The tyranny of thirty-five

Age thirty-five is a critical milestone in female life. It signifies the age at which fertility declines and falling pregnant is supposed to become instantly more difficult. We are told that thirty-five only has power over females. If you are a man, the adjective geriatric is unlikely to apply to you before the age of 65, if not later! Yet, should a woman attempt to conceive after this age, then she may be referred to routinely and clinically, as a geriatric. The terms geriatric mother and advanced maternal age are frequently used for women over thirty-five.

Thirty-five was also the supposed maximum number of years that the average female is supposed to be fertile. However, new research published in the Journal of the American Medical Association, has just upgraded this by two years, giving the average female a reproductive life span of thirty-seven years. This is because girls are starting their periods earlier and women are experiencing the menopause later.

However, this does not mean that the edge of the fertility cliff has moved two years to the age of thirty-seven.  Reproductive lifespan is not the same thing as reproductive age. But it does provide an opportunity to consider the tyranny of the idea of a cliff, represented by thirty-five in the first place.

A modern study, comparing fertility rates in 770 European women, found that when having sex twice a week or more for a year:

  • 78% of women aged 35 to 40 conceived within a year
  • 84% of women aged 20 to 34 conceived within a year

A 6% drop in average fertility between the ages of 20 and 40 is hardly a cliff and as a result of this many people are now beginning to call for a change in perspective.

Monolithic thinking creates stress and a stigma

The problem with monolithic thinking is that Doctors currently use the age of thirty-five as a cutoff point to guide the care of patients. Women over this age can get a barrage of often unnecessary extra testing and treatment. The stress caused by this can result in a care cascade that can do more harm than good.

Arwa Mawdahi, a specialist in female issues for the UK’s Guardian newspaper, calls the focus on thirty-five a kind of female shaming. She feels it makes the sole culprits for infertility. She wrote, “Fertility is complicated; it’s affected by multiple things and is different for every individual.” She suggests the focus should be in making childbearing more affordable for younger women.

As an example, she highlights a controversial advertising campaign from a few years ago where the American Society of Reproductive Medicine (ASRM). This reminded women in their twenties and early thirties that this is the age they are most likely to conceive. She said, “If organizations like the ASRM want women to have kids earlier in life, then the focus should be on making parenthood more affordable, not on fearmongering ad campaigns.”

Other factors should be considered

The new study findings, extending the female reproductive life span from thirty-five years to thirty-seven should provide a welcome opportunity to highlight the facts on female fertility. The important thing to note is that infertility can affect women of any age. If you are under thirty-five and you have had unprotected sex for over 12 months and not achieved a pregnancy then you must seek medical advice. If you are over thirty-five OR have underlying factors such as PCOS or Endometriosis then you should seek help after only 6 months of trying to conceive.