Upset because of the cultural misinformation on fertility rates after 35

liljoy-2 · December 2016

Ok, so this post is about a lot of women not knowing what the true probabilities of getting pregnant in any given cycle after 30 or 35 yo are. There is a lot of misinformation and general lack of education on this topic in society. So yes, everybody knows that fertility declines after 30 and even more so after 35 mainly due to egg quality. But what I didn't realize until starting to research/talking to REs (and I'm sure many others too) is that the probability/cycle is low to begin with (about 25% in your early 20s) and then drops to 5-10% by mid-30s, in the absence of any other issues like endometriosis, blocked tubes, low ovarian reserve, sperm issues, etc. (that are not uncommon in our 30s). With endometriosis for example and after 35, the chance/ cycle is 1% naturally!! And IUIs don't increase this chance much. And even IVF rates are not stellar (50% at most on average). So not getting pregnant easily after 35 or having m/c is not a "why me" situation, it's the general rule. I wish somebody had beaten me over the head in my late 20s to TTC even if I was not married/not in the right spot then.

Just wanted to vent a bit..

laurad75 · December 2016

I feel the same way. My doctor kept telling me not to worry when I was younger and single but concerned about my age. When I finally got married at 40 I went in for a TTC appointment with a new doctor who basically said it would be a miracle if I conceived with my own eggs. I just feel like I may have made different choices if I knew this was going to be so difficult.

vlagrl29 · December 2016

I conceived my first child at 30 first month no issues. 36 now. I try and not stress cause it doesn't help.

amberruka · December 2016

We gotta stay positive ladies....TTCAL in last few weeks had BFP's on a 37, 38, and 39 year old--all natural.

Momifbysea · December 2016

Yes, I was 38-1/2 with DD BFP, natural. My RE explained there are just more sides on the die we are rolling. Having said this, I'm not naive about declining egg quality at my current age. Still hopeful.

vlagrl29 · December 2016

Momifbysea said:

Yes, I was 38-1/2 with DD BFP, natural. My RE explained there are just more sides on the die we are rolling. Having said this, I'm not naive about declining egg quality at my current age. Still hopeful.

did they find anything in your tests that resulted in a diagnosis? Just curious. Now that I will be getting all these test I'm wondering if they don't find anything wrong what do they do?

PoeMasque · December 2016

Where are you getting your numbers? I'm a maternal child health nurse and a bit of a research junkie and I've never come across numbers like that.....in fact, the last research I read said quite the opposite. It's really after 40 that there is a sharp decline. However, the body does a sort of "last hurrah!" before menopause where women often become super fertile....so, I'm not sure it's as bleak as you think it is.

liljoy-2 · December 2016

PoeMasque I got the numbers mainly from the REs. I talked to no less than 4 of them and all showed me their charts and statistics that I mentioned above...Yes after 40 they show a sharp and kind of hopeless decline but the stats start declining after 35 (that's why they have age categories <35, 35-37 etc. when they report statistics). Of course there is variability as these are averages, so some women are luckier than others. Plus if there are no other factors such as endo, PCOS, male infertility, the chances are better.

I didn't want to dampen hopes, I just wanted to vent a bit since I felt misled /had no idea that the decline is from a 25%/cycle probability in your early 20s (for some reason I though the fertility rates are much higher to begin with hence all the birth control frenzy we get instilled early on, hahah).

vlagrl29 · December 2016

I just want to add that my hair stylist got pregnant from a friends with benefits 1 night when she was 39 and had her kid at 40. For as many depressing stories as there are - there are just as many good ones too. I just had a friend my age give birth a couple months ago. 3 of her kids were really easy to get pregnant with and another baby took 2 years - this is the one before her newest addition. They didn't go any medical route to get pregnant with that one.

liljoy-2 · December 2016

Of course there are success stories, it's just that on average the chances become rather low...and that's why fertility education should be more prominent in our society...otherwise women after 35 who have difficulty conceiving get frustrated and start asking why me when in fact it is what it is and they are in fact the majority not the minority...

kiwieloping · December 2016

I am also curious about where the numbers come from because I have been researching the S**T out of this and have not seen these types of numbers.

