Ep 310: How to Conceive After 40

Fertility Docs Uncensored is hosted by Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Susan Hudson from Texas Fertility Center, and Dr. Abby Eblen from Nashville Fertility Center. In this episode, they are joined by Ravi Agarwal, MD, from Reproductive Science Center of the San Francisco Bay Area in San Ramon. In this episode, they discussed the unique fertility challenges for women over 40 trying to conceive. Challenges include changes in egg number and egg quality that can affect their chances of conception and carrying a pregnancy. The hosts and their guest discuss how age impacts fertility, how testing guides treatment decisions, and why a personalized approach is essential. During this episode, the docs answered the following questions: What are the biggest fertility challenges women face after age 40? Women over 40 commonly experience both a decreased number of eggs and declining egg quality. As eggs age, they are more likely to have genetic abnormalities, which can make conception more difficult and increase the risk of miscarriage. Why does egg quality decline with age? Egg quality declines due to age-related genetic changes. A higher percentage of eggs become chromosomally abnormal over time, making it harder to achieve a healthy pregnancy. What fertility testing is recommended for women over 40? Testing often includes: AMH (Anti-Müllerian Hormone) to estimate ovarian reserve. Antral follicle count via ultrasound to assess how many eggs are present in the ovaries. These tests help predict treatment response and guide next steps. Can having more eggs help offset poor egg quality? In some women over 40, a higher egg number may partially compensate for reduced egg quality, increasing the likelihood of finding a genetically healthy egg. Do all women over 40 need IVF? No. Not every woman over 40 requires IVF. Some women can conceive without treatment, some are good IVF candidates, and others may not benefit from IVF at all. How do doctors decide which treatment is best after age 40? Treatment decisions are individualized and based on age, egg reserve, egg quality, medical history, and personal goals. This podcast was sponsored by U.S. Fertility.