The natural age limits of fertility in both women and men have become more apparent with the recent trend toward delaying childbearing.
Research indicates that among nulliparous women, the percentage experiencing infertility increases markedly with age, from 7%–9% among those aged 15–34 years to 25% among those aged 35–39 years and 30% among those aged 40–44 years.
the risk of infertility rises with age in women, because the eggs produced are of lower quality and their reproductive physiology shows signs of deterioration. Impaired ovulatory function, endometriosis, uterine leiomyomata and tubal disease are common causes.
The management of infertility ranges from counseling and advice to medications and surgery. The most common medical services received by women in the reproductive age facing infertility problems are clinical examination and reproductive advice (29%), testing of her and the male partner (27%) and ovulation medications (20%). Less commonly services utilized were intrauterine insemination (IUI) (7%), surgery or treatment for blocked tubes (3%) and assisted reproductive technology (ART) (3%).
Treatments for infertility can carry significant health risks to the mother and child. For example, a very rare but serious risk of using drugs for ovulation induction is ovarian hyperstimulation syndrome (OHSS), which is characterized by enlargement of the ovary and an accumulation of fluid in the abdomen. OHSS is usually self-limiting, resolving spontaneously within several days, though the most severe cases may require hospitalization and intensive care. In addition, some (but not all) research suggests that infertility treatments may be associated with an increased risk of gynecologic or breast cancer.
Infertility treatments have increased the rate of twin and higher-order multiple births, which put both mother and the unborn babies at higher risk of adverse outcomes. Though medical management of infertility is successful for many couples, some may need higher level treatment that has its own risks and costs involved.