A woman’s age and her likelihood of infertility are inextricably linked. As Menken et al noted in 1986 (1) and others have since confirmed (2-5), women who delay their childbearing are more likely to have difficulty conceiving when they do try to start a family. Explanations for this correlation between age and infertility have included a decrease in successful embryo implantation (6) and an increase in spontaneous abortions (7, 8) in women of advanced reproductive age (ARA, > 40 years old). Another possible explanation for infertility in older women is the fact that these women have had more time to develop and be exposed to diseases known to cause infertility. Since endometriosis is considered a disease of women who delay childbearing (9), would endometriosis and other diseases be more prevalent in older women? Since the ovary ages to the point of complete oocyte depletion (10), are ovulatory abnormalities more common in older women who wish to conceive? No one has looked at the possibility that some infertility diagnoses may be more prevalent in women of ARA and thus the underlying diseases leading to these diagnoses could be the cause of increasing infertility with increasing age.

We designed this retrospective study to investigate the hypothesis that older women would have a different pattern of infertility diagnoses than younger women. Since older women would presumably have more years of exposure to sexually transmitted diseases, we expected more tubal pathology in these infertile patients. It is well documented that as women approach menopause they experience more irregular menstrual cycles and thus we also anticipated finding more ovulatory problems in the older group, including an increase in the prevalence of luteal phase deficiency. We did not expect to see any differences between the frequencies of diagnoses of male factor, uterine defects, cervical factors, or unexplained infertility between the older and ...