If you are trying to get pregnant, it's important to know how age impacts fertility.
Younger and healthier women have the highest fertility rates, around an 85% success rate.
Fertility rates decrease 11% by age 34, 33% by age 40 and 87% by age 45.
Today we have with us Dr. Bradley Klebs, an Allina Health OB/GYN, to talk about how fertility differs by age and tips to improve fertility at each age.
What You Need To Know About Your Fertility In Your 20s, 30s and 40s
Featured Speaker:
Bradley Klebs, MD - OB/GYN
Bradley Klebs is a board-certified physician specializing in obstetrics and gynecology at Allina Health Hastings Nininger Road Clinic. He has professional interests in gynecologic surgeries, pregnancy and prenatal care, delivery, laparoscopic surgery, contraception, menstrual issues, infertility and urinary stress. Transcription:
What You Need To Know About Your Fertility In Your 20s, 30s and 40s
Melanie Cole (Host): If you’re trying to get pregnant, it’s import to know how age impacts fertility. My guest today is Dr. Bradley Klebs. He’s a board-certified physician specializing in obstetrics and gynecology at Allina Health Hastings Nininger Road Clinic.
Welcome to the show, Dr. Klebs.
Tell us a little bit about how a woman’s fertility changes as she ages.
Dr. Klebs (Guest): Well, it’s certainly better the younger you are and the healthier you are when you’re thinking of conception. There is about an 85% success rate and that diminishes with age. So, the difference in age, they say you can have a decrease of 11% up to age 34; 33% decrease by age 50; and an 87 decrease by age 45.
Melanie: So, let’s start with women in their 20’s, when our bodies are still able to recover quickly and it’s not as difficult to have a pregnancy. Tell us about what they can expect in terms of fertility and if there are any tips that you would like to give women in their 20’s to improve their fertility.
Dr. Klebs: Well, I think the biggest tip I could give is that women in their 20’s are usually healthy and they have a very good likelihood of conception meaning that they don’t have to worry too much and we recommend that they give a good 12 months of trial before seeking medical evaluation for a problem and that’s assuming they are in good health.
Melanie: What about some tips to helping them, you know, if they really are trying to get pregnant and they get a little stressed out in that 12 months before they see a specialist, what would you like them to know about behavior and lifestyle modification?
Dr. Klebs: Well, it is important, again, if they’re focusing on the technical aspect that we want the egg present, we want the sperm present at the right time and we want a healthy passage where they can meet and conception take place. So, what I recommend is that they stay in good health; that they exercise and maintain a stable weight; minimize stress in their life; maybe use a condom when they’re not trying to get pregnant to avoid sexually transmitted disease. Having an annual exam is always a good idea so that screening can be done and proper vaccinations administered. If there is a condition that the doctor picks up, then treat that condition so they’re in the best of health at the time of conception. Also, I think it’s real important that they take a pre-natal vitamin that contains folic acid because that can be nutritionally beneficial as well as prevent birth defects like spina bifida.
Melanie: That’s great advice. What are some reasons a women in their 20’s might have trouble getting pregnant?
Dr. Klebs: Well, the most common reason is anovulation where the egg is not being released in a timely manner. So, maybe during the year, they have less chance to conceive. Other problems that could be encountered involve blockage of the fallopian tubes which could have occurred of scarring of a past infection or past surgical procedure. You can have uterine abnormalities such as polyps or fibroids present; pelvic endometriosis; polycystic ovarian syndrome and, from a male perspective, a semen analysis that is not normal.
Melanie: Now, as we move into our 30’s, and more and more women are waiting a little while to get pregnant, what happens with your fertility in your 30’s?
Dr. Klebs: Well, as mentioned, it does decrease in the 30’s. Well, just 11%, so not a great deal but it’s important, again, to maintain your health. As we age, we have medical conditions that occur such as diabetes, hypertension, thyroid disease, fibroid formation of the uterus and then we mentioned pelvic endometriosis and previous surgery could have occurred such as ectopic pregnancies or a ruptured appendix that could interfere with fertility.
Melanie: So, what tips would you give a woman in her 30’s? That’s considering if she’s 35 and she really wants to get pregnant. What is some of your best advice for women to get pregnant in their 30’s?
Dr. Klebs: Well, I think it’s important that they see a healthcare provider for their annual check-up; that they maintain an appropriate lifestyle that we talked about. Again, that includes keeping a stable weight; avoid excess use of alcohol; limiting tobacco and not taking illegal drugs. Also, medications that sometimes people are on for various health conditions that may not be healthy or safe during pregnancy that would need to be substituted or discontinued when conception is planned.
Melanie: How long would you ask a woman in their 30’s to wait before they see a fertility specialist if they’re trying to get pregnant and haven’t yet?
