Pregnancy and age statistics

Designed for patients new to infertility treatments, our "infertility 101" covers infertility conditions, diagnoses and treatments. The Table above, and Figure 2 on the left summarize CHR's 2012 clinical IVF pregnancy rates by age. Some further explanations: Here reported pregnancy rates are "clinical" pregnancy rates, meaning that we do not count the so-called chemical pregnancies as pregnancies. A brief explanation as to why CHR presents pregnancy rates by embryos transferred: If a woman at retrieval produces no eggs, she, of course, has no chance of pregnancy. Likely reflecting CHR's cautious attitude towards Eco-IVF ("Mini-IVF"), 2011 cycles were too few for a valid statistical assessment. Here, too, CHR demonstrates a dramatic improvement in clinical pregnancy rate (42.3%), likely, reflective of overall improvement in embryo quality.
At first glance, one could conclude that pregnancy rates in donor egg cycles at CHR have decreased over the last two years from a peak in the mid-60% in 2009 to ca. Such statistical outcome data represent mean values, a very appropriate way of presenting data when the range of outcomes is relatively narrow. Note: Statistics may vary from previous years due to revised and updated source statistics or addition of new data sources. Dialysis removes harmful waste and excess fluid buildup in the blood that occurs when kidneys fail to function. Between 2001 and 2005, the percentage of all hemodialysis patients with adequate dialysis improved from 84% to 88% (Figure 2.12).
Reference population: ESRD hemodialysis patients and peritoneal dialysis patients under age 70. In all five data years, the likelihood of being on a transplantation waiting list decreased significantly with age. Smoking may be the single most important modifiable risk factor for heart disease, and providers can encourage patients to quit smoking.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2000-2004.
In all five data years, smokers ages 18-44 were less likely than the other age groups to receive advice to quit smoking.
More than 32% of adults age 20 and over in the United States are obese (defined as having a body mass index of 30 or higher),12 putting them at increased risk for many chronic, often deadly conditions, such as hypertension, cancer, diabetes, and coronary heart disease.13 Although physician guidelines recommend that health care providers screen all adult patients for obesity,14 obesity remains underdiagnosed among U.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey, 1999-2004. Physician-based exercise counseling is an important component of effective weight loss interventions,14 and it has been shown to produce increased levels of physical activity among sedentary patients.16 Regular exercise aids in weight loss and blood pressure control efforts, reducing the risk of heart disease, stroke, diabetes, and other comorbidities of obesity.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2004. In all three years, obese adults ages 45-64 and 65 and over were more likely to receive advice about exercise than those ages 18-44. There is consensus that recommended care for patients with a heart attack includes administration of aspirin within 24 hours of heart attack and at discharge, administration of beta blocker within 24 hours of attack and at discharge, angiotensin-II converting enzyme (ACE) inhibitor or angiotensin receptor blocker treatment among patients with left ventricular systolic dysfunction, and counseling to quit smoking among smokers. It should also be noted that the data collection method changed between 2004 and 2005 from the abstraction of randomly selected medical records for Medicare beneficiaries to the receipt of hospital self-reported data for all payer types. Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 1994, 1997, 2000-2004.
Note: Rates are adjusted by age, gender, age-gender interactions, and all-payer refined diagnosis-related groups scoring of risk of mortality. The NHQR tracks the national rates of the receipt of a recommended test for heart functioning (heart failure patients having evaluation of left ventricular ejection fraction [LVEF]), for recommended medication treatment (patients with left ventricular dysfunction prescribed ACE inhibitor or angiotensin receptor blocker at discharge), and an overall composite measure that describes the proportion of all episodes in which heart failure patients receive recommended care.
The use of ACE inhibitors for treatment of acute heart failure for patients with left ventricular dysfunction remained stable between 2000-2001 and 2004; however, the value for this measure increased between 2004 and 2005 when the measure was changed to also include angiotensin receptor blockers as an acceptable alternative to ACE inhibitors.
It should be noted that the data collection method changed between 2004 and 2005 from the abstraction of randomly selected medical records for Medicare beneficiaries to the receipt of hospital self-reported data for all payer types. Eligible AIDS patients receiving prophylaxis for Pneumocystis pneumonia (PCP) and Mycobacterium avium complex (MAC).
