Your fertility is mostly determined by genetics, which influences how many eggs you are born with.

Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.

Regular menstrual cycles are a sign of regular ovulation.

Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).

Basal temperature charting does not predict ovulation.

An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced.

The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception.

By age 44, most women are infertile, even if they are still ovulating regularly.

Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40′s with fertility treatment are using donated eggs from younger women.

Vitamin D may improve results of fertility treatments.

A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.

Being either underweight or overweight is clearly linked with lowered levels of fertility.

The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.

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Information source: HuffingtonPost.com

Your health may be more important than your age. Some 40-year-old women are biologically 25, and some 25-year-old women are biologically 40, given the fact that biological age is more relevant than chronological age. Biological age is a combination of chronological age plus how the body functions. A body that is free of illness and un-compromised by smoking, heavy alcohol use or obesity performs better. In other words, if you’re in your 40s and healthy, you have a much better chance of carrying a healthy baby to term than a woman of the same age who has a chronic illness or poor health habits.

Having had a prior healthy pregnancy is another predictor of success. For reasons doctors can’t explain, first pregnancies have more complications than subsequent ones. Thus, if your first pregnancy was problem-free, there is a better chance that your next ones will be, too. Surprisingly enough, doctors suggest that one of the best pregnancy candidates is a healthy 40-year-old woman who has three kids at home under age 7. Her body knows what to do


 At the same time, even older women who are in perfect health can’t avoid the higher risk for certain pregnancy complications. 
We clearly see a decline in the probability of pregnancy with age, as for a woman in her early 40s, the probability of pregnancy—whether or not she is undergoing fertility treatment—is about half that of a woman who is 30.

If the average miscarriage rate is 20 percent, the risk is closer to 25 percent for a woman in her 40s. Older moms are at greater risk of developing gestational diabetes because their endocrine systems aren’t quite as resilient as younger women’s.
In addition, all the body systems that pregnancy normally impacts get impacted a little more with age. For example, the extra weight gained during pregnancy may take a greater toll on an older woman’s musculoskeletal system, causing more back and muscle aches. 


According to the National Center for Health Statistics, the Cesarean rate for women older than 40 is 41 percent, almost double the rate (21 percent) for women between the ages of 20 and 24. There are three main reasons: An older woman’s uterus doesn’t always contract adequately; older women have a higher rate of pregnancy-induced high blood pressure, which often requires a Cesarean delivery; and older women are more likely to develop gestational diabetes and thus have bigger babies. 


Fetal growth restriction, which occurs when blood flow to the fetus is reduced, is also more common among older moms. That’s because as a woman ages, her circulatory system becomes less robust, so she may not deliver as much blood to the uterus and placenta. 
While good health habits can offset some potential problems, no amount of exercise or other behaviors can change one reality: the age of your eggs. Though scientists don’t know why, older eggs are more likely to result in babies with chromosomal abnormalities. For instance, the risk of having a baby with a chromosomal defect increases with the mother’s age: A 33-year-old woman has a 1 in 208 chance that her baby will have a defect such as Down syndrome, according to the American College of Obstetricians and Gynecologists. Among women 10 years older, that number is 1 in 19.

What are fibroids?

Fibroids are firm, round swellings that develop in the muscular wall of the womb. They may be as small as a grape or as large as a melon. They’re extremely common – between 50% and 80% of women have them. Typically, a woman will have several fibroids in her womb, all of different sizes. Fibroid tumors are benign and do not spread. Most of the time it is difficult to detect them until they have grown bigger and started causing problems, especially during pregnancy. When they grow in size to such an extent that they distort the inside of the womb, a woman may find that her periods become very heavy.

Fibroids and Pregnancy Difficulties

There are several ways in which fibroids may affect pregnancy. Fibroids can cause uncomfortable feelings of pressure or heaviness and cause sharp pain in the lower back and legs if nerves are compressed.

While some experts believe uterine fibroids do not cause miscarriage, others say they can. The key is a fibroid’s location and size. The closer it is to the center of the uterus, where a fetus is likely to implant, the more likely it is to cause problems.

Fibroids may grow rapidly during pregnancy as the levels of female hormones rise dramatically. Any fibroid greater than 5 centimeters—about 2 inches—can be problematic. A fibroid of this size has a lot of blood vessels and shunts blood flow away from the uterus to fuel its own growth. Although a fibroid may be small now, that could change when you become pregnant, making some preventive medicine even more important.

A rare complication of fibroids during pregnancy is known as red degeneration. This involves bleeding into the middle of the fibroid and tends to occur after the first trimester, and is thought to result from the tumor enlarging rapidly and outgrowing its blood supply. This can be extremely painful but will eventually settle without requiring specific treatment.

Fibroids are thought to account for about 2-3% of all infertility. If fibroids develop just under the surface lining of the womb this can interfere with the way in which a fertilised egg implants or attaches to the womb. This may lead to recurrent early miscarriage (usually so early that the woman doesn’t even know she’s pregnant) and infertility. More rarely a fibroid may block the cervix or the opening of the fallopian tubes into the womb. Later in pregnancy, fibroids can also disrupt the normal development and expansion of the womb, leading to premature birth. Very rarely, fibroids may cause a miscarriage before 23 weeks of pregnancy.

The most common problem with fibroids in pregnancy is delivering two to three weeks early, which is of little threat to the baby.

When a woman with infertility problems is found to have fibroids, the tumors may be removed if they’re large, to try to improve the chances of pregnancy.
Research suggests that when no other reason for infertility can be found, removing the fibroids increases the chance of conceiving by 40% to 80%
Very occasionally fibroids grow in the lower part of the womb and cause partial blockage of the birth canal. This may lead to a caesarean operation in order to deliver the baby.

While there are many reasons a woman may experience recurrent miscarriage, British researchers have recently found that one thing that can improve the pregnancy outcome is to remove fibroids that distort the shape of a woman’s uterus.These researchers examined 25 women with cavity-distorting fibroids who had surgery, and 54 women with fibroids that didn’t distort the cavity and who did not undergo any intervention. These patients were compared with a control group of 285 women with unexplained recurrent miscarriage.

The study found that women with fibroids distorting the uterine cavity had a total miscarriage rate of 77% and a live birth rate of 23%. Women with cavity-distoring fibroids also had a higher mid-trimester miscarriage rate (22%) than the group of women with unexplained recurrent miscarriages (8%).

The researchers found that women who had cavity-distorting fibroids and underwent surgery to remove them with a hysteroscopic myomectomy had significantly improved outcomes, with a significant drop in the mid-trimester miscarriage rate and a live birth rate increasing from 23% to 52%.

Research indicates that recurrent miscarriages can be devastating to women trying to conceive. Depression, anxiety and stress can all result from multiple miscarriages. These women may also be at higher risk for certain health conditions like a higher risk of heart attacks. In addition, myomectomy should be performed on those with fibroids that distort the uterine cavity in order to improve live birth rates. This is an outpatient procedure in which the fertility doctor uses a narrow fiber optic telescope inserted into the uterus through the cervix to look for adhesions inside the uterus. With a hysteroscopic myomectomy, the fertility doctor uses a resectoscope — a hysteroscope fitted with a wire loop that uses high-frequency electrical current to cut tissue. Finally, the researchers concluded that women with a previous history of mid-trimester loss should have a thorough exam for fibroids.