Age 35 Isn’t a Fertility Cliff. Why Do We Think It Is?

[Anonymous]

Anonymous wrote:/\ PP here. I'm sorry to hear that. And yes, exactly. Close to half of infertility cases are unexplained, so something like normal AMH results would be false reassurance that everything is okay.

According the Dept. of Health and Human Services, studies show a third of infertility cases are due to the female, a third are due to the man and the remaining third are due to either a combination of both the man and woman or unexplained reasons. So less than a third are truly unexplained.

However, the problem is a lot of testing and popular belief about infertility focuses on the female alone which doesn't quite line up with the data above.

[Anonymous]

Anonymous wrote:Question- I've suffered from infertility for almost 10 years (started trying at 25 and am 35 now). I've never had a miscarriage, but have had 2 pregnancies in my 30s. How common is that? It seems like there's so much emphasis on rainbow babies and losses, but what about those of us who just can't get pregnant (I did IVF). Is that really uncommon?

Nope. That is me too.....Except I couldn't get pregnant with ivf.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This Jean Twenge article from 2013 was popular when I was TTC: "The bottom line for women, in my view, is: plan to have your last child by the time you turn 40. Beyond that, you’re rolling the dice, though they may still come up in your favor. “Fertility is relatively stable until the late 30s, with the inflection point somewhere around 38 or 39,”

It also discusses potential reasons for society's age 35 cliff view.

https://www.theatlantic.com/magazine/archive/2013/07/how-long-can-you-wait-to-have-a-baby/309374/

Yep. Told you it was 40 and above....not 35!

My RE and my friend's RE at a different clinic both said after 37/38 it gets harder to have success. Granted we're talking about people already at the RE, but I trust their opinions more than the psychology professor that wrote that article.

Most people i know needed help after 35.

[Anonymous]

Anonymous wrote:

Anonymous wrote:/\ PP here. I'm sorry to hear that. And yes, exactly. Close to half of infertility cases are unexplained, so something like normal AMH results would be false reassurance that everything is okay.

According the Dept. of Health and Human Services, studies show a third of infertility cases are due to the female, a third are due to the man and the remaining third are due to either a combination of both the man and woman or unexplained reasons. So less than a third are truly unexplained.

However, the problem is a lot of testing and popular belief about infertility focuses on the female alone which doesn't quite line up with the data above.

I could not agree more. Refusing to think the man could be a problem is a huge disservice to so many couples.

[Anonymous]

I work with a guy who is the youngest of like 17 kids and his mom had him at 50 yrs. old naturally.

[Anonymous]

Anonymous wrote:I work with a guy who is the youngest of like 17 kids and his mom had him at 50 yrs. old naturally.

This was not at all uncommon back in the day. Very normal for women to have their last kid in their 40s.

[Anonymous]

By all means, lets keep spreading anecdotal data to encourage women from putting off having children. Everyone knows that one guy at work....

But what is actually happening is entire generations of women moving the starting line...to their own detriment. When my generation was coming along, everyone started at 30. Now, everyone starts at 34/35, then ten years from now it's going to be 38.

The good news is that science is catching up and most everyone has a chance to procreate, if they have the cash to pay for eggs, sperm, IVF, or some other science project.

The poor people are going to keep having kids young anyway...

[Anonymous]

Anonymous wrote:I suspect insurers play a role in this complicated determination too. They want to establish a cutoff as close as possible to where it actuarially makes sense to pay for tests like cell free DNA or extra ultrasound/visits to high risk practices for large numbers of women versus the cost of the expected complications avoided for mother and child.

One of the reasons that 35 became the cutoff is that it’s the age at which the risk of having a fetus with the common trisomies (t21, t18, t13) becomes greater than/equal to the risk of miscarriage from amnio. For that reason, OBs and MFMs would offer it beginning at age 35. This was before noninvasive testing like NIPT was an option.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

I had #2 at 33. I knew the risks of trying again at 35--namely, increased risk of miscarriages. We should shout this from the rooftops. Women should know the risk of having multiple miscarriages will go up trying to conceive at 35+.

They should know about it, but the impact shouldn't be exaggerated. Someone who has never had kids probably pictures a "miscarriage" as a really huge deal, like one step below a stillbirth. At least I did when I was younger.

Then I had three kids in four years, starting at 31. And I also had three pregnancy losses during this same period. They were all pretty early on and were not a big deal at all. No comparison between my experience and my friend who lost a fetus at 5 months.

Uh okay well glad for you that you didn’t care. I cared a lot. I was just discharged from the hospital last week after a complicated, but very early, miscarriage. Physically and emotionally painful.

[Anonymous]

35 too old for baby

[Anonymous]

Anonymous wrote:By all means, lets keep spreading anecdotal data to encourage women from putting off having children. Everyone knows that one guy at work....

But what is actually happening is entire generations of women moving the starting line...to their own detriment. When my generation was coming along, everyone started at 30. Now, everyone starts at 34/35, then ten years from now it's going to be 38.

The good news is that science is catching up and most everyone has a chance to procreate, if they have the cash to pay for eggs, sperm, IVF, or some other science project.

The poor people are going to keep having kids young anyway...

My mom had a patient who gave birth at 65. But I know plenty of childless women who pushed off until late 30s and weren't able to have kids even with ivf.

[Anonymous]

Anonymous wrote:35 too old for baby

Just stop.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I suspect insurers play a role in this complicated determination too. They want to establish a cutoff as close as possible to where it actuarially makes sense to pay for tests like cell free DNA or extra ultrasound/visits to high risk practices for large numbers of women versus the cost of the expected complications avoided for mother and child.

One of the reasons that 35 became the cutoff is that it’s the age at which the risk of having a fetus with the common trisomies (t21, t18, t13) becomes greater than/equal to the risk of miscarriage from amnio. For that reason, OBs and MFMs would offer it beginning at age 35. This was before noninvasive testing like NIPT was an option.

Yes, but as the article OP posted noted, the risk of miscarriage from amnio has decreased significantly since that calculation was done.

[Anonymous]

Anonymous wrote:I think this would be good for women to know: "One of the largest studies found that 78 percent of women aged 35 to 40 will conceive within a year, compared with 84 percent of women aged 20 to 34."

The difference between the groups isn't the part that stands out as much as the 16% of women 20-34 who WON'T conceive in a year and the 22% ages 35-40. I honestly didn't know the number was that high.

Conceiving is one thing, but conceiving a normal-karyotype pregnancy and carrying to term is something else.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:/\ PP here. I'm sorry to hear that. And yes, exactly. Close to half of infertility cases are unexplained, so something like normal AMH results would be false reassurance that everything is okay.

According the Dept. of Health and Human Services, studies show a third of infertility cases are due to the female, a third are due to the man and the remaining third are due to either a combination of both the man and woman or unexplained reasons. So less than a third are truly unexplained.

However, the problem is a lot of testing and popular belief about infertility focuses on the female alone which doesn't quite line up with the data above.

I could not agree more. Refusing to think the man could be a problem is a huge disservice to so many couples.

Yep. Wasted 10 years and countless ivfs on it. And now I'm into the AMA range