28 April 2020

Things you should know about fertility when you are 20, 30 and 40

By the Editorial Comitee IVI Blog

Fertility is an issue that can’t help having an impact on a large portion of our lives. From the age at which we start being sexually active, right through to looking out for signs of the perimenopause, there’s always an aspect of it to think about.

You may be more focused on effective contraception in those early years, you may breeze effortlessly through the unique personal journey of conception, pregnancy and childbirth without a second thought, or you may run into unforeseen obstacles. The good news is that with the continuous medical and technological advances that we see in assisted reproduction, we can usually find ways to steer around any bumps on the road to parenthood. Let’s get going with a quick roundup of things you should know about fertility in your 20s, 30s and 40s.

Fertility in your 20s

Most people in their 20s are in their prime fertility wise, but life being what it is, many 20-somethings are more interested in contraception than in pregnancy. Those who do decide to start a family may feel taken aback if the results are not instant. Here’s a quick fact check on fertility in your 20s.

  • Contraception does not make you infertile

Whatever contraceptive you use, you need to know that none (with a single exception) have any impact on your future fertility. The hormonal contraceptive pill, barrier methods, intrauterine devices, none of them will damage your future family plans. The exception is the Depo-Provera contraceptive ‘shot’. This does not cause infertility but can delay the return of fertility for six to 12 months. Read more about contraception and fertility here.

  • Conception could take longer than you expected

When you’re in your 20s it’s easy to assume that pregnancy follows immediately when you stop taking contraceptives. But in fact, for a normally fertile couple, the natural pregnancy rate is around 10% each month. However, an impressive 92% of couples aged 19 to 26 will become pregnant within a year of unprotected sex, increasing to 98% after two years. So, don’t worry – it will probably happen.

  • But what if it doesn’t happen?

People in their 20s could well be unaware of any fertility problems, so when pregnancy doesn’t happen it can be a shock. The most common cause of infertility in women in their 20s is irregular ovulation, frequently caused by Fertility treatments are available and can very often help.

Fertility in your 30s

Evolving social and financial structures in the Western world mean that more and more women are postponing motherhood until their 30s. And for good reason. Women in their 30s could well feel more ready for motherhood in emotional, relationship and career terms. The only drawback is the approach of a decline in fertility.

  • Your 30s: the decade of ‘fertility events’

Having hardly given fertility a thought in your 20s, and with all sorts of difficulties looming if you leave it until your 40s, for very many people your 30s is when everything happens. The age of 35 is something of a watershed: under 35 is the best time to plan your family, either through having children or vitrifying your eggs for the future; once over 35 you should be thinking of talking to a specialist to give you a sense of your likely success rate if fertility problems should arise. The decline in fertility that begins around this time comes as a result not only of a lower ovarian reserve, but also a decline in the quality of the remaining eggs. This means that chromosomal abnormalities are more likely, leading to a higher chance of miscarriage.

  • Lifestyle factors have an impact on fertility in your 30s

Obesity and smoking are among the lifestyle issues that can have an impact on your fertility. Being overweight or extremely underweight can inhibit normal ovulation. Smoking and overconsumption of alcohol are also associated with decreased fertility. Sexually transmitted diseases like chlamydia and gonorrhoea are also important causes of infertility in women.

  • Fertility preservation for women in their 30s

One of the scientific and technological advances now available to women in their 30s is the possibility of cryopreservation: the freezing and storage of their own eggs to keep alive the possibility of motherhood in the future. The optimum time to do this is before the age of 35, with ‘young’ eggs retaining all the characteristics they had at the time of collection. Watch our video about the vitrification of oocytes to learn more.

Fertility in your 40s

It’s perfectly possible to have a successful pregnancy at 40 but the fact is that by this age, an averagely healthy woman has around a 5% chance of conceiving per menstrual cycle. Added to the declining likelihood of conception is the increased chance of miscarriage.

  • Declining egg quality leads to an increase in miscarriage and birth anomalies

The deteriorating quality of oocytes with advancing age leads to more likelihood of miscarriage. The rate of abnormal embryos increases from 55% at age 38 to 88% for women over 44 years old. These figures compare with a less than 15% chance of miscarriagefor a woman in her 20s.

  • Men’s fertility starts to decline too

Although it does not have the equivalent cut-off point of menopause, men’s fertility also starts to decline after the age of 40. For example, a young woman of around 25 with an equally young partner would take an average of five months to conceive, but if her partner is over 40 it takes about two years, and longer if he is over 45. There is also a higher risk of miscarriage.

  • Treatment for infertility in your 40s

Women with ovarian failure due either to age or a medical condition still have the option of pregnancy and childbirth. The first fertility treatment would normally be an IVF cycle using preimplantation genetic diagnosis to detect any aneuploidies or chromosomal abnormalities. This allows for transfer of only healthy embryos. In the event that this is not successful, there is still the opportunity of IVF with the use of donated eggs. Many women make this choice because success rates are higher than for other fertility treatments, often significantly so. You can find out more about the IVI egg donation program here.

Questions about fertility in your 20s, 30s and 40s?

Many women of all ages experience problems with infertility and have urgent questions about what help may be available. New treatments and techniques are being developed all the time, so don’t assume you know all the answers without checking. You can browse our website for the latest information about infertility treatments and success rates, or simply get in touch with us using our online contact form.

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