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How Loud is Your Biological Clock, Really?

July 2, 2013

An article published in the July/August issue of The Atlantic says contrary to widespread beliefs which have pushed us into a “baby panic”, women do not suffer a significant decline in their fertility until the age of 40. The article suggests we have at least five more years (from 35, the well-cited age of fertility decline) during which women can get pregnant quite easily. Sounds like we can hit the snooze button on our biological clocks, right? Not exactly.

Author Jean Twenge reviews several studies on age and fertility quoting one study that found only a four percentage point difference in the fertility of a 28-year-old woman compared to a 37-year-old. Another study, she reviewed, found that 89% of 38-year-old women are fertile. Twenge herself is not a statistician and four percentage points is more significant than she suggests, but more importantly, she glosses over the fact that these studies were conducted on healthy, normal weight women (excluding women with infertility, and including only women with proven fertility). The truth is that a healthy 30-year-old woman has a 20% chance of conceiving each month, or a cumulative 45% chance after three months. That number drops down to just 5% by the time she reaches 40 years of age, not to mention the increased risk of miscarriage and chromosomally abnormal embryos that comes with age.

Serena H. Chen, M.D., a fertility doctor at IRMS Saint Barnabas in New Jersey says that while there is no need for women to run around as though the sky is falling, it is important to understand these fertility statistics and how they apply to us. “On average, 75-80% of women if they are healthy and normal weight won’t have trouble trying to conceive, but that isn’t the case for the majority of the population. One half of women are overweight and one third of women are obese, so that eliminates half of the population right there. If a woman has an existing medical condition, that brings us down to the minority of people who won’t have a problem conceiving. Then we have to take into account unexplained infertility,” Chen informs. In reality, the data accounts for only a small percentage of reproductive-aged women.

The information presented in Twenge’s article is counterproductive in a time when we should be encouraging awareness, education, and involvement in our own health care. According to a study conducted by EMD Serono, women grossly overestimate their fertility. Those surveyed believed women had has much as an 80% chance of conceiving per month at age 30, and 40% chance at age 40. Sending the message that women should put their fertility concerns on the back burner is certainly a disservice considering the lack of awareness amongst the general public. “It is like we are back tracking in regards to education and awareness. The article takes such a patronizing attitude when we should be empowered to get information out there and let everyone figure it out for themselves. The solution isn’t no information, it is let’s figure out how to handle this in a positive and proactive way,” Chen argues. Too often, fertility patients report being unaware of the female fertility decline and wishing they had been equipped with information and resources sooner. “Fertility specialists see the consequences of not being proactive. If you want kids, it is not unreasonable to see a specialist and get evaluated,” she says.

By getting a fertility evaluation, women can educate themselves without committing to family building or fertility treatment. Fertility doctors can perform blood hormone tests and an ultrasound to evaluate the risk of fertility conditions like diminished ovarian reserve, endometriosis, and Polycystic Ovarian Syndrome (PCOS). Once a woman has this information, she can make an informed decision about when to start building her family and may even consider preserving her fertility until she is ready. Even before a woman tries to conceive, Dr. Chen recommends making healthy lifestyle changes, losing weight, getting seven hours of sleep, and taking a vitamin supplement. Without individualized feedback on our fertility there is no way to know for sure what our chances of successfully conceiving will be, so why wait?

To schedule a fertility evaluation with a fertility doctor near you, contact our Patient Care Advocates at 1-855-955-BABY (2229) or email

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