Regardless, sorry to hear you are feeling down and having regrets about your decision to wait to TTC. Try to stay positive (as hard as it is) because beating yourself up is not going change anything. Previous posters are right - there are tonnes of women would get KTFU well into their late 30s and 40s : )

On the flip side, my perspective is that I did not want children in my 20s and nothing any stats said would change my choice. I would not have been in a place in my life to be the best parent. I would have had tonnes of regrets. Even though it is taking longer now in my mid-thirties and we are now contemplating adoption, I wouldn't change a thing.

bestofjoy said:

Ok, so this post is about a lot of women not knowing what the true probabilities of getting pregnant in any given cycle after 30 or 35 yo are. There is a lot of misinformation and general lack of education on this topic in society. So yes, everybody knows that fertility declines after 30 and even more so after 35 mainly due to egg quality. But what I didn't realize until starting to research/talking to REs (and I'm sure many others too) is that the probability/cycle is low to begin with (about 25% in your early 20s) and then drops to 5-10% by mid-30s, in the absence of any other issues like endometriosis, blocked tubes, low ovarian reserve, sperm issues, etc. (that are not uncommon in our 30s). With endometriosis for example and after 35, the chance/ cycle is 1% naturally!! And IUIs don't increase this chance much. And even IVF rates are not stellar (50% at most on average). So not getting pregnant easily after 35 or having m/c is not a "why me" situation, it's the general rule. I wish somebody had beaten me over the head in my late 20s to TTC even if I was not married/not in the right spot then.

Just wanted to vent a bit..

liljoy-2 · December 2016

Well for one, right here on the Bump is where the stats are: https://www.thebump.com/a/fertility
And for IVF rates here: https://www.advancedfertility.com/ivf-age.htm
And for the quality of eggs (by 40 more than half are abnormal): https://www.advancedfertility.com/age-eggs-chromosomes.htm

Of course there are quick searches ( I researched quite a bit but didn't save the links) but reflect what the REs have shown me.

kiwieloping · December 2016

I read those. I work in research so more into the academic studies which do not have conclusive numbers and certainly am not seeing the 5% at 35. Anyway, I do not want to argue I just want to encourage optimism. Considering the average first time mother in my country is 29 years old there is obviously a solid chance of getting pregnant after 20s!

liljoy-2 · December 2016

I want to be optimistic too and I was but after talking to these REs that basically told me that my chances are so low with IUI (they told me less than 5% because I have endometriosis) and not higher than 15% with natural/mini-IVF (where you only produce up to 4 eggs) I became very pessimistic. I already failed one IUI and one micro-IVF so...I begin to think it is the endo that really screws up things more than anything else...

vlagrl29 · December 2016

well I'm still optimistic. I ovulate on time and my cycles are regular. Should we have conceived #2 earlier than now? Maybe but neither of us were ready. I had a horrible pregnancy with DD and needed time to forget it. DH was building a photography studio and was so stressed this time last year he almost had an ulcer. Also I don't think people in their 20s early 30s should just get married to have a baby. That doesn't do anyone any good. What would be a better use of time is reading stories about women who have successfully conceived later in life.

kiwieloping · December 2016

I always wonder...if men had problems like endo, would there be a solution or treatment that solves it already?

@bestofjoy Hang in there

It could still happen. TTC this past year for me has been the most up and down and stressful time of my life. I never thought I would cry when I got my period or feel so down on myself as a women month after month. I don't have any diagnosis at this time so I can only imagine it has been even harder on you!

edited for grammar

vlagrl29 · December 2016

bestofjoy said:

I want to be optimistic too and I was but after talking to these REs that basically told me that my chances are so low with IUI (they told me less than 5% because I have endometriosis) and not higher than 15% with natural/mini-IVF (where you only produce up to 4 eggs) I became very pessimistic. I already failed one IUI and one micro-IVF so...I begin to think it is the endo that really screws up things more than anything else…

I'm sorry about your endo - I'm sure it's really hard. I know am only 7 months in and its annoying for me. There still are such a thing as miracles.

PoeMasque · December 2016

@bestofjoy its very possible you would have had the same issues getting pregnant in your 20s. There's no way to know if it's your age or just your body. I've had several friends with severe issues in their early 20s. Failed IVF several times before ever having a successful pregnancy. I've also had several friends get pregnant easily in their 20s, only to have multiple early losses or babies with genetic abnormalities. I'll be honest, if I'd started TTC in my 20s and had such a hard time back then I would be much more devastated than I am now. I'm sorry that this journey is not working out as expected for you, but I'm still very sure that your numbers are not accurate. None of the sources you have cited would be considered credible to a researcher and a lot of the "credible" data on fertility is from census data prior to the 1800s and has been proven to not accurately reflect our populations today. Either way, YOU are not a data point, this is your lived experience and infertility is devastating. It's ok to be upset about that. Maybe go visit the infertility board, there are many of stories of success after a lot of IF issues there

liljoy-2 · December 2016

kiwielopingbride That's a good question. This endometriosis is like a phantom disease. They say they don't know how it comes about, they don't know how to treat it, they don't know how to even diagnose it without a surgery that's no fun. I don't think they are really serious about it and it is so under-diagnosed. I'm assuming that a lot of "unexplained" infertility could be this..

