Understanding Fertility and Conception
Eighty five percent of all couples trying to conceive will become pregnant within one year. Approximately 7 million or 1 in 6 couples will have difficulty conceiving and may need medical help to identify and treat the possible causes of infertility. The good news is that there are treatments now to help almost everyone.
Infertility is a disease of the reproductive system that inhibits a couple's ability to have a baby. Infertility affects men and women equally without discrimination, and for this reason both partners should actively participate in the diagnosis and treatment process. Infertility is not uncommon and you are not alone.
40% of all infertility cases may be attributed to the woman, 40% to the man, in 10% of cases both partners contribute to the problem, and 10% of the time the cause can not be identified and it is unexplained.
The standard definition of infertility is the inability to achieve a pregnancy after one year of unprotected intercourse in couples where the woman is under age 35. Because a woman's fertility declines naturally as she gets older, couples should consider seeking medical help after six months of trying when the female partner is over age 35.
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When to seek treatment
Advanced Age Infertility
A woman’s fertility peaks in her mid-20’s, begins to decline around 27 and drops off more steeply after age 35. A woman’s fertility is measured by her ability to achieve a pregnancy on a given month. For women, the ability to conceive is tied to the quality of her eggs. As women age, hormonal changes begin to take place. There is a lot going on but of particular interest are the two main hormones controlling the development and release of the egg each month. These are FSH (follicle stimulating hormone) and LH (lutenizing hormone).
A rising FSH level is linked to a decreasing egg quality. Decreased egg quality means it becomes more difficult for the sperm to fertilize the egg naturally. There may even be chromosomal abnormalities occurring within the egg itself, which is why amniocentesis is recommended for pregnant women over 35.
To illustrate this point, the natural pregnancy rate for women >30 is 20-30% per month but by age 40 the likelihood of conception occurring drops to > 5% per month.