How old is too old to get pregnant naturally without fertility treatment? When you ask a realtor the three most important factors in selling a house, you’ll likely hear: location, location, location. When you ask a fertility doctor the three most important factors in fertility, most will respond: age, age, age.

While we’ve made progress in getting out the message to women in their 20s and 30s of the importance of age and its impact on fertility, we still have a long way to go. Recently in the Creating a Family Facebook Support Group a 41-year-old member asked how long she should try to get pregnant on her own before seeing an infertility doctor. She had been trying for almost a year.

Research has found that 30% of women believe that their fertility will decline gradually until menopause, and 30% thought they could get pregnant without difficulty at age 40.  Truthfully, most women are most fertile in their 20’s and fertility starts rapidly declining after age 35. The chance of getting pregnant without fertility treatment at age 40 is only 5%. 

How Does Age Affect Fertility?

More women in the US are delaying childbearing until they are in their 30s or 40s. About one-third of couples trying to conceive once the woman is over 35 struggles with fertility issues. Age affects fertility in the following ways:

• Ovaries become less able to release eggs.
• The quantity of eggs in the ovaries is less.
• The quality of egg health is diminished.
• A woman’s overall health is more likely to include conditions that can cause fertility problems.
• There is a higher risk of miscarriage.

What Other Fertility Risk Factors Should I Know About?

In addition to her age, a woman’s overall health should be considered when she considers pregnancy. It is not true that a healthy woman will not have trouble conceiving after the age of 35 or 40, but it is true that an unhealthy woman may have more trouble. Specifically, you should think about the following and share your assessment of these risk factors honestly with your physician.

• Tobacco and/or nicotine use
• Alcohol consumption, particularly if in excess
• Stress levels
• Insufficient or unhealthy diet
• Physical exercise and/or athletic training
• Being overweight or underweight
• History or presence of sexually transmitted infections (STIs)
• History of miscarriage
• Painful, absent or irregular periods
• Endometriosis or pelvic inflammatory disease
• Other relevant health problems, including those that cause hormonal changes (i.e., polycystic ovary syndrome, primary ovarian insufficiency, etc.)

It’s not just the woman’s general health that should be considered when a couple is trying to get pregnant. Your doctor can discuss with you the different factors that might be affecting your male partner’s fertility health, though many of the ones listed here would affect him too.

How Old is Too Old to Get Pregnant Naturally?

If you are ready to try for a pregnancy, it is wise to start with a full check-up and consultation with your doctor. When you schedule the appointment, let her know that you and your partner are concerned about the risk for decreasing fertility. The appointment should include a full health history for both you and your partner. It can be helpful if you track your ovulation for several months before the appointment to give the doctor a fuller picture. A man will likely have a semen analysis scheduled to consider his fertility health also.

Depending upon your age, your histories, and your initial fertility analyses, the doctor might also order further fertility testing. These tests can include:

• bloodwork – to check ovulation or hormone levels
• ultrasounds – to visualize your ovaries
• hysterosalpingography- a die test to study the uterine and fallopian tube structure
• laparoscopy – minor surgery using a micro camera inserted through small incisions to visualize the abdominal cavity

How Long Should We Try Before We Seek Infertility Treatment?

If you are 35 or younger, it’s recommended that you try to conceive for a year before seeking medical treatment for infertility, unless you have several of the previously mentioned risk factors that can make it more difficult to conceive. If you have any of these risk factors, talk with your doctor sooner.

If you are 35 or older, you should try for only about 6 months before seeing your doctor. Your doctor will likely want to consider treatment options such as oral medications, artificial insemination, or maybe even in vitro fertilization. Make sure to have a thorough conversation about your options, including additional resources that your specialist recommends for educating yourself. A solid relationship with a trusted specialist can be your biggest asset in deciding what treatment path is right for you.

How long did you try or have you been trying to get pregnant?

Image credit: Photo by Matheus Ferrero on Unsplash