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Female Infertility

Woman with Pregnancy Test

What is female infertility?

Since 2009, the World Health Organization has defined clinical infertility as a disease of the reproductive system defined by the failure to establish a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Specialists recommend starting fertility diagnosis and treatment after 12 months if the woman is below the age of 35; after 6 months for women between 35 and 39; and after 3 months for women 40 or older. In 2017, the International Glossary on Infertility and Fertility also defined infertility as an impairment of a person’s capacity to reproduce either as an individual or with his/her partner.

Female Fertility: Commonly Asked Questions

How many eggs is a woman born with?

A woman is born with about 1 million eggs. However, since they are constantly dying on their own by the time of her first menstrual period, the number of eggs has already decreased to between 300,000 to 500,000 eggs.

What is Decreased Ovarian Reserve (DOR)?

As a woman ages, the number and quality (as determined by proportion of eggs with normal chromosomes) of her eggs in the ovaries decrease. This reduction in number and quality of the eggs is called ‘decreased ovarian reserve’ (DOR). This is more of an issue in infertility as women delay childbirth. There are many reproductive consequences, including increased risk of:

  • infertility
  • miscarriage
  • maternal and fetal complications in pregnancy
  • problems in the babies

In addition, more advanced DOR is accompanied by other medical problems such as:

  • Decreasing bone mass, increasing the risk of fracture
  • Abnormal bleeding of the uterus due to lack of ovulation
  • Hot flashes

At what age is a woman most fertile?

A woman’s fertility peaks before the age of 30, with a monthly pregnancy rate between 20% and 25%. This pregnancy rate rapidly declines when a woman approaches her late 30s. About one in two women experiences infertility by the age 40. Aging impairs fertility: it reduces egg quality, lowers the chance of embryo implantation, increases the chances of miscarriage, and the risk for the potential baby to be born with genetic defects related to abnormal numbers of chromosomes (aneuploidy).