More and more women are choosing to wait until their 30s or later to have a baby for the first time. About 20 percent wait until after age 35. However, the longer a woman waits, her fecund ability (ability to conceive) becomes less. By the time a woman is 40, her chances of becoming pregnant drop to 5 percent. According to the U.S. Department of Health and Human Services Office on Women’s Health, “about one third of couples in which the woman is over 35 have fertility problems.” If you are over 35 and having difficulty conceiving, your fertility doctors in Kansas City can advise you if assisted reproductive technology (ART) is a viable treatment for your situation.

There are several factors that are taken into consideration. For example, the age of a woman’s uterus is not as important as the age of her eggs. As a woman gets older, the quality and quantity of the eggs decline. At birth, women are born with approximately one to two million eggs in their ovaries—a lifetime supply. By the time puberty arrives, only 300,000 to 400,000 eggs remain. At this stage, 1,000 more die each month, until the supply of eggs is exhausted,  estrogen production stops, and the woman goes through menopause somewhere between the ages of 40 to 60.

Kansas City fertility doctors can determine your fertility potential by performing “ovarian reserve” tests to determine the remaining egg supply. There are several tests that are used to assess ovarian reserves, and your fertility doctors will decide based on their experience which ones should be performed. Some of the tests are:

Antral follicle counts-- Antral follicles, also referred to as resting follicles, are small follicles approximately 2-8mm in size. Counting the number of antral follicles in the ovaries is done using vaginal ultrasound. A normal antral count is considered 15-30. Less than 4 is considered very poor.

FSH testing (Day 3)—As a woman ages, follicle stimulating hormone (FSH) levels become elevated in an effort to elicit a response from the ovary.  High day 3 FSH levels, exceeding 20 IU/L, are linked with low conception rates.

AMH blood levels—AMH (anti-mullerian hormone) blood levels are thought to indicate the remaining ovarian reserve. An early marker of ovarian aging, AMH levels do not fluctuate during the month, so the test can be performed on any day of the cycle. Women with low AMH levels show a poorer response to fertility drugs and fewer eggs retrieved during IVF.

While ovarian reserve testing can tell us about the quantity of eggs left, female age is currently the best indicator for quality. Discuss ART success rates with your fertility doctors in Kansas City to best determine your course of action.