My husband and I are trying to have a baby one last time. I am 41 years old. Is it anything I should be doing to prepare? Is there any medication I can take from the doctor that will increase fertility?

The. The best answer is to see a reproductive endocrinologist (fertility specialist) to determine what your potential for getting pregnant is, or you may lose valuable time. Most women will be unable to get pregnant by the age of 45, but may start experiencing a lot of difficulty, even using fertility treatments, as early as age 42. Additionally, miscarriage rates rise for the same reason the risk of down's syndrome rises after 35...The eggs that are released (ovulated) are more prone to have chromosomal errors. As previously mentioned your reproductive potential can be assessed by performing 3 tests: day 3 fsh, amh & an antral follicle count on ultrasound. The important thing to mention is that while there may be age available statistics, those are just averages for your age group. Your chances may be better or worse based on these values and your history. Typically a normal value for fsh is 4-8. A value between 8-15 may indicated decreased ovarian function, and above 15 may predict significant problems getting pregnant. One test that is newer and shows a lot of promise is the amh value. A value less than 1.0 suggests compromised ovarian function and may suggest decreased responsiveness to medication. Often an amh value may pick up subtle ovarian dysfunction before the more traditional test, fsh. The information derived from the amh test can be used to influence what treatment is chosen for your particular circumstance. In a study we published at brown university, amh values less than 1.0 corresponded with less eggs retrieved during ivf (6 or less eggs). Finally, the antral follicle count involves counting the number of "developing eggs" (follicles) and can be used to estimate your ovarian function as well. A fertility specialist will also be able to evaluate and treat other factors that may decrease your chances of getting pregnant. In the interim it is always best to continue taking prenatal vitamins, limit caffeine intake to once daily, avoid cigarette smoke and eat healthy. Stephan krotz, M.D. Advanced fertility center of texas.
Good. Good question since going prepared is always in your favor. I am afraid that you may be so fond of the success rates for your age. Here are several general comments regarding fertility statistics. We believe that the fertility rate averages about 20% per cycle (month), in young women. If we start with 100 couples and each month 20% conceive then at the end of 12 months, 92% will be pregnant. We find that about 10-13% of the population will not be pregnant after 12 months of trying. By 24 months less than 1% of normal couples fail to conceive. Fertility drops with age. Fertility rates in the us are about 147/1000 women at age 25-30 and they fall to about 13/1000 women by age 40. So, don't delay for more than 6 months before getting a consultation with a fertility specialist. We have tests to help us understand what might prevent you from getting pregnant. I believe that making a diagnosis is required to have a discussion about treatment. The wrong treatment can be costly and delay success. You will need tests for ovulation, anatomy (uterus and tubes), egg quality and sperm quality. Important advice for women over 40 please get your physician to determine your fertility potential. Common tests for this include an ultrasound for antral follicle count and blood levels of fsh and amh. I plan to add health guides on these topics to my profile in the next few days. If you have borderline tests then get started immediately and if the tests are abnormal then carefully consider the implications of treatment. Most people believe that ivf is the last treatment that they would ever consider but that has really changed in the last 10 years. Ivf is actually the most successful treatment that we have - period, hands down. Ivf is not always needed but it is also not the most expensive treatment in many cases. You can spend more money on low success rate treatments in an effort to avoid ivf. We can often provide "refund guarantee" financing for ivf; which means that if you do not have a live baby then you will get a refund of most of your money! (disclaimer - this option may not be offered to older women or it may be too expensive.) ivf success rates vary from center to center and you should check the outcomes for the centers available to you. The following web links will take you to publicly available data. All ivf centers are required to publish their outcomes but the published data is about 2 years old because we have to wait for deliveries and then for the data to be formatted for publication. Society for assisted reproductive technologies (sart): www. Sart. Org centers for disease control (cdc): http://www. Cdc. Gov/art/index. Htm fertility success rates: http://fertilitysuccessrates. Com/ is a web site that takes the cdc stats and compares them. Ivf centers are prohibited from making direct comparisons themselves. These resources will help fill in the information that I do not include in this answer. The data available are from 2009. The national average live born delivery rate based on all treatment cycles started is 12.6% for women aged 41 - 42.99 and 4.2% for women aged 43 and older. You should look at this data for your purpose because it includes everyone who tries ivf, whether they had an embryo transfer or not. I should also include for completeness that you can become pregnant using the eggs of a younger woman (donor egg ivf), if your own eggs prove to be poor quality. Donor egg ivf is very successful with success rates as high as 75-80% per try. I suggest that you have a consultation with an ivf specialist who can suggest some tests to determine your potential for success. You do not have much time so please seek help sooner than later. Best of luck.