Taco Bout Fertility Tuesday

What's My Fertility Age?

March 26, 2024 Mark Amols, MD Season 6 Episode 13
Taco Bout Fertility Tuesday
What's My Fertility Age?
Show Notes Transcript

Join Dr. Mark Amols in this revealing episode of Talk About Fertility Tuesday as we delve into the nuances of fertility age. Have you ever heard or wondered if your biological clock is ticking differently from your chronological age? In 'What's My Fertility Age?', Dr. Amols demystifies common myths about egg age and fertility. Discover the truth behind statements like 'my eggs are acting younger' and understand how age affects your fertility, both in terms of egg quantity and quality. This episode not only clarifies the concept of ovarian reserve but also addresses how different ages impact your reproductive journey. Whether you're contemplating starting a family soon, or down the road, this discussion provides essential insights for anyone concerned about their fertility health. Arm yourself with knowledge, bust myths, and get answers to your pressing fertility questions. Don't forget to share this episode with friends and family who might benefit from these insights, and join us again next week for more enlightening discussions on Talk About Fertility Tuesday!

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Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

Today we talk about what's my fertility age. I'm Dr. Mark Amos, and this is Taco. About fertility Tuesday, I'm sure you're heard it before, maybe your doctor told you. Maybe a friend told you, but at one point, someone has said that your. Eggs, or their eggs are acting a different age. Sometimes they'll say your eggs are acting younger, sometimes they'll say they're acting older. But the question is, can your eggs actually act older and can they act younger? Well, the simple answer is no, your eggs can never act older or act younger. So then the question is, what are they talking about? So you've heard me talk about this several times on the podcast, which is. Ovarian reserve does not mean your chances of getting pregnant. Ovarian reserve is just a measure of. How well you'll respond to medication. We give it to you. So, as the joke I always say. Is, if there's an egg contest and we're seeing who can make the most. Eggs, people with higher ovarian reserves can make more eggs. And, people with lower ovarian reserves are not going to make as many eggs. Now, this doesn't mean that some people. Who are younger have eggs that are acting poorer than we would expect for their age, just like it doesn't mean that people who are older aren't responding better than people that are their same age. But the question is, is that misconception of are my eggs actually like a 25 year old? And so if I've had patients come. In my office who are 38, and. They say, oh, I'm not worried, my doctor told me my eggs are that. Of a 25 year old. And so today I, want to. Talk about what does that really mean? And do you not need to be worried, or do you still need to be concerned? Because although you may have better ovarian. Reserve than someone else who's 38, your eggs are still acting like they're 38 from a genetic standpoint. So let's start first by talking about. The eggs you were born with. Every egg you're ever going to have. Matter of fact, before you were born, you actually had more eggs. Before you were born, you actually had 2 million eggs. Before you were even born. And at, 20 weeks of pregnancy, you actually had 6 million eggs. And then the day you're born, it starts dropping. And by the time you hit puberty, the number of eggs are down to 350,000 eggs. And by the time you hit 35, you're probably down to about 35,000 eggs. And by the time you hit 45. You'Re down to less than 5000 eggs. Now, the important part to understand is if the eggs are all golden eggs, it doesn't matter, right? Because who cares which golden egg you get? As long as they're golden eggs, they all work. But they're not. In reality, most of the eggs, as. You get past 35, end up being poor quality. So prior to age 35, only about 40% of the eggs are going to. Be abnormal, meaning those eggs are going to not lead to a pregnancy. And if you do get pregnant, those. Eggs may lead to a miscarriage, or potentially even a child with some type of chromosomal problem, like down syndrome or tricemy 13 or turn syndrome. As soon as you hit 38, it flips even more. Now, only 40% people have normal eggs, and 60% of those eggs are going to be abnormal. And by 42, 85% of those eggs are genetically abnormal. Which means as you mature, one of. The things that occurs is the ratio between the genetically normal eggs and the. Genetically abnormal eggs changes where they are. More abnormal as you get older, because. You'Re using most of the good ones. What this basically means is you can. Never outrun your age, meaning there is. No woman who is 45 years of. Age walking around whose ratio of eggs are, more like a 32 year old. Just like there's no 26 year old. Who'S walking around with eggs of that. Of someone who's 45. Now, what people are talking about when they say, oh, your eggs are acting like that of a 25 year old. Is they're talking about the ovarian reserve. They're saying, hey, compared to most women who are 44, you're going to make. More eggs, and the number of eggs. You make are going to be equivalent. To someone who's 30. So, for example, let's say you're 44 years of age and you go through IVF and you're able to get 20 eggs. That's what I expect for someone 30 years or younger. So their eggs are acting like that because they can respond as well. But that 44 year old, 20 eggs she got, there may not even be one normal egg in that bunch. And on the same token, if you. Have someone who, let's say, is 22, and let's say their ovarian reserve is. That of someone who's 44, someone who's. 44 in a normal way, not good. But 44 average, what you would find is that their chances are much better. Even though they might only make a. Few eggs, like three eggs, because they're. Young, their eggs might be acting older, meaning with regards to response, but technically. Because of the genetics and, because there is more likelihood the embryos will. Be normal, their chances are better. And what's important is there is a. Steep decline after age 35. Prior to age 35, the pregnancy rate starts out around 20% per month of having conception, and then by the time. You hit 35, it's down to about 15. But by age 40, the chances per. Month of naturally conceiving goes down to about 5%. In one study, it was shown that. Couples having regular, unprotected sex. So again, they weren't trying to just get pregnant, but just not trying not to get pregnant. Around 60% of the women aged 35. Will conceive within a year. But compared to people who are 20 to 24, 86% of them would conceive within a year. And the result of this is because. When you are younger, you have more eggs that are genetically normal. And as you get older, it's always going to get poorer. It doesn't matter if you have the. Best looking eggs on earth, it's always. Going to be lower. And so this is an important concept, because this could, in some ways, make someone be overconfident. I've had some women who