Long gone are the days of most women marrying their high school sweethearts and starting a family right away. In fact, the average age of first time marriage in the United States is 27 for women and 29 for men, up from 20 and 22 in 1960. Many women are also waiting until their 30s and 40s to have children. About 20 percent of women now have their first child after age 35, according to the U.S. Department of Health & Human Services. But these shifts in age don’t come without consequences. Couples are struggling to have families and are turning to fertility drugs.
How aging affects fertility
Aging has many effects on a woman's chances of having a baby, including:
- Ovaries becoming less able to release eggs
- Smaller number of eggs remaining
- Eggs are not as healthy
- Increased risk of health conditions that can cause fertility problems
- Increased risk of a miscarriage
Robin Fogle, M.D., a reproductive endocrinologist at Piedmont Atlanta Hospital, advises women to use the following guidelines when deciding whether it is time to seek medical advice and possible fertility intervention:
“If a woman is under 35 years of age, she should try on her own for one year before seeking medical treatment. If a woman is 35 or over, she should try for six months before seeing a specialist.”
However, if a woman knows she has a pre-existing condition like irregular periods, blocked fallopian tubes, or problems with her partner's sperm, Dr. Fogle says it is wise to start exploring fertility options even sooner.
Primary treatment for ovulation disorders
Fertility drugs are the primary treatment for women with ovulation disorders. They can be taken orally or via injection. These medications work by causing the release of hormones that trick the brain into inducing ovulation. The two most common fertility drugs used today are Clomid and Letrozole. Dr. Fogle says both of these options yield great results.
“About 80 percent of women who take Clomid or Letrozole will ovulate, and about 50 percent of these women will conceive, usually within three to four months of therapy.”
Side effects of fertility drugs
Like any medication, fertility drugs do not come without side effects. Women on fertility drugs can feel moody, get headaches, suffer from hot flashes, and have visual changes. However, Dr. Fogle says these disturbing symptoms are usually short-lived and there is no conclusive evidence that fertility drugs have any long-term side effects.
Fertility drugs and multiples
However, with the use of fertility drugs comes the increased chance of having multiples. Fertility drugs stimulate ovaries, increasing the odds that several eggs will be released at the same time. A woman’s chance of having multiples is dependent on several factors, including which medication she’s taking, the dosage, and how sensitive her body is to the drugs. Generally with Clomid, chances of having twins is 5 to 10 percent and less than 1 percent for triplets, and these percentages may be even less with Letrozole.
“The increase in multiples has actually slowed down over the past decade, possibly because fertility treatments have become more refined,” says Dr. Fogle. “We never play around with hormones. We monitor our patients very carefully and are confident there is a great chance of safely achieving pregnancy when drugs are used with appropriate monitoring.”
For a list of Piedmont’s reproductive endocrinologists, click here.
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