From dwindling egg reserves to ‘fertile windows’, there is much to know when it comes to optimising your chance of conception. We chat to Fertility SA obstetrician and fertility expert, Dr Kate Gowling, to find out more.
“Women reach their peak fertility at the age of 25,” says Dr Kate Gowling. From there, it begins to decline – gradually at first, with a more marked drop after the age of 35. This decline in fertility is due to a combination of decreasing egg numbers as well as egg quality and comes with a corresponding increase in the chance of miscarriage and embryonic chromosome abnormalities. So what do you need to know to improve your chances of conception?
Stats to know
So, if fertility begins to drop after the age of 25, what are the chances of natural conception after this age? “Before the age of 30 women have a 25 percent chance of pregnancy per cycle”, says Dr Gowling. Between the ages of 30–35 this drops to 15 percent and to 12 percent between the ages of 35–40. After the age of 40 there is just a five percent chance of falling pregnant naturally per cycle.
Get the timing right
The best chance for natural conception is the mid to late 20s and early 30s, so it’s important to take this into consideration if planning a family. Timing of intercourse is also important as the ‘fertile window’ of each cycle only lasts from about five days before ovulation up to the day of ovulation.
The good news is that sperm can survive inside the female reproductive tract for up to five days. Therefore, intercourse needs to occur prior to ovulation, but not necessarily daily. Intercourse every one to two days leading up to ovulation offers the highest chance of conception. Understanding your cycle and when you are ovulating is important to help identify the fertile window. Women can track their cycle through various apps and get to know their cycle through monitoring for signs of ovulation, such as cervical mucous changes. The highest chance of conception occurs when the cervical mucous is slippery and clear.
Quality over quantity
Egg quality can be affected by a range of factors, including increased BMI, endometriosis and various chronic medical conditions – however age is the biggest factor, and the main predictor of infertility.
Younger women with low egg numbers are just as likely to conceive compared to young women with high egg numbers. It’s the age, not the egg reserve, that’s important.
But, as women age, and their egg reserves lessen, the quality of the eggs that remain also becomes paramount.
AMH, or Anti-Mullerian Hormone, is a blood marker of ovarian reserve. It can help to assess a woman’s egg reserve and to see if it is appropriate for her age. This is important as women are born with all the eggs they are ever going to have (approximately one to two million). By age 30, only 12 percent of eggs remain, decreasing to three percent by age 40. In some women, however, this reserve drops off at a faster rate.
AMH cannot predict the chance of pregnancy. It is one test only and reflects the egg reserve at that current time. It can, however, be helpful in deciding when to start trying for a pregnancy or give an idea as to whether someone may have fertility issues at a younger age than expected due to low egg reserve.
Have a plan
About one in six Australian couples will be diagnosed with infertility. The cause of the infertility may be related to female factors, male factors, or a combination of both. The options available to couples depends on the underlying cause, but may include:
Tubal flushing with an oil-based solution. This helps to improve natural conception for three to six months, particularly in women with unexplained infertility of endometriosis.
Laparoscopy, a surgical procedure to examine the organs of the abdomen in order to find and treat any cause of infertility, most commonly endometriosis. A tubal flush can also be performed at the same time.
Ovulation induction with medications or low dose injections to help the ovary to release an egg.
Intrauterine insemination (IUI), where a sperm sample is washed and injected into the uterus just prior to ovulation.
In vitro fertilisation (IVF).
Get personalised advice
Fertility is personal so it's important to have a personalised treatment plan designed just for you. Speaking with a fertility specialist about your options is a great place to start. You can book an appointment with Dr Gowling here.
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