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Age and Fertility...The Facts Remain the Same

a blog by Dr. John S. Rinehart, Reproductive Medicine Institute, August 13, 2013

There has been a lot of chatter on the internet recently about the appearance of a study suggesting that women are more fertile than they think regardless of advancing age. The ‘takeaway’ from this is that women should not worry so much about their fertility potential. As a fertility expert, I find this approach disturbing to say the least. Every day I talk to women who have delayed childbearing and now want to have a child that is genetically their own (not conceived with the help of donor eggs or embryos). Unfortunately, they no longer have the fertility potential to do so, and I cannot offer them treatments which are successful.

Determining the precise, or even approximate time, when a woman will lose her ability to have children that are genetically her own, is fraught with uncertainty. The tests used to predict “ovarian reserve” are quite poor at identifying which woman will be able to conceive a child and which one by our modern technologies in assisted reproductive medicine, no matter how advanced they may be.

In the end, decisions can only be made after as much information as possible is obtained. Then each person must perform their own risk- benefit analysis. To a certain extent, the field of reproductive medicine is fortunate in that many of our treatment options do not carry a large physical risk. The psychological burden is significant because of the work involved, the private nature of the issue, and the importance of the issue at stake.

As a guideline, the older a woman is and the longer she has been trying to conceive without success, the more important it becomes that she seeks help in gathering information so that she can make an informed rational decision about what is best for her. [Successful conception means having a full – term, healthy child as miscarriages are often the first signs of a reduced ovarian reserve.]

Our data and experience over the past years has finally resulted in a continuing campaign to educate women as to their limited reproductive years, offering them proactive options including egg freezing, embryo banking and other alternatives that may offer them a greater window of time. This single study that seeks to invalidate this information is irresponsible. As much as we would like the situation to be different and the reproductive cycle as infinite, the truth is that in the area of human reproduction, time is not on our side.


For the past thirty years, John S. Rinehart, M.D., Ph.D., J.D., has maintained an exclusive practice in infertility and reproductive endocrinology in the Chicago area. He is a Founding Partner in Reproductive Medicine Institute. Dr. Rinehart is board certified in the fields of Obstetrics/Gynecology and Reproductive Endocrinology. He completed his residency in obstetrics and gynecology at Johns Hopkins Hospital and his fellowship in reproductive endocrinology at Harvard Medical School and Brigham and Women’s Hospital. In addition, Dr. Rinehart completed his law degree with a concentration in health law at DePaul University College of Law, Chicago, in 2002.

Dr. Rinehart maintains his academic connection as an Assistant Clinical Professor of Obstetrics and Gynecology at University of Chicago Pritzker School of Medicine. Dr. Rinehart is the Director of the Division of Reproductive Endocrinology and Infertility at Evanston Hospital/Northshore University Health System and St. Francis Hospital in Evanston, Illinois

In 1986, Dr. Rinehart helped establish Evanston Hospital’s first IVF program, one of the first private-practice based IVF programs in the country, and one of the nation’s largest. In addition, Dr. Rinehart aided in the development of many innovative procedures and treatments for use in assisted reproductive technologies.

Dr. Rinehart continues to focus his expertise on providing comprehensive reproductive medical care to women, men and adolescents.

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