Dr. Klebs: I think 12 months is still reasonable. I think when you get into your 40’s, then it’s maybe going to be shortened to 6 months or less depending on the situation, I think, if there’s good timing, which we typically think of a 28-day menstrual cycle. In mid-cycle, around day 14, would be an ideal time to be trying to conceive on day 12, 14 or 16 of the cycle, counting day 1 as the first day of menses.
Melanie: Now, as a woman gets closer to her 40’s and starts thinking about her biological clock and time is running out and she may or may not be able to have a child in her 40’s, tell us a little bit about what happens with fertility in your 40’s and what are some possible risks of getting pregnant?
Dr. Klebs: Yes. Fertility in the 40’s is more of a concern and as we mentioned, women should seek medical help sooner and that can be by an infertility specialist. Actually, a reproductive endocrinologist could be used in that capacity and sometimes genetic counselors are useful. Once again, you really are running out of time so to speak. The eggs may be limited—the reserves there and you want to get things going as quickly as possible. Again, you want to maintain good health and be evaluated so that everything could be in the best condition possible to achieve the pregnancy. If a problem is diagnosed, then it can be addressed so that a successful pregnancy can be achieved.
Melanie: And, what would be some risks? Is it more dangerous for a woman in her 40’s to get pregnant? Is it more dangerous for mom and/or baby?
Dr. Klebs: Yes, it is. Dangerous meaning once they’re pregnant, they have higher incidence of conditions, so during the pregnancy, the doctor would have to watch for things like gestational diabetes, pre-eclampsia, chronic hypertension, fetal growth restriction, pre-term labor, chromosomal anomalies and so forth, but it’s certainly manageable. I think people are very thrilled and with our population, the way they are having longer careers and taking educational courses, conception is occurring in the 40’s more frequently now than in the past.
Melanie: So, in just the last few minutes, Dr. Klebs, if you would, give your best advice for women of any age that are considering getting pregnant; trying to get pregnant and cover fertility and even pre-natal vitamins. Should they start even before they’re thinking of getting pregnant? Just give us your best advice.
Dr. Klebs: Yes. I advise women to have their annual check-ups or a pre-conception clinic visit where they can be evaluated and if there is a health condition found, then it can be addressed so that they are in the best of health when they do try to conceive. Again, that includes vaccinations that need to be kept up to date and just screening for diabetes, possibly, so that that is recognized and treated in advance. We mentioned the importance of taking a pre-natal vitamin when you’re planning on conception and that it should include folic acid and that women in their 40’s should think of seeing an infertility specialist sooner in the course of trying because their time is limited.
Melanie: It’s really great information. Thank you so much, Dr. Klebs. You’re listening to The WELLcast with Allina Health. For more information, you can go to AllinaHealth.org. That’s AllinaHealth.org. This is Melanie Cole. Thanks so much for listening.
What You Need To Know About Your Fertility In Your 20s, 30s and 40s
Melanie Cole (Host): If you’re trying to get pregnant, it’s import to know how age impacts fertility. My guest today is Dr. Bradley Klebs. He’s a board-certified physician specializing in obstetrics and gynecology at Allina Health Hastings Nininger Road Clinic.
Welcome to the show, Dr. Klebs.
Tell us a little bit about how a woman’s fertility changes as she ages.
Dr. Klebs (Guest): Well, it’s certainly better the younger you are and the healthier you are when you’re thinking of conception. There is about an 85% success rate and that diminishes with age. So, the difference in age, they say you can have a decrease of 11% up to age 34; 33% decrease by age 50; and an 87 decrease by age 45.
Melanie: So, let’s start with women in their 20’s, when our bodies are still able to recover quickly and it’s not as difficult to have a pregnancy. Tell us about what they can expect in terms of fertility and if there are any tips that you would like to give women in their 20’s to improve their fertility.
Dr. Klebs: Well, I think the biggest tip I could give is that women in their 20’s are usually healthy and they have a very good likelihood of conception meaning that they don’t have to worry too much and we recommend that they give a good 12 months of trial before seeking medical evaluation for a problem and that’s assuming they are in good health.
Melanie: What about some tips to helping them, you know, if they really are trying to get pregnant and they get a little stressed out in that 12 months before they see a specialist, what would you like them to know about behavior and lifestyle modification?
Dr. Klebs: Well, it is important, again, if they’re focusing on the technical aspect that we want the egg present, we want the sperm present at the right time and we want a healthy passage where they can meet and conception take place. So, what I recommend is that they stay in good health; that they exercise and maintain a stable weight; minimize stress in their life; maybe use a condom when they’re not trying to get pregnant to avoid sexually transmitted disease. Having an annual exam is always a good idea so that screening can be done and proper vaccinations administered. If there is a condition that the doctor picks up, then treat that condition so they’re in the best of health at the time of conception. Also, I think it’s real important that they take a pre-natal vitamin that contains folic acid because that can be nutritionally beneficial as well as prevent birth defects like spina bifida.
