Advancing age is one of the biggest causes of fertility-related anxiety, mainly in women trying to get pregnant, especially when approaching their mid-thirties or early-mid-forties. The earliest you can start a family, the better your chances. Leaving it too late can be detrimental, especially for women. As women age,  the ability of ovarian cells to counteract the effects of oxidative stress declines, resulting in a steady decline in egg quality and quantity.

If you are trying to conceive and are in your mid-late thirties or early to mid-forties, here are some essential things to note:

• Women are born with a fixed number of oocytes (eggs). However, as women age, the ovaries start to slow down in the quantity and quality of eggs it produces at the start of each egg maturation cycle, usually around 90 days. And low egg quantity is often seen in women diagnosed with Diminished ovarian reserve (DOR). This means you have a low number of eggs remaining in the ovaries. The test to confirm this is usually (AMH) anti- Mullerian hormone blood test.
• Mitochondria dysfunction is the driver of premature ovarian ageing, and various factors can expedite the process.
• The average age of menopause for a Caucasian woman is 51 years old; for a Black woman is 49.3 years. Several lifestyle factors contribute to this, like smoking, Obesity, stress, a history of hormone contraceptive use and being exposed to cigarette smoking regularly. However, in general, the age of natural menopause is 52 years.
• Women diagnosed with a diminished ovarian reserve in their 30s reach menopause very quickly than those who don’t.
• The more ovulatory cycles you have had since menarche will determine how quickly you reach menopause. This puts women who have PCOS at an advantage. Several studies show that PCOS women are more fertile the older they get because most have fewer cycles where they ovulate and tend to have a large ovarian reserve even in their forties which is a bonus for  PCOS women, as long as they look after themselves.

• Smoking, excessive alcohol consumption, obesity, improper diet, stress, environmental factors, exposure to chemicals, radiation, and unhealthy lifestyle link oxidative stress with premature ovarian ageing.
• Genetic susceptibility contributes to ovarian ageing and early menopause before age 52.

Believe it or not, scientific research hasn’t yet discovered a cure for diminished ovarian reserve (DOR). Hence, women are quickly advised to seek embryo donation from younger women when they seek IVF treatment to help them achieve their dreams of motherhood.

Premature ovarian ageing can affect women as early as in their twenties, so it’s not limited to women in their thirties or forties alone.

What’s the way out?

• If you have a regular cycle and ovulate every month without structural issues, the sooner you start a family, the better your chances. However, consider fertility preservation if you want to delay starting a family until your mid-late thirties.
• Change your lifestyle. This one is a real game-changer and a natural way to reverse the effects of ageing on the quality of eggs you ovulate.
• Exercise. Obesity is highly considered a state of high oxidative stress and is known to reduce fertility, the frequency of pregnancy and live birth. Regular exercise can reduce extra weight and oxidative stress and is therefore recommended when trying to become pregnant naturally or through IVF.
• Start taking care of your general and reproductive health soon enough. This applies to both men and women.
• Stop smoking if you do, and limit drinking excessive amounts of alcohol, especially when trying to become pregnant.
• Bisphenol A, a chemical present in plastic containers and the lining of canned food, increases oxidative stress in animal studies. In humans, they lead to lower implantation rates in natural pregnancy or fertility treatment. So make sure to reduce your exposure to this chemical.
• Detox regularly. This is the reason why I created my 6-week fertility restore cleanse.  In just 6 weeks, you can transform your health and restore fertility with our fertility cleanse program.
• Supplement with Coenzyme Q10(CoQ10), in its active form ubiquinol. Here is one good brand I recommend. CoQ10 is a component of the mitochondria electron transport chain that has been shown to mitigate mitochondria dysfunction in animal studies. Some women treated with CoQ10  had made better quality eggs and reported better IVF outcomes.
• Use herbs. They are whole natural plants found everywhere around us but sadly often ignored by many. Herbs are in abundance for a reason; they provide health and nourishment to our body, soul, and spirit. Medicinal herbs can prevent premature ovarian ageing and improve fertility in various ways, such as regulating vital reproductive hormones in both men and women, preventing transmitted bacteria, fungal and viral infections, Improving mitochondria function and egg quantity and quality, Reducing inflammation, Modulating immune responses. Our herbal conceive tea bundle offers an all-in-one package to get you started 

Bottom line

Knowing your fertility status and ovarian reserve is important if you are aged 35 years and over, as this will give you something to work with.

There are several tests that you can request from your primary healthcare provider.

Antral follicle scan (AFC)

This test is done by using a transvaginal ultrasound usually on days 2-3 of the cycle. A count of less than 5-7 follicles is suggestive of diminished ovarian reserve.

Serum FSH 

In women with (DOR) A blood test is usually done on days 3-5 of the menstrual cycle. Levels higher than 10 IU/L is seen in women who have diminished ovarian reserves.

Anti-mullerian hormone (AMH)

This is a hormone produced by the granulosa cells of the antral and preantral follicles. Serum AMH levels show the ovarian pool of primordial follicles. To get an accurate result it’s recommended that AMH is tested together with AFC as this gives a better idea of ovarian reserve.

Estradiol levels (E2)

Elevated estradiol on days 2-3 of the menstrual cycle can be attributed to impaired function of the ovaries and its ability to recruit follicles linking to poor ovarian reserve and low fertility.

As said earlier, when a diminished ovarian reserve is suspected, one treatment option is IVF with a natural cycle/minimal stimulation protocol to help retrieve at least some amount of good-quality eggs.

Overall, age is an important factor with regard to fertility, the earlier you start trying to start a family, the better your chances. The good news is that most women will be able to improve the quality of their eggs naturally to help achieve a better outcome naturally or through fertility treatments.