Aging and infertility in women

E T r i fi t t i c d s p s s I ACKGROUND emale fertility begins to decline many years prior to the nset of menopause despite continued regular ovulatory cyles. Although there is no strict definition of advanced reroductive age in women, infertility becomes more proounced after the age of 35. A classic report on the effect of emale age on fertility found that the percentage of women ot using contraception who remained childless rose steadily ccording to their age at marriage: 6% at age 20 to 24, 9% at ge 25 to 29, 15% at age 30 to 34, 30% at age 35 to 39, and 4% at age 40 to 44 (1). Similarly, a sharp decline in regnancy rate with advancing female age is noted with onor insemination studies (which control for fertility of the ale partner and coital frequency) (2) and with assisted eproductive technologies (ART) including in vitro fertilizaion (IVF). The risk of spontaneous abortion increases with emale age (3). According to the 1999 Assisted Reproductive echnology Success Rates, the percentage of clinical pregancies (gestational sac as imaged with sonography) that ailed to result in a live birth rose according to the woman’s ge: 14% for patients under age 35, 19% at age 35 to 37, 5% at age 38 to 40, and 40% after age 40 (4).