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Does fertility decrease with age?

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Posted on Thu, 14 Jul 2016
Question: Hi,

I know sometimes there isn't a specific reason for not getting pregnant when you had no problem with previous children - and age isn't always a factor for some women. Sometimes there is no known cause – it just doesn’t happen or takes a while. My husband and I conceived relatively easy by timing things with both of our sons (conceived at 29 and 33). We tried for a third child the month I turned 37 and tried for 6 months. I know my body very well, I have regular cycles, and have the timing down. However, I was on Lamictal and Lexipro for managing my mild bipolar disorder II/anxiety/depression. The medication returned me to my normal self – I felt great when trying to conceive the third child. So I don't believe any stress levels/mental health issues are to blame. However, my husband was on Lexipro for social anxiety disorder but didn't have any sexual dysfunction issues. However, I “heard” it can affect quality of sperm? But maybe it was my age or his age - 33 to 37 is 4 yrs - fertility can go down drastically for women especially – but not necessarily for everyone! I guess I just want closure as to why it didn’t happen and I know you can’t pinpoint anything but just wondering if the meds “could have” affected fertility. We only tried for 6 months and decided to “close up shop”. I should note that we were not on any medication when we conceived the boys. I also had my pelvic area checked out via an Ultrasound recently and the results showed that it was very healthy.

Thank you for any insight you can give me.

And thank you for your time!

Kind Regards,
XXXX
doctor
Answered by Dr. Mahesh Koregol (38 minutes later)
Brief Answer:
Reduced egg quality and quantity with age

Detailed Answer:
Hi XXXXXXX

I understand your concerns about infertility. Egg reserve reduces drastically with age especially in women.

Though egg reserve looks good on ultrasound scan , quality might be low.

I suggest you get blood tests FSH and AMH to know ovarian reserve and correlate with ultrasound scan report.

Considering your age, I suggest you go ahead with procedures like IUI ( Intrauterine Insemination). This is next way forward.

Meanwhile get semen analysis of your husband to know about his semen quality now.

Let me know if you need any more help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mahesh Koregol (3 hours later)
Thank you for your prompt response Dr. XXXXXXX Koregol.

But can medications (particularly those targeting the central nervous system for depression, etc.) play a role in infertility?

Thank you,
XXXX

doctor
Answered by Dr. Mahesh Koregol (6 hours later)
Brief Answer:
Yes

Detailed Answer:
Hi,

Yes. They do play a role marginally but not much. Age and oocyte quality are most important parameters.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mahesh Koregol (2 days later)
Thank you - just one more question.

Do antidepressants affect men more than women for the marginal infertility?



I should clarify that my husband was on Lexipro when trying for our third child. I have found a website authored by a valid sex therapist/psychiatrist that reports that more and more studies show the drug can affect sperm quality/mobility, etc. My husband didn't have any sexual dysfunction issues while on Lexipro, which can be a side effect so that didn't affect fertility but am suspicious about the impact on his sperm quality/count. Neither of us were on any meds when we conceived our first 2 children relativly quickly.
doctor
Answered by Dr. Mahesh Koregol (21 hours later)
Brief Answer:
Semen analysis needs to be done

Detailed Answer:
Hi,

Yes. These medications do cause reduced sperm / semen parameters and could be a cause for concern.

It is better if you get semen analysis done to know if it has impacted sperms. There could be impact of age also on the sperms.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3797 Questions

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Does fertility decrease with age?

Brief Answer: Reduced egg quality and quantity with age Detailed Answer: Hi XXXXXXX I understand your concerns about infertility. Egg reserve reduces drastically with age especially in women. Though egg reserve looks good on ultrasound scan , quality might be low. I suggest you get blood tests FSH and AMH to know ovarian reserve and correlate with ultrasound scan report. Considering your age, I suggest you go ahead with procedures like IUI ( Intrauterine Insemination). This is next way forward. Meanwhile get semen analysis of your husband to know about his semen quality now. Let me know if you need any more help.