Make a Plan
This is why you need a reproductive life plan! This simply means thinking ahead about whether you want to have children, and if so, when (ideally) you’d like to have them. ACOG, the national society of OBGYN doctors, recommends that you have a reproductive life plan and talk about it with your OBGYN once a year.
Why? Because your peak fertility years are your teens and 20s, and many of us aren’t thinking about having kids until our 30s or later, when our fertility has declined and it’s much harder to get pregnant. Each of us may also have individual risk factors for infertility that we need to consider (like endometriosis, fibroids, a history of pelvic surgery or chemotherapy, or risk factors like smoking).
It’s About Quantity and Quality
The reason it’s more difficult to get pregnant later is because women are born with all the eggs they will ever have (unlike men, who continuously make sperm once they hit puberty), and unfortunately it’s a downhill slope for us until menopause, with some sharp drops at age 35-37 and again beyond 40.
You actually lose most of your eggs before you’re even born - crazy, right? - and then every month your overall pool of eggs is decreasing, even though only one egg each month is being recruited (kind of like a star quarterback) to be the egg that ovulates that cycle. The others that were ready and waiting in the wings that month but weren’t selected to ovulate simply die off.
And it’s not just egg quantity….egg QUALITY declines as we age, again because we were born with this whole pool of eggs and we’re not making new ones, and the built-in machinery that helps the egg divide once it ovulates (and then again when it’s fertilized by a sperm) ages just like the rest of the cells in your body.
So by the time we reach our late 30s and early 40s, most of the eggs end up dividing abnormally. This is why the risk of chromosome problems like Down syndrome increases after age 35 and especially after age 40, and it’s why infertility and miscarriage rates are so much higher then too. Not to mention the fact that as you get older there’s a higher risk of having complications during your pregnancy.
The Take-Home Message
So what’s the take-home message…..and is there any good news here? What I want you to remember from this post is the importance of that reproductive life plan and thinking ahead about when you want to have children - and if it’s not until your late 30s or beyond, talk to your doctor about your plan. Sometimes women choose to freeze their eggs to use later when they’re ready to conceive. (This is no guarantee of future pregnancy, but it’s an option to consider - the pros and cons of which we’ll cover in future posts.) Some women, after talking to their doctor about their individual health and circumstances, may choose to pursue pregnancy at an earlier age.
I see too many women who wish they’d known or had the opportunity to pursue fertility options when they were younger and had a better prognosis. So think ahead, make a reproductive life plan, and talk to your doctor about it early and often!
