If you are over age thirty, or if you or your partner has reason to believe there is a risk factor in your background (such as a history of genital infections, irregular periods, or cancer treatment), this certainly justifies an early fertility evaluation. We also suggest that a woman who has a history of two or more miscarriages and no live births seek out a fertility specialist. If you and your partner are over age thirty or there are clues from your past that either one of you might have a fertility problem, and you still don't get pregnant after optimizing your chances by timing intercourse around ovulation, then we believe you need not wait as long as six months before seeking medical help.
If you and your partner have been trying to have a baby for about a year with no success, you may have fertility problems as a couple. But this does not mean you will never have a baby. Fertility problems are common and shared among men and women, and treatments are available. In fact, most of the couples who seek our help will eventually have a baby.
Fertility through the Decades
We are able to help young couples in their twenties who are having a difficult time achieving a pregnancy, couples in their thirties who may already have one child but can't seem to have another one, and even women into their forties and rarely in their fifties who thought having a baby was beyond their reach.
Most women know that it's harder to get pregnant when they get older. But complications during pregnancy also become more common with age. Age increases the risk of miscarriage and the need for a cesarean delivery and also boosts the chances of pregnancy-related diabetes and of having twins.
At birth, a woman has all the eggs she will ever have. As she ages, so do her eggs. And as an egg ages, it is more likely to develop a chromosomal abnormality. A fertilized egg with abnormal chromosomes is the single most common cause of miscarriage; at least half of all miscarriages are due to abnormal chromosomes. A woman in her twenties has a 10 percent chance of having a miscarriage each time she becomes pregnant. In her late thirties, the odds of a miscarriage are about 20 percent to 30 percent because of declining egg quality, and a woman in her forties faces a 50 percent to 60 percent risk of miscarriage.
Although age has a significant impact on pregnancy outcome and infertility, advancing age alone should not prevent you from trying to become pregnant. More than one third of all pregnancies and births in the United States occur in women who are in their thirties or older. Good prenatal obstetrical care has made pregnancies in older women safer than they were twenty to thirty years ago. The following sections illustrate typical scenarios in couples achieving pregnancies at different decades of their reproductive life.
A Baby in Your Twenties