Infertility is defined as the inability to conceive a child despite trying for one year. The condition affects about 5.3 million Americans, or 9 percent of the reproductive age population, according to the American Society for Reproductive Medicine.
To become pregnant, a couple must have intercourse during the woman’s fertile time of the month, which is right before and during ovulation. Because it’s tough to pinpoint the exact day of ovulation, having intercourse often during the approximate time maximizes the chances of conception.
After a year of frequent intercourse without contraception that doesn’t result in pregnancy, a couple should go to a health-care professional for an evaluation. While a gynecologist may be a good place to start, a board-certified fertility specialist is probably most appropriate, especially in patients over 36 years old. In some cases, it makes sense to seek help for fertility problems even before a year is up.
A woman over 30 may wish to get an earlier evaluation. At age 30, a woman begins a slow decline in her ability to get pregnant. The older she gets, the greater the chance of miscarriage, too. A woman’s fertility, however, doesn’t take a big drop until around age of 37-40.
Age and fertility is an important concept to understand. Women are born with their full complement of eggs – about 4-5 million. However, only about 250,000 survive until puberty – most eggs are lost before a woman even has her first menstrual period! A woman ovulates about 500 times in her lifetime before reaching menopause; thus, most eggs are lost through processes other than ovulation – called apotosis or atresia – eggs are lost every day and at different rates that varies from woman to woman. This helps to explain why a woman may experience egg quality or egg quantity related fertility problems at various ages, and why woman of all ages who are experiencing infertility should seek the care of a fertility physician.
A man’s age affects fertility to a much smaller degree and 20 or 30 years later compared to a woman. Despite a decrease in sperm production that begins after age 25, some men remain fertile into their 60s and 70s.
A couple may also seek earlier evaluation if:
- The woman isn’t menstruating regularly, which may indicate an absence of ovulation that would make it impossible for her to conceive without medical help.
- The woman has had two or more miscarriages (or the man had a previous partner who had two or more miscarriages).
- The woman or man has had certain infections that sometimes affect fertility (for example, pelvic infection in a woman, or mumps or prostate infection in a man).
- The woman or man suspects there may be a fertility problem (if, for example, attempts at pregnancy failed in a previous relationship).