The nation's obstetricians and gynecologists have once again publicly underscored the role that age plays in women's fertility.
In a revised opinion released Wednesday, the American College of Obstetricians and Gynecologists emphasized that women's ability to have babies declines gradually "but significantly" beginning around age 32, then more rapidly after age 37.
The statement is not intended to alarm women, or to suggest that age is the primary cause of fertility problems, Dr. Samantha Butts, a member of ACOG's Gynecologic Practice Subcommittee on Reproductive Endocrinology, told The Huffington Post.
"I can hardly imagine a provider who would tell a patient, 'You must be pregnant by age fill-in-the-blank,'" said Butts, an assistant professor of obstetrics and gynecology with the Perelman School of Medicine at the University of Pennsylvania. "But I also think it's our responsibility to provide information so our patients can have a framework to think about things."
The new opinion updates an earlier one, released in 2008. Its findings are largely the same, Butts said, though the new version uses more forceful language in encouraging women struggling to conceive to be referred to fertility specialists.
Women older than 35 should receive an "expedited evaluation" and possibly undergo treatment after six months of trying, and failing to conceive -- or sooner, if clinically indicated, the statement says.
"In women older than 40 years, more immediate evaluation and treatment are warranted," it adds.
In June, Jean Twenge, author of The Impatient Woman's Guide to Getting Pregnant, made waves with an article in The Atlantic, which argued age-related "baby panic" is based on largely questionable data.
"Fertility does decrease with age, but the decline is not steep enough to keep the vast majority of women in their late 30s from having a child," she concluded.
Butts said the new opinion is backed by studies looking at natural fertility within the population, as well as results from hundreds of fertility clinics on thousands of cycles of in vitro fertilization. "I would say it's based on very, very sound evidence," she said.
According to the statement, changes in egg quality, quantity and certain hormones are not the only age-related factors that can influence fertility; as women get older, they are also at greater risk for certain disorders, which can affect fertility. Women should regularly see women's health specialists and primary care physicians to optimize their overall health, and eliminate behaviors, such as smoking, which can hurt fertility, Butts said.
They should also be sure to have frank discussions with their doctors about their "reproductive life plans" -- if they want children, how many they want and the details of their specific circumstances, Butts added. Some new technology like egg freezing, though costly, is no longer considered experimental by the American Society of Reproductive Medicine.
Butts believes the more women understand about the factors that can influence fertility, the better. "Education about these things is exquisitely important," she said.