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Should people in their late 20s & early 30s worry about their fertility?

fertility in your 20s and 30s

Jessica Napier recently took to her She Says column in Metro to raise a question many women start to ask themselves as they approach or enter their 30s: should she be starting to worry about her fertility?

Most women who want to become pregnant in their 30s and beyond do not know that they are born with a finite number of eggs that deplete as they grow older. Specifically, women at birth have between 1-2 million eggs, by puberty that number has decreased to 300-400 thousand, and at 37 most women have around 35,000 left. Not only do women lose eggs, but the eggs they do have age: the mitotic spindles which organize chromosome separation during cell division function less well as women grow older, leading to more abnormal eggs and therefore more infertility and miscarriages.

This process is normal and natural, but unfortunate in a world where things like career stability and finding a partner are happening later in life. So what can we do for those hoping to become parents after their window of optimal fertility? In the past, options included aggressive treatment, donor eggs or adoption, but this has recently changed.

Egg freezing has revolutionized female fertility preservation and has given women more of a choice. To be sure, it is not a guarantee – the quality of eggs to be frozen affects the outcome, hence the higher success rates with younger eggs. Not to mention, most women who come to our clinic hoping to freeze their eggs have not yet challenged their fertility and do not know if they have an underlying problem that could make conception difficult.

The process used to freeze the eggs, the statistics for the individual clinic and the experience of the lab staff are all important factors when considering this procedure. Egg freezing is much more delicate than many other in vitro fertilization (IVF)-related procedures because the egg hosts so much machinery and water that it significantly limits the number of freezing methods that can be used without damaging the egg.

Today, many clinics market frozen donor eggs with high success rates. In the right hands the technology is certainly there, but I always caution my patients that until they go to use the eggs, we do not know whether they will work. For that reason, as soon as you are ready to be pregnant, it is important to try. The earlier you try the more options we have if we run into challenges.

Scientific and technological advances have given hope that one day we will be able to make eggs from stem cells, but we are not there yet. Perhaps in another 15 years? We are almost there with sperm! But until that time, egg freezing is the best option we have to preserve female fertility and we are fortunate for all the science that has been invested to make this technology come such a long way.

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