Female fecundity and age.

PIP: Studies have shown that fertility (defined as number of live births) declines with age in women. However, it is not known to what extent other factors, such as male reproductive capacity and coital patterns affect this decrease. Male fecundity may also decline with age, and coital frequency is believed to decline with length of marriage. All these factors are closely related to the woman's age. The effects of male fecundity and coital frequency can be eliminated in evaluating female fecundity by studying patients who have received artificial insemination and restricting the group to those with azoospermic husbands. In 2193 patients drawn from 11 centers in France that offer artificial insemination with frozen donor semen, women over 30 exhibited a marked decline in fecundity. The cumulative success rate after 12 cycles of insemination was 73% for those under 25, 74.1% for the 26-30 age group, 61.5% for those 31-35 years old, and 53.6% for those over 35 years. The difference in fecundity with age was consistent across the centers, an important factor to note since the mean success rate per cycle differed considerably among the participating centers. The decreased fecundity in women over 30 may be attributed to gynecologic diseases, or effects of age on the incidence of tubal deciliation and occurrence of ovulatory disorders. New guidelines for counseling on reproduction may be needed for women over 30. Currently, counseling regarding reproduction and maternal age is limited to increased risks of Down's syndrome and other genetic abnormalities and risks of spontaneous abortion and perinatal deaths. The age of a woman should be considered when deciding when to start an infertility workup or stop treatment for infertility, and in selecting appropriate candidates for tubal surgery and in vitro fertilization. There is also a need to reevaluate individual and societal goals regarding childbearing to accommodate women's desires to have both a family and a career.

PMID: 7057834 [PubMed - indexed for MEDLINE]