When is it too late to conceive?

Our biological clocks are a constant reminder that fertility is not a static state. As we age, the quality and quantity of our eggs (or sperm, for men) gradually decline. This natural process, known as fertility decline, is an important consideration when planning to conceive. According to American College of Obstetricians and Gynecologists, studies have shown that a woman’s fertility begins to decrease significantly after the age of 35, with a more pronounced decline after the age of 40. Average woman’s fertility peaks in her mid-to-late 20s, and then begins a gradual decline. This biological clock is not a fixed or predictable timeline. Factors such as overall health conditions, lifestyle choices, and underlying medical conditions can all influence an individual’s fertility and the rate at which it declines.

The reasons for this fertility decline are multifaceted. Aging can lead to chromosomal abnormalities in the eggs, increased risk of miscarriage, and a higher likelihood of complications during pregnancy. It’s important to understand that while advancements in reproductive technology have made it possible for some individuals to conceive later in life, there are still limitations and risks associated with advanced maternal age.

Options for women, who wish to start a family later in life, have expanded with the advancements in assisted reproductive technologies, such as in vitro fertilization (IVF) and egg freezing. These technologies, combined with a healthy lifestyle and proactive preconception care, can help to conceive and carry a pregnancy, even for women in their late 30s and 40s.

Risks of pregnancy at an advanced age

Pregnancy at an advanced age, generally defined as 35 years or older, carries a higher risk of various complications. These include:

1. Increased risk of miscarriage: The risk of miscarriage rises significantly with age, with women over the age of 40 having a 25-50% chance of experiencing a pregnancy loss.
2. Chromosomal abnormalities: The likelihood of having a child with chromosomal abnormalities, such as Down syndrome, increases with maternal age. The risk of Down syndrome, for instance, rises from 1 in 1,250 at age 25 to 1 in 100 at age 40.
3. Gestational diabetes: Older women are more prone to develop gestational diabetes, which can lead to complications for both the mother and the baby.
4. Preeclampsia: This serious pregnancy complication, characterized by high blood pressure and organ damage, is more common in women over the age of 40.
5. Placental problems: Older women have a higher risk of placental abruption (premature separation of the placenta) and placenta previa (low-lying placenta), both of which can be life-threatening.
6. Cesarean delivery: The likelihood of requiring a cesarean section increases with maternal age, which can lead to a longer recovery time and a higher risk of complications.
7. Preterm birth: Older mothers are more likely to deliver their babies before 37 weeks of gestation, which can result in a range of health issues for the newborn.
8. Stillbirth: The risk of stillbirth, the loss of a baby during pregnancy, is higher in women over the age of 35.
9. Postpartum depression: Studies have shown that older mothers are more susceptible to developing postpartum depression, which can have a significant impact on the mother’s well-being and the family’s overall adjustment to the new addition.

Egg freezing: Fertility preservation

Now women have ways to preserve their fertility and extend their window for starting a family. Egg freezing, for instance, allows women to “bank” their eggs or embryos for future use, giving them a better chance to conceive when they’re ready to start a family. This technology has been particularly beneficial for women who wish to focus on their careers or other life goals before starting a family, as it can help mitigate the age-related decline in fertility. Additionally, advancements in IVF techniques have improved success rates, making it a viable option for women who are struggling to conceive naturally due to age-related factors.

Planning for pregnancy at an older age?

For women who are considering starting a family later in life, it’s important to have proactive preconception care and genetic testing. This includes:

1. Comprehensive medical check-up: Women should undergo a thorough medical check-up to assess their overall health, identify any underlying conditions, and address any potential fertility-related issues.
2. Genetic screening: Genetic testing can help identify any inherited genetic disorders or chromosomal abnormalities that may increase the risk of complications during pregnancy or affect the baby’s health. Genetic testing, such as carrier screening and preimplantation genetic testing, can be beneficial for older parents. These tests can help identify any genetic or chromosomal abnormalities that may increase the risk of certain conditions in the baby, allowing for appropriate medical interventions.
3. Lifestyle modifications: Making adjustments to diet, exercise and stress management can help optimize the body’s readiness for pregnancy and minimize the risks associated with advanced maternal age.
4. Preconception counseling: Working closely with a fertility specialist can help women understand the unique considerations and develop a personalized plan for a safe and healthy pregnancy.

Also Read: Dydrogesterone: Solution for Hormone Imbalance

PCOD (Polycystic Ovary Disease)