Menopause Mondays: Women’s Fertility and the Biological Clock

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New Girl has got me thinking: Where have all the good eggs gone? During a recent episode, Sadie, the show’s “friendly neighborhood gynecologist,” broke the news that a woman can lose up to 90 percent of her eggs by age 30. Jess (and I!) had a little more than a minor freak-out. Very funny, FOX. Isn’t this supposed to be a sitcom? While I’m past my baby-making days (and probably so are many of you), our lives are full of young women—our sisters, daughters, and friends—who we want to experience the same joy in raising children that we did in raising them. It’s up to us to make sure they have the know-how to make that happen.

Well, there is good news and there is bad news. First, the bad news: About 95 percent of 30-year-old women have only 12 percent of their original number of ovarian follicular cells, which can develop into eggs. And at 40, only 3 percent of the cells remain, according to research from the University of Edinburgh. Now, the good news: The research says that before birth, females have roughly 600,000 cells. That means that even if you lose 88 percent of them by the time you blow out 30 candles, you can still celebrate having 72,000 cells left. While it’s easiest for women to become pregnant before age 35, all egg-laying ovaries are not created equal, says David B. Smotrich, MD, a Diplomate of the American Board of Obstetrics and Gynecology specializing in Reproductive Endocrinology and Fertility. During your early 30s, your eggs can decline in quality and you might begin ovulating less frequently, even if you are having regular periods, Smotrich says. A 30-year-old woman has a 20 percent chance of getting pregnant per cycle, but by the time she’s 40, her odds drop to 5 percent per cycle, according to the American Society for Reproductive Medicine. That’s where some newfangled fertility tests come in. Yep, Jess and Cece aren’t the only women getting their test on.

If you plan to have a baby in the great “someday,” Smotrich recommends treating yourself to a baseline exam or two for your 30th birthday. Follow up with yearly tests until age 35, semi-annual tests (I suggest you time them with the Victoria’s Secret semi-annual sales!) until 39, and quarterly tests thereafter to monitor your fertility, he says.

Here are some of your fertility-testing options:

Follicle-Stimulating Hormone (FSH) Test A blood test that measures your body’s levels of follicle-stimulating hormones, which control your menstrual cycle and your production of eggs, he says.

25-Hydroxy Vitamin D Test A blood test that determines if your body is deficient in calcidiol, your body’s main form of stored vitamin D. Calcidiol levels generally decline with age, and deficiencies can predispose your baby to health complications, according to Smotrich.

Estradiol Test A blood test that measures the amount of a hormone called estradiol in your blood. Estradiol is a form of estrogen that is largely made in and released from the ovaries, adrenal cortex, and the placenta, which forms during pregnancy to feed a developing baby, he says.

Anti-Mullerian Hormone (AMH) Test A blood test that estimates the number of the eggs in the ovaries, according to Smotrich.

Running out of eggs—and time? Medical interventions can help women older than 35 conceive. During in vitro fertilization, for instance, eggs are harvested from your ovaries, frozen unfertilized, and stored for later use. Your eggs can then be thawed, combined with sperm in a lab, and implanted in your uterus. In women ages 35 and younger who undergo up to six cycles of in vitro fertilization therapy, the live-birth rate ranges from 65 to 86 percent. Women ages 40 and older have half the chance of giving birth from in vitro therapy, with their rate ranging from 23 to 42 percent, according to an analysis of more than 6,000 patients published in The New England Journal of Medicine. The procedure typically costs about $10,000 per cycle, according to Smotrich.

During perimenopause, it is possible to conceive a healthy baby, while at the same transitioning to menopause, he says. However, since the risk of chromosomal complications increases with the mother’s age, Smotrich recommends women older than age 35 talk to their doctor about having their developing baby monitored for chromosomal conditions including Down syndrome. Tests include anuchal scan, a type of ultrasound, and amniocentesis, also referred to as amniotic fluid test or AFT, in which a small amount of amniotic fluid, which contains fetal tissues, is sampled, he says.

