Fertility After Age 35

Waiting until you are ready to start a family makes sense. But waiting may carry some risks. In most women, fertility begins to drop in the late 20s or early 30s. Fertility falls more quickly after age 35. But there’s good news, too. Today, one in five women in the United States has her first child after age 35.

Getting Older
As women get older, their bodies are less able to do things. This includes getting pregnant. Ovulation may become less regular as the ovaries age, and eggs may be less healthy. Other things that can lower the
chances of getting pregnant are:
• Scar tissue on reproductive organs. Infections or surgeries may cause scar tissue.
• Fibroids or other growths in the uterus. Fibroids are more common in women over age 30.
• Endometriosis. This can cause blocked tubes and may progress with age.
• Less mucus in the cervix. This makes it harder for sperm to get to the uterus.
• Health problems. These may include high blood pressure or diabetes.

Ways to Increase Your Chances of Getting Pregnant
Many lifestyle choices may affect fertility. Here are some things to consider:
• Smoking. If you smoke, try to stop. Both smoking and passive smoke harm ovaries. And men who smoke have lower sperm counts.
• Body weight. Try to maintain a healthy weight. Being greatly overweight or underweight may affect your periods. You may not ovulate every month.
• Uncontrolled health problems. Regular exercise and a healthy diet may help manage chronic health conditions and improve overall health.
• Alcohol and caffeine. Drinking too much alcohol or caffeine may affect your fertility. You should see your obstetrician/gynecologist right away for a fertility evaluation if any of the following is true:
• You are over age 35 and have not gotten pregnant after trying for 6 months.
• A home fertility test shows that you or your partner may have a problem. You can buy fertility tests
over the counter.
• Your periods are not regular, or they are very painful.
• You have had more than one miscarriage.
• You or your partner has had health problems that may affect your fertility. These may include sexually transmitted diseases (STDs) or eating disorders.

A Fertility Evaluation
Your ob/gyn can do a fertility evaluation. It may include:
• A medical history. You will discuss your periods, birth control history, and sexual patterns. You will also discuss your history of health problems, medicines, and surgeries.
• A physical exam. Your ob/gyn will look for things like extra hair growth, breast discharge, and infection or growths in your vagina. You may also have a Pap smear.
• Blood tests. Your hormone levels may be tested with blood tests. Abnormal levels may cause a problem with ovulation.
• X-rays or ultrasounds of your organs. These may reveal cysts or noncancerous growths.
• Diagnostic surgery. Minor surgery may reveal scar tissue, fibroids, or polyps.

Cervix (SUR-vix): The lower, narrow end of the uterus that connects to the vagina.
Cysts: Sacs filled with fluid on the ovaries.
Endometriosis (en-doe-me-tree-OHsus): A condition in which tissue that normally lines the uterus grows outside of it.
Fibroids (FY-broidz): Noncancerous growths in the uterus.
Hormones: Chemicals made by the body.
Ovaries (OH-vur-eez): The two glands on the sides of the uterus. They produce eggs and hormones.
Ovulate (AW-view-late): When the ovary releases a mature egg into a fallopian (fuh-LOpee-un) tube. The egg travels through this tube to the uterus.
Polyps (PAUL-ups): Noncancerous growths in the lining of the uterus.
Uterus (YOU-dur-us): Where a fertilized egg (embryo) grows during pregnancy.

Provided as an educational resource by Merck