KLake42 · December 2016

A story came out about a year ago that some of the "watch out for your ticking clock" warnings were sometimes more dire than they needed to be. There are a lot of women getting pregnant in their late 30s.

That said, I have the kind of ovaries that aged out a little earlier than average. So even though I've seen plenty of peers get knocked up at my age, that wasn't in the cards for me. I probably would have had trouble even if I'd got started at age 30 or 33 instead of age 37. But I wasn't ready to parent then.

It's good to be realistic about your circumstances, and use that realistic approach moving forward, with the choices you make now. But there's no use in regretting choices you made in the past.

liljoy-2 · December 2016

If anyone is still interested, I found these detailed statistics from Piedmont Reproductive Endocrinology Group:

Treatment Specific Pregnancy Rates:

Successful Pregnancy Rates for a “normal, fertile” couple is around 20 to 25% chance per month with timed intercourse. However, pregnancy rates in women decrease with advancing age and miscarriages and risks of abnormal pregnancies (Down’s and Turner’s syndrome) increase with age.

Fertility rates are highest in women in their late teens to late twenties (30% chance per month)
>35 years of age: 15% chance per month
>40 years of age: 5 to 10% chance per month
>43 years of age: <5% chance per month

Background miscarriage rates for any pregnant couple is around 15 to 20% chance
Age 35, miscarriage rate if >25%
Age 40, miscarriage rate is >30%
Age 45, miscarriage rate is >50%

Couples who are infertile have less than a 5% chance of pregnancy per month without treatment but this does depend on the infertility factors present (no sperm, blocked tubes or ovarian failure have a zero% chance).

Most infertility treatments are designed to try and improve the <5% chance per month to closer to the normal rate (20%) if possible (depends on female age and other infertility factors such as ovulation disorders, sperm abnormalities, tubal disease, pelvic adhesions, endometriosis, etc.).

These below quoted pregnancy rates are based on female age <35 years old. In women over age 35, these quoted pregnancy rates will be lower, especially in women over age 40 (unless using Donor eggs).

No treatment: <5% chance per month

No costs

Ovulation induction (Clomid or Femara and hCG injection): 5 to 12% chance per cycle

$100 - 150 (meds)
Day 12 mid-cycle follicle scan (transvaginal ultrasound): $125

Ovulation induction and intrauterine inseminations (IUI): 8 to 15% chance per cycle

$600 to 900 per cycle (including meds/follicle scan/IUI)

Stimulated Ovulation and IUI (SOIUI; using injectable gonadotropins): 10 to 25% chance per cycle

$3000 per cycle (includes meds/ultrasounds/bloodwork/IUI)

Minimal IVF: 20 to 35% chance per cycle

$6,000 per cycle (includes meds/ultrasounds/bloodwork/embryology lab charges)

Standard IVF: 40 to 60% chance per cycle

$12,000 per cycle (includes meds/ultrasounds/bloodwork/embryology lab charges)
Frozen embryo transfer (if had excess available embryos to freeze): 40% chance per transfer cycle

$3000 per cycle (including meds/ultrasounds/bloodwork/embryology lab charges)

Donor Egg IVF: 50-70% chance per cycle

$18,000 per cycle (including meds/ultrasounds/bloodwork/embryology lab charges/egg donor and donor screening)

PoeMasque · December 2016

I think you either misread the info originally or you were quoting numbers for an "infertile" couple because what you just posted says women over 35 have a 15% chance per month....which is definitely what I've seen before, but your original post said 5-10%

The numbers you just posted all match up with what I've read too.

justsuzie · December 2016

tw......loss mentioned

I wonder if women over 35 feel their time is "running out" and then stress about getting pregnant and end up stressing themselves out to the point where the stress takes over and lessens their chances of getting pg because of it. I got pg the first month of trying and I was 36.5 and we weren't actively trying, just letting things happen. I ended up having an ectopic loss but age played no role in that. My ob said that a lot of the statistics out there aren't as black-and-white as they appear.

