Does age matter? Psychological implications for women of the age of onset of infertility

Infertility is a label that encompasses a vast diversity of medical diagnoses and life circumstances. Although 1 in 8 couples will struggle with infertility at some point during their lives, their individual experiences can be quite different. One such difference is the age of onset or diagnosis of infertility, as infertility can occur at any point during a woman's reproductive years. In this post, I'll discuss some of the different emotions infertility can produce depending on the age of the woman involved. Although age also plays a role in how men experience their infertility, it seems to be less powerful factor than for women, for whom age and fertility potential are closely linked. Thus, I'll mainly be focusing on this issue from the female perspective.

Psychological implications for being diagnosed while "young"

Although everyone's experience is different, it seems that for the "under 35" set, certain emotional themes are more likely to come up when infertility occurs. The main one I see in my practice is a feeling of shock, especially at the beginning of diagnosis and treatment. In the majority of cases, women who have always enjoyed good health and normal gynecological functioning assume that they will be able to have children without help as long as they don't "wait too long" and start trying in their 20's or early 30's. It is thus often difficult to accept that there is a problem.

Once the knowledge that there is a problem sinks in, it is often accompanied by feelings of failure and low self-esteem. I have heard so many wonderful, successful women tell me that because they are having difficulty conceiving a child, they feel inferior to their peers. They worry that they have done something wrong, often on a karmic level, to cause their infertility. They tend to feel angry at and betrayed by their bodies--why aren't they working in the manner nature intended? Further, these negative self-feelings come at a time when their friends, relatives, and peers are busy building their own families, seemingly without effort. Thus, women in the "under 35" age bracket tend to feel left behind from a developmental perspective, and can often experience social isolation. To make matters worse, because they are in the typical family-building time of life, they are often subject to intrusive questions on the parts of others about when they are going to have children. Additionally, they may be the unhappy recipients of uniformed but perhaps well-meaning lectures about how they shouldn't "wait too long to have a baby or (insert bad outcome here)".

Psychological implications of being diagnosed with infertility when a little "less young"

Women in their late 30's and 40's often have a somewhat different experience of being diagnosed with infertility. For them, the shock of an infertility diagnosis often seems to be less intense. It is fairly common knowledge that fertility potential decreases with age--thus, women diagnosed a little later in life often aren't totally blown out of the water that they must contend with this issue. Instead, they often deal with intense feelings of self-blame and recrimination. "If only I'd started trying when I was younger!" is a refrain I have heard many times, even though for these particular women, starting a family at an earlier point in life was often a difficult or impossible choice for them. In addition, women dealing with infertility in their late 30's or 40's must also endure comments from others that that they waited "too long". These women may also feel developmentally out of sync with other women their age, who now have children or have decided to live child-free.

As an aside, it seems that when a woman is in the "less young" age bracket, it is often assumed that she could have had children earlier if she had chosen to, and thus the cause of her problem is more volitional in nature. However, I suspect that many women may have had preexisting infertility conditions all along, but may have simply been unaware of it. I myself was diagnosed with infertility at age 30; but if my life circumstances had been such that I hadn't started trying until now, in my early forties, I would have no way of knowing that at least for over a decade, I was infertile. As I have a talent for self-recrimination, and seem to take it up at every available opportunity, I am sure I would be focusing on how I made the "wrong choices" right this very minute. But in reality, it would be entirely inaccurate.


No matter what your age when your infertility is recognized, it is important to be aware that the timing of your diagnosis may affect how you experience your infertility. In particular, be try to be alert for feelings of low self-esteem, isolation, and self-blame and recrimination. By better understanding those feelings from a developmental perspective, it will be easier to acknowledge what I consider to be the timeless truth of infertility--that it probably isn't anyone's "fault".