are advanced. Age, and they'll say, oh, I'm not too worried. I've been told my eggs are that. Of a 25 year old, and this. Is someone who's, 40 speaking to. Me, and I have to tell them. No, that's actually not true. You might make eggs like a 40, I mean, like someone who's younger, but your eggs are still acting like someone. Who'S 40 years of age. The genetics will not change. Now, I don't want to make. You feel like, oh, the clock hits 40, and now it's all bad. There are some differences. There are some women out there who may have more normal eggs at 40 compared to someone who else is 40. But in general, the rule is going to be true when you have eggs acting a different age. They're not saying that eggs genetically are. Going to be acting that age. They're just talking about how well they're. Going to respond to medication. And that's where it does improve your chances, because clearly, if you are 44 years of age, and we know that 95% of the eggs are abnormal, well. Then, yeah, you want to make 20 eggs to be able to have a chance here. So if you're one of the people who can only make four or five. Eggs at a time, you're going to have a lower chance. But if you're one of those people who can make a lot, you'll do. Better, versus the one who's 21. If they can only make three or. Four eggs, I'm not that worried, because. I know even though their numbers, their FSH levels, their AMH levels may all. Look like someone who's older, their genetics are likely going to be better, and they're probably going to have better chances. Now, like anything, there's no rule. Things can always be outliers, but this. Is, in general, what would happen. So one of the most important concepts. Out of this podcast is to understand that when you're looking at those ovarian reserves, at the end of the day. Your age plays the biggest impact. So even if you're one of those people who have great ovarian reserve, but you are more mature, you have to. Keep in mind that it's going to keep getting worse. So let's say you are 38 and you want three kids, doing artificial inseminations. Is probably not going to be a good option, because sure, you might get pregnant at age 38 with no problems. And even by maybe age 41, when you go try again, you might get. Pregnant, it's going to be more difficult. But now, by 43, you may not do as well. And so when you're looking at the age of your eggs, you're talking about the response, but when you're looking at. The quality of your eggs, you're always. Looking at your age. someone who has very good ovarian. Reserve has more time. So if you're 42 and you have a very high ovarian reserve, well, then. You may not be as pressured to start treatment right away. But if you're 42 and you have. A low ovarian reserve, lower than expected for someone 42, you need to get started right away. Both people will have the same chances. Statistically of getting the same ratio of. Normal versus abnormal eggs. But the person who has the better ovarian reserve is going to get more eggs and will have a better chance. So technically, when someone says your eggs. Are acting younger, yes, your chances are going to be better than your peers. Because your ovarian reserve is better, which means you can get more eggs, which improves your chances. However, it does not mean that your. Chances are better than the person younger. With you if they have lower ovarian, reserve. So if you're 38 with great ovarian. Reserve and someone's 24 with poor ovarian. Reserve, it doesn't necessarily mean that you're. Going to do better. And that's the important part about this. You can't look at someone and say your eggs are acting younger. You can just say your eggs are. Responding better than we expect for this current age, but they don't become that younger age. And the point why I bring this. Up is because, again, I don't want. Someone to think that when someone says. Their eggs are acting younger, that genetically they're acting younger. They are not. They will always act the age they are. It's just a response. So if you are more mature in doing IVF, if you have a good ovarian reserve, you'll make more eggs. If you're someone with a lower ovarian. Reserve, you'll make fewer eggs. But again, statistically, if one person goes. Through four times, it gets the same amount of eggs as the person goes through one time, their chances are going to be similar. Because in the end, with the same amount of eggs, they have the same. ratio of normal versus abnormal. In the end, you just want to. Talk to your doctor, and every situation is a little bit different. When I talk about these things, these are just to inform you so you can make an informed decision. And more important, make sure you're not. Making decisions off of misinformation. Because, to be honest, before I was a fertility doctor, if someone would have told my wife that her eggs were acting old, I would have actually thought. Her eggs have higher risk of having. A baby with down syndrome. Because that's what I think of, When they say they're acting older. And what I realized after I started learning these things is that, no, my. Wife'S eggs weren't acting old to increase. The risk of having a child with down syndrome. It was just acting old in the fact that it took more medication similar. To someone who was older to get the same amount of eggs, versus someone. Who was younger who could have taken less medications to get the same amount of eggs. There are also multiple studies out there have shown that even when you look. At ovarian reserve, high fshs, low. Amhs, and low anthropological counts, they do. Not correlate with having more abnormal eggs compared to your peers. So the point is, if you're young. And someone tells you that your eggs. Are acting old, lift your head high. Because you know you're still young and. You'Re going to do fine. If you're someone who's a little bit more mature and they say your eggs are acting young, well, that's great. You're probably going to be able to. Do things a little bit easier than. Someone else who's the same age. So as most women age 40 need. Two cycles of IVF, you might only. Need one to be able to have success. Hopefully this was a helpful podcast for you. Maybe one of your friends are going through this. If they are, let them know about this. Or if your friends boast about how their eggs act like they're 22 but. They'Re actually 45, let them in and know that hey, your ovarian reserve may. Be good, but your chances are still not good and you need to start treatment right away. That's the main point of this podcast. Don't let someone tell your eggs are good and think that you have more time. Age is the bigger factor. And the same token, if you're someone who's younger and someone tells you have older acting eggs, remember you're younger. Your chances are good, but you might also want to start sooner because your ovarian reserve might be lower, but your chances are better. As always, if you like this podcast, please come back. Listen to us again next week. I always enjoy doing these, and if you love it, give us a five star review on your favorite medium and has always come back. I look forward to talking to everyone again next week on talk about fertility Tuesday.