More and more women ask us every day about the importance of their age and if they should become pregnant sooner rather than later.
Age hardly has an influence on male fertility, but is highly influential for women in terms of their reproductive prognosis.
In men, sperm production and regeneration is constant from puberty to senescence. However, in women, the loss of eggs is an exponential and irreversible process that occurs from birth until menopause and there is no way to slow it down.
Women are already born with their lifetime supply of eggs (around a million) because their ovarian activity begins around the 12th week of gestation and egg production irreversibly ends around the fifth month of pregnancy. This means that women have a limited “ovarian reserve”. Since birth, the number of eggs declines every month and even every day because the number of eggs continues to decline since the first menstruation, however this is also when ovulation begins. Every woman ovulates around 400 times throughout her lifetime. This means that only about 400 eggs out of the million that exist at birth will be ovulated; the rest will diminish without maturing or being released from the ovary. The highest fertility period in women is approximately between 16 and 30 years of age. Menopause is reached with only a few dozen remaining eggs.
It is therefore very important to make an appropriate prognosis, recommend fertility treatments as needed and learn about the ovarian reserve because this and egg quality diminish with age and as a result, fertility reduces and miscarriages and foetal malformations increase.
The response to medication in IVF treatments also depends on the woman’s ovarian reserve. It is easy to estimate the ovarian reserve with an ultrasound scan to see the ovaries and measure the Anti-Müllerian hormone with a blood analysis. This hormone accurately reflects the number of remaining follicles; the “stock” a woman has when she comes in for consultation.
At Instituto Bernabeu, we develop new protocols with different adjuvant medications and administration methods that provide women with the best possibilities, because we are aware that their chances constantly decline.
A woman’s age, and especially her ovarian reserve, is currently one of the most important limiting factors in terms of treatment success.