PoeMasque · December 2016

@justsuzie theuve actually done research on stress and fertility and it's all bunk. Stress does nothing to impact fertility. Nothing. Not that we shouldn't have known that by looking at how many women who are homeless, jobless, in abusive relationships, addicted to drugs, etc have no trouble getting pregnant.

I cant tell you how NOT helpful it is to hear over and over again "it'll happen when you stop trying!" Or "my sister took a month off and that's when they got pregnant" great, thanks. I've done all the things and I'm still not pregnant. My guess is your sister did them too and one of the times she did did one of the things she got pregnant.

Sorry, I can't bear misinformation and I think that saying stress causes infertility only makes people stress more. Stress will absolutely not decrease your chances of getting pregnant.

however, gaining or losing significant amounts of weight might....so if stress causes significant changes in weight (as in you need to buy new clothes) then it could affect things. But that's really a metabolic issue....

justsuzie · December 2016

@PoeMasque
https://www.annalsofepidemiology.org/article/S1047-2797(16)30240-X/fulltext
https://www.nih.gov/news-events/news-releases/nih-study-indicates-stress-may-delay-women-getting-pregnant
https://sciencenordic.com/how-stress-affects-conception

Just a few studies I found. My OB explained to me that stress can affect ovulation. But, I'm no expert and I am sure that anyone can find studies to oppose any idea. I do know that some women on another board said that when they were overly stressed out, their cycle was affected.

PoeMasque · December 2016

@justsuzie i couldn't read the first article (the link didn't work), but the second one absolutely does not prove that stress decreases fertility. It's correlative and based on an enzyme in your saliva that dissolves carbs. It's actually pretty bad science to have an article that doesn't point out the flaws or "buts" about a study, so it's hard for me to believe this once paper can overturn what authorities on the subject currently agree on. That said, it's possible that for SOME women, stress may play a role, but I have not yet seen any concrete science on that (we DO know that working night shift can make TTC more difficult, but that's related to disrupted sleep patterns)

I'm a maternal child health and ER nurse, not only do my textbooks say stress does not hinder fertility, but I can tell you from personal experience that women under ridiculous amounts of stress still get pregnant on accident all the time.

I can also tell you from personal experience that having people tell you to "just relax and it will happen" is one of the least helpful and least empathetic things you hear while TTC.

vlagrl29 · December 2016

I do have to say I was extremely stressed in October and it made me ovulate late that month and have a much longer cycle. While stress may not affect some people in the TTC department I do believe it affects others.

justsuzie · December 2016

https://www.berkeley.edu/news/media/releases/2009/06/15_stress.shtml

Stress can have an effect on ovulation. I know that from my personal charting and listening to stories from other women on the ttcal board. I think knowing this helped me to seek out ways to alleviate my stress which helped me sleep better and got my cycle back on track. But I am not trying to convince anyone. I think personally knowing that stress can cause problems actually can be positive because that is something I can take steps to change. And feeling like I have some power in my journey ttc when other odds are stacked against me gives me peace of mind. And that is worth just as much as hope to me. But, I'm not a doctor, just someone looking to find a way to have some control in the process.

liljoy-2 · December 2016

I know this may come as no surprise to many of us here, but this topic is still controversial: does intercourse in the TWW impact our chance? This scientific study says yes.

https://www.ncbi.nlm.nih.gov/pubmed/24746744

vlagrl29 · December 2016

no I don't think so

PoeMasque · December 2016

This study also says that more studies are needed before anyone changes their practice since they only used "the calendar method" and did not actually pinpoint ovulation.

It was also only done on white, educated, older women....so it may not translate to other populations.

Interesting info on how semen cause changes in the uterus though!

KLake42 · January 2017

I could swear I saw a different study indicating that intercourse during the TWW *helped* fertility, but this study suggests that it hurts it? That's nuts.

I think I'll stick to my theory that lots of (gentle) orgasms all month long helps improve fertility (or it at least improves mood)... though maybe I'll skip the implantation window.

liljoy-2 · January 2017

Soon, there will be a TTC after 50 thread

Janet gives hope, giving birth at 50 https://www.reuters.com/article/us-people-janetjackson-idUSKBN14N1W6
It's funny and sad how the only two types of comments on social media to this news are: 1) she's old, she shouldn't have kids and 2) that's good, my grandma/aunt/mom etc. got pregnant at 50/48/53 etc (yeah, sure). Nothing regarding the actual science or procedure she most likely did (donor eggs or frozen eggs) and the probabilities and fertility topics. Women are not educated about biology and the current baby making science (I wasn't either until I hit a wall hard).

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