Age and infertility.

Data from Western communities where no artificial methods are used to control fertility show a gradual decline in fertility with age that becomes steeper after age 40 years and approaches 0 by 49 years. Increasing age of the male partner and reduced coital frequency may also influence this decline. The authors of a recent review of the literature in this field have concluded that women who defer childbearing until their early 30s risk only a slight biological decline in their fecundity provided that they have avoided hazards of early sexual activity such as tubal disease. Tubal disease however is not an important cause of infertility and there is no evidence that prolonged use of oral contraceptives has an adverse effect on fertility. Of most concern is the idea that fertility is declining in both men and women because of environmental factors. Such factors would predominantly affect older women because of the prolonged exposure of their oocytes to such influences but deteriorations in semen characteristics have also been reported. In general the research suggests that advancing age is not a major factor in infertility and couples should not be excluded from investigation and treatment on the basis of age alone.