Impact of female age and nulligravidity on fecundity in an older reproductive age cohort

Fertil Steril. 2016 Jun;105(6):1584-1588.e1. doi: 10.1016/j.fertnstert.2016.02.028. Epub 2016 Mar 5.


Objective: To provide female age-related estimates of fecundity and incidence of infertility by history of prior pregnancy among women 30-44 years of age.

Design: Prospective, time-to-pregnancy cohort study.

Setting: Not applicable.

Patient(s): Women, between 30 and 44 years of age, attempting to conceive for ≤3 months, and no known history of infertility, polycystic ovarian syndrome (PCOS), or endometriosis.

Intervention(s): Not applicable.

Main outcome measure(s): Fecundability and incidence of infertility.

Result(s): Compared to women aged 30-31 years, fecundability was reduced by 14% in women 34-35 years of age (fecundability ratio [FR] 0.86, 95% confidence interval [CI] 0.68-1.08), 19% in women 36-37 years of age (FR 0.81, 95% CI 0.60-1.08, 30% in women 38-39 years of age (FR 0.70, 95% CI 0.48-1.01), 53% in women 40-41 years of age (FR 0.47, 95% CI 0.28-0.78), and 59% in women 42-44 years of age (FR 0.39, 95% CI 0.16-0.93). Fecundability did not differ between women aged 30-31 years and 32-33 years. In general, fecundability and cumulative probability of pregnancy was lower for women who had never had a prior pregnancy.

Conclusion(s): Women experience a significant reduction in fecundity and increase in the probability of infertility in their late thirties. At any age >30 years, women who have never conceived have a lower probability of achieving a pregnancy.

Clinical trial registration number: NCT01028365.

Keywords: Reproductive aging; fecundability; infertility.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Age Factors
  • Cohort Studies
  • Female
  • Fertility / physiology*
  • Gravidity / physiology*
  • Humans
  • Infertility, Female / diagnosis
  • Infertility, Female / epidemiology
  • Pregnancy
  • Pregnancy Rate / trends
  • Prospective Studies
  • Reproduction / physiology*
  • Surveys and Questionnaires
  • Time-to-Pregnancy / physiology*

Associated data