Melanie: That’s great advice. What are some reasons a women in their 20’s might have trouble getting pregnant?
Dr. Klebs: Well, the most common reason is anovulation where the egg is not being released in a timely manner. So, maybe during the year, they have less chance to conceive. Other problems that could be encountered involve blockage of the fallopian tubes which could have occurred of scarring of a past infection or past surgical procedure. You can have uterine abnormalities such as polyps or fibroids present; pelvic endometriosis; polycystic ovarian syndrome and, from a male perspective, a semen analysis that is not normal.
Melanie: Now, as we move into our 30’s, and more and more women are waiting a little while to get pregnant, what happens with your fertility in your 30’s?
Dr. Klebs: Well, as mentioned, it does decrease in the 30’s. Well, just 11%, so not a great deal but it’s important, again, to maintain your health. As we age, we have medical conditions that occur such as diabetes, hypertension, thyroid disease, fibroid formation of the uterus and then we mentioned pelvic endometriosis and previous surgery could have occurred such as ectopic pregnancies or a ruptured appendix that could interfere with fertility.
Melanie: So, what tips would you give a woman in her 30’s? That’s considering if she’s 35 and she really wants to get pregnant. What is some of your best advice for women to get pregnant in their 30’s?
Dr. Klebs: Well, I think it’s important that they see a healthcare provider for their annual check-up; that they maintain an appropriate lifestyle that we talked about. Again, that includes keeping a stable weight; avoid excess use of alcohol; limiting tobacco and not taking illegal drugs. Also, medications that sometimes people are on for various health conditions that may not be healthy or safe during pregnancy that would need to be substituted or discontinued when conception is planned.
Melanie: How long would you ask a woman in their 30’s to wait before they see a fertility specialist if they’re trying to get pregnant and haven’t yet?
Dr. Klebs: I think 12 months is still reasonable. I think when you get into your 40’s, then it’s maybe going to be shortened to 6 months or less depending on the situation, I think, if there’s good timing, which we typically think of a 28-day menstrual cycle. In mid-cycle, around day 14, would be an ideal time to be trying to conceive on day 12, 14 or 16 of the cycle, counting day 1 as the first day of menses.
Melanie: Now, as a woman gets closer to her 40’s and starts thinking about her biological clock and time is running out and she may or may not be able to have a child in her 40’s, tell us a little bit about what happens with fertility in your 40’s and what are some possible risks of getting pregnant?
Dr. Klebs: Yes. Fertility in the 40’s is more of a concern and as we mentioned, women should seek medical help sooner and that can be by an infertility specialist. Actually, a reproductive endocrinologist could be used in that capacity and sometimes genetic counselors are useful. Once again, you really are running out of time so to speak. The eggs may be limited—the reserves there and you want to get things going as quickly as possible. Again, you want to maintain good health and be evaluated so that everything could be in the best condition possible to achieve the pregnancy. If a problem is diagnosed, then it can be addressed so that a successful pregnancy can be achieved.
Melanie: And, what would be some risks? Is it more dangerous for a woman in her 40’s to get pregnant? Is it more dangerous for mom and/or baby?
Dr. Klebs: Yes, it is. Dangerous meaning once they’re pregnant, they have higher incidence of conditions, so during the pregnancy, the doctor would have to watch for things like gestational diabetes, pre-eclampsia, chronic hypertension, fetal growth restriction, pre-term labor, chromosomal anomalies and so forth, but it’s certainly manageable. I think people are very thrilled and with our population, the way they are having longer careers and taking educational courses, conception is occurring in the 40’s more frequently now than in the past.
Melanie: So, in just the last few minutes, Dr. Klebs, if you would, give your best advice for women of any age that are considering getting pregnant; trying to get pregnant and cover fertility and even pre-natal vitamins. Should they start even before they’re thinking of getting pregnant? Just give us your best advice.
Dr. Klebs: Yes. I advise women to have their annual check-ups or a pre-conception clinic visit where they can be evaluated and if there is a health condition found, then it can be addressed so that they are in the best of health when they do try to conceive. Again, that includes vaccinations that need to be kept up to date and just screening for diabetes, possibly, so that that is recognized and treated in advance. We mentioned the importance of taking a pre-natal vitamin when you’re planning on conception and that it should include folic acid and that women in their 40’s should think of seeing an infertility specialist sooner in the course of trying because their time is limited.
Melanie: It’s really great information. Thank you so much, Dr. Klebs. You’re listening to The WELLcast with Allina Health. For more information, you can go to AllinaHealth.org. That’s AllinaHealth.org. This is Melanie Cole. Thanks so much for listening.