Expert: Edward Joseph Ramirez, MD, FACOG - 7/3/2009

Question
I am a young 44 year old trying to conceive. I am in good health, regular periods (28 days). I started a good healthy diet, light exercise, liquid vitamins and also started taking Vitex to increase fertility, all this I started 2 months ago. I was told I have a Fibroid about 8 years ago, still no issues. In my research I have read two different things regarding Vitex, either helping with Fibroids and also reports that I should not take Vitex if I have a Fibroid. Again, I have been very regular for the most part.
What concerns should I have, and what can I do to help conceive at my age?
I am located in Tampa FL. Thank much!

Answer
Hello,

Now-a-days, 44 is still very young.  You are barely halfway through your lifetime.  Unfortunately, it is at the limits of fertility age.  You should read the previous letter that I just answered because I talked about my theory regarding women's fertility age.

I am not familiar with "Vitex".  It is not medicinal, so I cannot answer to that part of the question.  Unfortunately, despite your very healthy lifestyle, your ovaries and eggs are more tied directly to time than anything else.  Hence, there is a decreased fertility rate with increasing age.  The fertility age of eggs is only to the early forties, unless you have been perpetually pregnant, in which case, there seem to be some preservation of the eggs and a prolonged fertility into the mid to late forties.  The statistical chances of pregnancy at your age is < 1 per year of trying.  That is not to say you cannot get pregnant, it is just very rare and very very difficult, especially if trying naturally.  In Vitro Fertilization will give you an increased chance of pregnancy because it leaves less of the process to get pregnant, to chance.  Your body goes through 9 steps to get pregnant, and even if you ovulate a good egg, it does not do everything perfectly every time.  On the other hand, IVF accomplishes 7 of the 9 steps.  So if you visited most fertility specialists, that would be their recommendation.  Some fertility clinics will not even allow you to try with your own eggs at your age.  They will require that you use donor eggs.  In my center, I have had a pregnancy at 45 but it miscarried.  That will probably be the experience of most clinics.  But, I don't restrict my patients from trying at least once.

The problem with age is not necessarily ovarian function.  Your ovaries are obviously still functioning fine leading to regular menstrual cycles.  That also means that you are still ovulating.  The problem is an egg quality issue.

I hope that answers your questions.  I'm sorry for the lack of good news.

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.