While men experience a drop in fertility after age 50, mom’s age is the most important one in terms of conceiving, according to Smotrich. Still, older men have increased levels of sperm DNA instability, which is linked with a higher risk of autism and schizophrenia in children, according to Eric J. Topol, MD, Professor of Genomics at The Scripps Research Institute and author of The Creative Destruction of Medicine.

Our baby makers don’t work forever. Thank goodness. Can you imagine if they did? But if we keep an eye on our fertility clock, we can help make sure that when our lives are ready for pregnancy, childproofing, and dirty little handprints all over our walls (and our hearts), so are our bodies. If you are more in the grandma stage of life than the mom stage, share this information with the young women in your life who are in their childbearing years. It is up to us to help educate the younger generation so they can someday have the families of their dreams.

 Suffering in silence is OUT! Reaching out is IN!

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • So much for the “plenty of time for that later” theory that leads so many young couples to postpone starting families.

    • Ginger, unfortunately biology doesn’t always agree with our lives’ plans! Hopefully more options will become available for couples to conceive later if that’s what’s best for them!

  • In my advocacy with breast cancer in young women, harvest your eggs!

    • Harvesting your eggs prior to undergoing breast cancer treatment is a great point, Haralee!

  • I remember smugly thinking I had nothing to worry about since my mother had 3 of her children in her 40’s. That wasn’t the case for me though. I learned and will be sure to pass this information onto my adopted daughter.

    • I’m so glad you to hear you are spreading the word!

  • While I am past the point of this having any effect on me, it is interesting to know. Thanks.

    • Thanks, Jennifer! Please share this info with the younger women in your life! 🙂

  • I think the one point that most women aren’t told about is the egg situation. Many women over 35 are dumbfounded at these kinds of stats. Thanks once again for the wonderful information presented all in one place. I also like how you reference your sources.

    • You are so right, Shelley! Young women need to understand their fertility BEFORE their fertility begins to decline!

  • Wow,seeing your stats, which I’ve never really investigated, make me realize even more what a blessing we have in our son. I gave birth to him at age 43 and he was not planned, but we are oh so happy he joined our family.

    • That’s so wonderful, Rajaen! A blessing, indeed!

  • A good primer of the life of our eggs. Sharing with my infertility groups.

  • I had no idea. I thought you pretty much kept being as fertile as always…right up till you weren’t.

    Women should be taught this as girls…so they can make more informed decisions.

    Thanks!

  • With a 19 yo daughter I’ll keep this information in my back pocket. I had no idea so many tests are available for fertility testing. Thanks.

    • Haha, Darlene! Hopefully there will be even more options for her later in life!

  • already commented so I tweeted your OUT!!

  • It’s so wonderful that you’re sharing this. I think most women (at least in my generation) were raised to believe that we should wait until we were in a stable relationship with a stable career and finances before having children. However, as you said biology does not always agree with our life plans. It is important for women to know about their fertility before it is too late. Thank you for a great post!

    • Thank you Jen. It’s important for women to know about this before it’s too late is so correct. I’m trying to get this information out there as much as possible. Biology aside, I don’t think any mothers on here could say they felt stable and ready in their finances to start a family but did it anyways and it all works itself out.

  • Good info–wish I’d known some of this younger. Which is, of course, the point of sharing! 😉

    • Thank you Carol. I’m looking at websites with younger audiences to also share this with. This is definitely an article to email our daughters…

  • WONDERFUL Post.thanks for share..more wait .. …

  • Thank you for sharing this interesting article. But it got me all panicky, I feel like the clock is ticking and I’m running out of time. I’m already 24 and still don’t have plans of settling down.

    • Ellen Dolgen

      No need to panic – it is just meant to empower you! Knowledge is power. Knowing when perimenopause begins can help ensure that you make the best decisions for you!

  • Although the above tests are available to test our fertility, i think it is still best to encourage conception at an earlier age. I personally put my life/ children before any career goals. You only appreciate this fact once you have adorable children and understand what is important in life.

    • Ellen Dolgen

      I think motherhood is fabulous, too. Now – I am a new Grandma of a 6 month old little girl. I am blown away at how special this time in my life is. Little Aviva brings so much joy to both my husband and me. That being said, every women is different and her needs are different. So, it is good to understand you biological clock so that you can be in charge of the your family planning.