifestyle: Maintaining a balanced diet rich in fruits, vegetables, and whole grains, along with regular exercise, can improve reproductive health. Avoiding smoking, excessive alcohol consumption and managing weight are key to maintaining hormonal balance.


2. Fertility Testing; Regular gynaecological check-ups and fertility tests such as AMH levels, FSH levels, and ultrasound scans to assess ovarian reserve are crucial for women over 30. Early detection of fertility issues can provide more options.


3. Fertility Preservation: For women who are not ready to conceive, egg freezing (oocyte cryopreservation) is an excellent option. By freezing eggs at a younger age, women can preserve their fertility for future use.


4. Consult a Specialist: For women over 35 who are planning pregnancy, consulting a fertility specialist is essential. This can help optimize reproductive health and increase the chances of conception through natural or assisted reproductive technologies like in vitro fertilization (IVF). 


The impact of age on female fertility is a significant concern for many women. Understanding how age affects the reproductive system, taking proactive steps to preserve fertility, and consulting with a doctor can help women make informed decisions about their reproductive health. While ageing is beyond our control, modern medical advancements and a healthy lifestyle can help extend the window of fertility for women who choose to start a family later in life.