Impact of female age and nulligravidity on fecundity in an older reproductive age cohort

Capsule:
Women experience a significant reduction in fecundity and an increase in the probability of infertility in the late thirties. At any age >30 years, women, who have never conceived before, have a lower probability of conception.

Authors:
Anne Z. Steiner, M.D., M.P.H., Anne Marie Z. Jukic, Ph.D.

Volume 105, Issue 6, Pages 1584-1588

Abstract:

Objective:
To provide female age-related estimates of fecundity and incidence of infertility by history of prior pregnancy among women 30–44 years of age.

Design:
Prospective, time-to-pregnancy cohort study.

Setting:
Not applicable.

Patient(s):
Women, between 30 and 44 years of age, attempting to conceive for ≤3 months, and no known history of infertility, polycystic ovarian syndrome (PCOS), or endometriosis.

Intervention(s):
Not applicable.

Main Outcome Measure(s):
Fecundability and incidence of infertility.

Result(s):
Compared to women aged 30–31 years, fecundability was reduced by 14% in women 34–35 years of age (fecundability ratio [FR] 0.86, 95% confidence interval [CI] 0.68–1.08), 19% in women 36–37 years of age (FR 0.81, 95% CI 0.60–1.08, 30% in women 38–39 years of age (FR 0.70, 95% CI 0.48–1.01), 53% in women 40–41 years of age (FR 0.47, 95% CI 0.28–0.78), and 59% in women 42–44 years of age (FR 0.39, 95% CI 0.16–0.93). Fecundability did not differ between women aged 30–31 years and 32–33 years. In general, fecundability and cumulative probability of pregnancy was lower for women who had never had a prior pregnancy.

Conclusion(s):
Women experience a significant reduction in fecundity and increase in the probability of infertility in their late thirties. At any age >30 years, women who have never conceived have a lower probability of achieving a pregnancy.

Clinical Trial Registration Number:
NCT01028365.

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