Routine voluntary HIV testing is recommended by the Centers for Disease Control and Prevention as part of normal medical practice in all health care settings.19 HIV infection is a serious health disorder that can be diagnosed before symptoms develop. To normalize HIV testing as a routine part of medical care, in September 2006, the Centers for Disease Control and Prevention published revised recommendations that all patients ages 13-64 be tested on a voluntary basis. Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Family Growth, 2002.
In 2002, just over half of people ages 15-44 ever had an HIV test outside of blood donation (Figure 2.24). Among people ages 15-44 with any HIV risk behaviors in the last 12 months, those ages 20-24 had the highest rate of HIV testing (35.3%). Of eligible patients (966 AIDS patients with at least two CD4 cell counts below 50), 81.8% received MAC prophylaxis in 2004, which is not significantly different from 2003 and is below the Healthy People 2010 target of 95%. This Q&A reviews the scientific and medical debates about later motherhood, seeking a balance between understanding the biological barriers to having babies in later life, and the lived reality – that many women do have healthy pregnancies in their late thirties. The Office for National Statistics (ONS) reports that in 2012, nearly half (49%) of all live births were to mothers aged 30 and over, and that nearly two-thirds (65%) of fathers were aged 30 and over. Some of the social and cultural trends that affect the timing of motherhood are worthy of debate (see Question 6, below). This tends to simplify and distort the science around fertility, and panic many women when their chances of having a baby at the time that is right for them are high. The idea that delayed motherhood poses a problem, for women, babies and for the health service, has become widely aired in recent years. The fertility statistics show that increasing proportions of women are having children in their late 30s. The widely citied statistic that only 66% of women aged 35 to 39 will be pregnant after a year of trying if based on a 2004 article in the journal Human Reproduction, which in turn is based on an analysis of French birth records from 1670 to 1830. For modern women, the reality is far better expressed in a 2004 study by David Dunson and colleagues, published in Obstetrics and Gynecology.
However, this does not mean that all women who want to get pregnant in their late 30s will be able to – and this is really where the problem lies. This could be related to her age: for example, the RCOG notes that early ovarian ageing happens in around 10% of women in the general population.

If a woman does not find out that she is struggling to get pregnant until she is in her mid to late thirties, by the time she comes to accessing fertility treatment she is likely to be nearly 40. It is widely understood that as women get older, they experience a decline in egg production and quality. Many women in their mid-thirties fall pregnant without treatment, conceive a fetus without anomalies, and carry the pregnancy successfully to term; and in these cases, attempts to cajole women into having babies earlier than they want to is likely to increase anxiety for no good reason. Given the trends towards later motherhood, it is striking how little positive attention is paid to the possibilities of egg freezing, and also egg donation. A 1990 study in the New England Journal of Medicine differentiated between pregnancy complications and outcomes for the babies. The general point here is that there are relatively higher risks to older mothers and their babies than to younger mothers. In other words, while the risks of pregnancy complications increase with age, this does not mean that women having babies at the age of 35 or over are de facto putting themselves or their babies at increased risk. Whatever the age of the mother, the process of pregnancy and birth themselves pose a level of risk to the woman and her baby, through hypertension, bleeding, difficult labours and so on. The difference between statistical significance and clinical significance is very important in working through the relationship between what we might know about the relative risks of later maternal age, and what women, doctors and policymakers might be advised to do with regard to women having babies later in life. The organisation of maternity services is, fundamentally, is where the policy implications of later maternal age should lie. Even if they have not undergone fertility treatment, older women are also naturally more likely to have twins or triplets, which as well as having a higher risk of congenital anomalies (around 5% more common in multiple pregnancies than in singleton pregnancies), are also at risk of growth restriction and preterm birth, which in turn is associated with other complications such as cerebral palsy and learning difficulties. Second, the care pathways for women who terminate their pregnancies following a diagnosis of fetal anomaly should be improved.
Currently, the risk of fetal anomaly tends to be used rhetorically to scare women into not leaving childbearing too late – and yet women who terminate pregnancies because of fetal anomalies tend to experience a lack of sympathy and sensitivity. With all this going on, doctors and policymakers need to tread very carefully when issuing messages to women about how they time their childbearing.
We should also be honest in saying that the context in which women make their fertility choices is not necessarily ideal, and it would be better if young mothers stood a decent chance of being career women too. Fertility treatment is expensive and uncertain, but most women know that already: and they also know that it can work in some cases. If policymakers are worried by the consequences of later maternal age, they should be focusing on supporting prenatal screening services, preparing maternity services to be better able to cope with obstetric complications, and funding decent miscarriage care and fertility treatment. Though, once again, our center's IVF pregnancy rates were more than excellent, the degree of excellence does not even become fully apparent until the adverse selection of patients undergoing IVF cycles at CHR is considered.
