As a woman gets older, getting pregnant becomes harder. Moreover, as she crosses 40, 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. Moreover, to top it all your fertility reduces. However, 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. Moreover, 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 to have a baby is 25 – 35 years.
However, 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 40 has also significantly increased over the last decade. While getting pregnant at 40 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 40 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:
There is an increased risk of having babies with genetic abnormalities like Down syndrome in advanced age because an older woman faces a high risk of having eggs with structural problems. Which means that the eggs have a defect in the way they are formed. These eggs may not fertilise easily. If even they do fertilise, the survival rate will be low and would result in a miscarriage. If the fertilised egg develops into a baby, then there is a risk of the baby suffering from some congenital disabilities which could be developmental, physical or mental.
The risk of miscarriage increases as a woman ages, because of the presence of chromosomal abnormalities in the egg. Poor-quality eggs and chronic health conditions together like hypertension, diabetes increases the risk of miscarriage (Miscarriage Meaning in Hindi).
With advanced age, the risk for pregnancy complications increases like:
Due to pre-existing health conditions and pregnancy complications the risk of stillborn or loss of pregnancy increases in an older woman.
The risk of premature delivery increases in women of older age group. Because with age pregnancy complications increase like high blood pressure, and reduced blood supply to the uterus, thus restricting the growth of the baby. Therefore, early delivery may be required.
The risk of multiple pregnancies increases with age. As the ovarian reserve starts to decrease with age, the body signals the ovaries to release more eggs, so the chances to conceive with twins or more increases.
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 40 years. To know how to boost fertility in your 30's or 40's or 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 40 years, the possibility of getting pregnant naturally each month comes down to 5%. The only drawback of trying to get pregnant naturally, or opting for the best fertility foods while trying to get pregnant, after 40 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. Moreover, 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. However, motherhood now does not have to be limited to younger women only. Advances in fertility treatments have helped many older women to conceive successfully.
Q1) WHAT IS GERIATRIC PREGNANCY?
A) In the past, doctors used to define geriatric pregnancy for women who used to conceive at an advanced age of 35 years and above. Now it is termed as Advanced Maternal Age.
Q2) WHAT AGE IS HIGH RISK TO HAVE A BABY WITH GENETIC PROBLEM?
A) The risk of having a baby with Down syndrome or any other genetic anomalies increases with age. When a woman is in her mid-30’s, the risk becomes more. At age 35, the risk of having a baby with Down syndrome is 1:350, at age 40 it is 1:100, and at age 45 it is 1:25.
Q3) IS ADVANCED MATERNAL AGE HIGH RISK?
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.