As a woman gets older, getting pregnant becomes harder. And as she crosses 35, she experiences many changes in her life. Advanced age comes with a fair share of hurdles and adjustments. Your eyesight suddenly begins to weaken. You don’t have the energy that you once used to have. You feel that your body is failing you. You become susceptible to medical conditions such as blood pressure, diabetes and heart problems. Your hair begins to grey at a more rapid pace. And to top it all your fertility reduces. But the desire to have a baby becomes stronger.
Advanced maternal age (AMA) or advanced reproductive age is a term used to define women who conceive when they are 35 years or older. With advanced age, there is a trend of decreasing fertility, as the quality and quantity of eggs deteriorate. A woman not only finds it difficult to get pregnant, but the chances of miscarriage also increase. And if also she conceives it would be a high-risk pregnancy.
As we know the ‘Reproductive Age’ of a woman starts with her first menstrual cycle at around the age of 12 or 13, and it continues until her last periods, i.e., until the onset of menopause. So, with advancing age, her fecundity (fertility) starts declining, that means she doesn’t remain fertile throughout her life. So, elders in the family always focus on saying that there is a right age to have a baby and the best time period to have a baby is 25 35 years.
But nowadays, the concept of delayed parenthood is slowly increasing. More couples are pushing past the 35 years age mark before they start a family. Many women are planning a second pregnancy after 35. The number of women who are planning their first child after 35 has also significantly increased over the last decade. While getting pregnant at 35 has its own risk, but age does not appear to be a barrier to parenthood any longer. Older couples do not think twice when they decide to have a child past their prime. All thanks to advances in fertility treatment like IUI, IVF, ICSI, and they can also opt for egg freezing.
When a woman has reached advanced maternal age and is thinking to start a family, then the key to a healthy pregnancy, will be to consult a doctor and have a thorough medical check-up, mainly if she has some underlying health conditions (hypertension, diabetes, thyroid problems), because conceiving with health issues will have a direct effect on the developing baby. If one is overweight, then it is time to follow a strict healthy diet and an exercise regime before planning a pregnancy.
Getting pregnant at 35 risks - There are some risks associated when a woman plans her pregnancy at an advanced age, which she needs to be aware of and consider minimising the risk factors. A female is born with a fixed number of eggs, and as she ages the quality and quantity of eggs available significantly decreases, thus reducing fertility. The incidence of medical conditions like diabetes and hypertension also increases, and this, in turn, increases pregnancy complications. The risks associated are:
Advanced maternal age group women find it difficult to conceive or may take a longer time to get pregnant. So, there should be an advanced maternal age pregnancy guideline, where a woman is explained the do’s and don’ts before planning a pregnancy.
Fertility starts declining after the mid-’30s and plummets when a woman reaches 35 years. To increase the chances of pregnancy in older women, we recommend them:
Conceiving naturally - Fertility declines with age, but the rate at which it declines increases with age. So, a woman under 30 years have 25% chance of getting pregnant naturally in each cycle, above 30 years the chances come down to 20%, and by 35 years, the possibility of getting pregnant naturally each month comes down to 5%. The only drawback of trying to get pregnant naturally after 35 is that it can take a while, or not happen at all as fertility starts declining at a steady pace. So, if you have been trying for a while and have not been successful, it is advisable to visit a fertility consultant. Because with age, the ovarian reserve reduces, and the quality of eggs also becomes poor, which can lead to infertility.
Conceiving with ART (Assisted Reproductive Techniques) - At an advanced age, each day matters. So, resorting to assisted reproductive techniques may increase the chances of pregnancy. After a brief period of ovulation induction, IVF can make the optimal use of the limited eggs left in the ovary. Provided the matured egg retrieved in that specific cycle is of good quality. And for women for whom ovarian stimulation to retrieve good quality eggs have failed, then IVF with donor egg should be considered. A donor of younger age with a matching profile of the woman is selected. Donor egg/Donor embryo IVF treatment can also be helpful for women who have had their menopause to conceive successfully. If associated with medical comorbidity, Surrogacy can also be an option for advanced age group mothers.
Medicover Fertility clinics are among the top fertility clinics in Europe now in India. With state-of-the-art technology and technical expertise of doctors, we have been helping older women in planning a pregnancy.
The concept of delayed parenthood is slowly increasing. Careers get preference and accumulation of assets is a priority. Family planning takes a back seat. The theory that most people follow now is about securing themselves financially before they have a child. That way, they can give the child all the comforts and necessities of life. So, this has resulted in couples to plan a pregnancy at an advanced age.
So, the cases of infertility are on the rise due to work-related stress, irregular eating habits, reduced ovarian reserve and ageing eggs. But motherhood now does not have to be limited to the younger women only. Advances in fertility treatments have helped many older women to conceive successfully.
A) If the woman has some underlying chronic health conditions like hypertension, diabetes, thyroid problems, then conceiving at an advanced age can be of high risk and can cause pregnancy complications.