A few peculiarities deserve explanation: For example, one may wonder why younger women, under age 30 years, have poorer pregnancy rates than women between 30 and 40 years. Indeed, during 2012, CHR served a larger number of young women with severe POA than ever before, many with undetectable AMH levels and FSH levels approaching menopausal levels.
Approximately 90% of women under treatment suffer from POA, either based on abnormally low age-specific AMH, abnormally high age-specific FSH levels, or both.
Considering that CHR, up to age 38, practically never transfers more than 2 embryos and up to age 40 never more than 3, this is, again, quite a remarkable number. Indeed, the data very well demonstrate the continuing "graying" of CHR's patient population as IVF cycles in the oldest age groups increased the most. In presenting the above data, we, however, also want to point out once more that statistical data has to be interpreted with extreme caution in medicine. In women with significantly diminished functional ovarian reserve (DFOR), whether due to POA or older age, the range of outcomes, however, becomes much wider and, most importantly, with significant risk involves the ZERO range (i.e.
Hemodialysis is the most common method used to treat advanced and permanent kidney failure. This rate did not improve from 1999 for the total population or for any age group (Figure 2.14). This rate remained statistically unchanged for every age group during this time period (Figure 2.15). Data were analyzed for two selected historical years (1994 and 1997) and annually with each NHQR (2000-2004). However, individual and community programs have shown progress in influencing behavior change.
However, during that same time span, the rate of new AIDS cases decreased for adults ages 18-44 while increasing for children ages 13-17, adults ages 45-64, and adults age 65 and over (Figure 2.22). The revised recommendations also expanded the existing recommendations for screening pregnant women. Without adequate treatment, as HIV disease progresses, CD4 cell counts fall and patients become increasingly susceptible to opportunistic infections. Participation in this network is voluntary, and network data represent only patients who are actually receiving care. It situates this discussion in its wider social context, and indicates the policy implications that might flow from a trend towards later maternal age.
For this group, the chances of being able to conceive a healthy pregnancy and give birth without serious complications are good. A more precise account of the figures reveals that about 29% of births are to women aged 30-34, 16% are to women aged 35-39, 4% are to women aged 40-44, and less than 1% are to women over 45.
It reflects the fact that in the twenty-first century, women have access to effective contraception, and this gives them the scope to construct their lives around choices about partners, careers, and friendships. There is no right to have a child, and it is not always possible to control whether one becomes pregnant or not. The abortion statistics show, further, that a sizeable proportion of women have unintended pregnancies at this age.
This found that, if they were having sex twice a week, 82% of women aged between 35 and 39 fell pregnant within a year. The social trend towards later motherhood, which is evidenced by the growing number of mothers in their 30s, indicate that getting pregnant is not a problem for the majority of women aged 35-39. That is to say, women become progressively less fertile, and embryos are more likely to have anomalies, which in turn can contribute to the risk of miscarriage.
The studies cited below indicate the kind of problems that are associated with pregnancy and neontatal outcomes in older mothers. The issue at stake here is only how much additional risk is posed by advanced maternal age.

This study delineated between women aged 35 or younger, women aged 35-39, and women aged 40 or older. The implication of the 2005 Obstetrics and Gynecology study is that, for women aged 35-39, and even for women aged 40 and older at delivery, most of the risk factors that are known about and statistically significant will not present a clinical problem. The National Down Syndrome Cytogenetic Register indicates that there were 1,115 cases diagnosed in 2010 to women aged 35 and over, of which 60% ended in abortion (around 90% of cases diagnosed prenatally), and just over 400 cases of Edwards and Patau syndrome.
At a time when there is greater awareness of fetal anomaly, better technology to detect anomalies at earlier gestations, and a demand for screening from women whose age puts them at greater risk, it is crucial that the resources are provided for women to obtain accurate diagnoses as quickly and sensitively as possible. Currently, it tends to be the case that women diagnosed with an anomaly at gestations of under 24 weeks are signposted towards termination services that may not offer them the choice to terminate their pregnancy using surgical methods.
