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    After Age 44, Fertility Successes Are Few

    High-Tech Infertility Rx 'Reasonable' Until Mid-40s

    1 in 5 Patients Over 40 Seek Treatment continued...

    As early as 15 years before menopause, a woman's ability to become pregnant declines. Egg production starts to decline and more of the eggs she does produce contain chromosomal problems that make infertility, miscarriage, and birth defects more likely.

    This "double whammy," as Klipstein calls it, leads to a precipitous drop in fertility after age 40. But up until about age 43 fertility rates still differ dramatically from woman to woman, depending on ovarian reserve.

    Infertility specialist Michael Soules, MD, tells WebMD that a woman's best predictor of fertility in her early 40s is her mother's age at menopause. Soules is managing partner for Seattle Reproductive Medicine and a former president of ASRM.

    "If your mother entered menopause at age 50 that is a good sign that you will retain ovarian function longer," he says. "But there are no guarantees."

    What About Those Celebrity Moms?

    Just seven women in the study were over the age of 45 when they entered treatment, and none of them achieved a successful pregnancy.

    In recent years the number of women giving birth in their mid- to late-40s has doubled in the U.S., but Klipstein says this rise reflects the increased reliance on donor eggs.

    "The media convey the message that pregnancy in your mid-40s is no big deal, because this celebrity mom is giving birth at age 47 and that one is giving birth at 50," she says, adding that a successful medically assisted pregnancy over age 45 almost always involves a donor egg.

    A woman in her early 40s, using her own eggs, has about a 7% to 10% chance of getting pregnant with high-tech infertility treatments and a 50% to 80% chance if she uses a donor egg.

    Don't Delay Treatment

    Klipstein and Soules agree that the main message to women who want to have children after 40 is don't wait too long before seeking help.

    "Younger women have the luxury of waiting, but we recommend that women over 40 who haven't gotten pregnant on their own in six months seek treatment," Klipstein says.

    Though live birth rates have increased slightly in recent years among women in their early 40s using their own eggs, Soules says it is unlikely they will rise much more.

    "The clear message is don't delay a month longer than you can help it if you are approaching 40," he says. "And don't think you are the exception that proves the rule. That is dangerous thinking."

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