However much prenatal screening services develop, there will always be some women who choose not to have screening, or who have a positive result but choose not to terminate the pregnancy. Culturally, increased attempts to portray disability in a positive light often gloss over the daily, practical problems faced by parents of disabled children and young adults. On one hand, it is important to be honest, and recognise that a woman who is biologically infertile cannot get pregnant just because she wants to. The continual conflation of the problems facing women at aged 35 with those aged over 40 seems deliberately designed to present women with a worst-case scenario, as though there is a need to scare women in their early thirties into rushing into pregnancy.
The pie chart in Figure 1 on the right demonstrates, for example, how adversely selected CHR's patients were in regards to age: only approximately 30% of patients were under age 35. This, however, is an almost expected finding at our center: Women who seek out fertility treatments at such young ages are usually more severely affected by infertility. All patients who received 4 or more embryos were above age 41, and in such patients a clinical pregnancy rate of 15.6% is remarkable. On more careful analysis, however, this conclusion is proven wrong because standard donor egg cycles, indeed, still demonstrated pregnancy rates around 60.0% in 2011.
No two patients are ever 100% alike, and looking at outcome data, based on patient age alone, especially for older women, is not always the best way to asses individual patient's pregnancy chances. It is for that reason that CHR above, for the first time, reports clinical pregnancy rates by the number of embryos transferred. Changes in the incidence of new AIDS cases are affected by changes in HIV infection rates and by the availability of appropriate treatments for HIV-infected individuals. But many of these social and cultural debates tend to be played out through a discussion of the clinical problems about older women’s ability to carry a pregnancy in their thirties and give birth to a healthy child. As a 2014 commentary by the US obstetrician WR Cohen in the British Journal of Obstetrics and Gynaecology (BJOG) concludes, after reviewing the extent to which maternal age affects pregnancy outcome, ‘it is important to remember that the great majority of pregnancies in older women are relatively uncomplicated and end quite satisfactorily. In 2012, almost 27,000 women aged 35 and over had an abortion; and this number and rate has remained stable since 2002. We know that in general, women aged 35-39 have a reasonable chance of getting pregnant; but when an individual woman aged 36, or 38, tries to become pregnant she might not always succeed.
At a purely biological level, if this woman had tried to conceive earlier, she would have had a better chance of becoming pregnant.
But women who froze their eggs at 30 had a 72 per cent chance of becoming pregnant by thawing these eggs at 41.
The high rate can be explained only in part by obstetric and medical comorbidities and the propensity of older women to have dysfunctional labour. No – they simply mean that maternity services should be aware that older mothers might present these additional complications, and organise around them accordingly. Women carrying more than one baby have an increased risk of anaemia, hypertensive disorders, haemorrhage and postnatal illness. For these women, who are often terminating a much wanted pregnancy, having to go through the induction of labour causes additional distress.
Potentially, this might become one consequence of later motherhood, where women feel that their pregnancy is their last chance to have a child. It is assumed that there is a contradiction between enabling women to avoid having a baby with a congenital anomaly, and supporting parents of children with disabilities. At a general level, the evidence strongly suggests that women are likely to find the process of conceiving, being pregnant, and giving birth more straightforward if they are under 40, and there is little to be gained from denying that this is the case. The likely reality is that more women will have children in their mid to late thirties, and the likely outcome of that is that most pregnancies, births, and babies will be healthy. Women respond, not to journal articles and pronouncements from Royal Colleges, but to their personal circumstances and the experiences of those around them. Again, considering this degree of adverse patient selection, CHR's age-specific cycle outcomes have to be considered nothing but spectacular.
This means that to be included in these statistics, a patient had to have at least one embryo available for transfer. Within each number of embryo transferred, younger patients, of course, will do better than older patients, though the range of difference narrows as women age.
For example, if a woman at retrieval produces no eggs, she, of course, has no chance of pregnancy. This is despite the fact that the percentage of conceptions leading to abortion has generally decreased for women aged 35 and over in the past 20 years, reflecting the trend towards later motherhood.
In other words: women in their thirties might have to try harder to get pregnant, particularly if their partner is also in his late thirties. These women’s choices should be supported in a practical way, through providing care, education and opportunities for disabled babies, children and adults.
These circumstances and experiences suggest to them that having babies in one’s thirties is quite normal.
Early transplantation that decreases or eliminates the need for dialysis can also lessen the occurrence of acute rejection and patient mortality. Policymakers need to be realistic about disability, offering less rhetoric and more practical support.

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