The competition to strive and settle in life is a priority for many couples. This era has opened up new directions for education and employment. No wonder late marriages is fast becoming a norm in society. Social, emotional, and financial security demand have pushed the age for pregnancy.
Mrs Shilpa Mhatre, aged 36 & her husband, 40 years (name changed to protect identity) wanted to start the journey of parenthood, having decided they were now settled in life.
The concern was, can I get pregnant and what are my chances for pregnancy?
The refined question is what are the chances of getting natural pregnancy after 35?
As the biological clock ticks for a female partner after the 30s and much faster after 35 years or so. The eggs or the ovarian reserves decline faster after the age of 35. The reproductive potential of humans decreases, overall, there are 5% to 15% chance of achieving a natural pregnancy after age 35.
As such having timely sex may increase the chances of pregnancies but the overall chances of the same are highly reduced by this age. Overall reproduction is a highly inefficient process in the case of humans. Even under normal conditions, a woman in her mid-20s has a 25–30% chance of pregnancy every month. Fertility starts to decline when in her early 30s, and more so after the age of 35. By age 40, the chance of getting pregnant naturally in any monthly cycle is around 5% to 10%
The human body has designed intelligent ways to select the best embryos. The best quality eggs are utilised first or during early reproductive years and as the age progresses, not only the numbers but also the quality of eggs deteriorates. Time-bound cellular damage happens with these eggs too.
So there are 5 to 10% chances of natural conception. The older woman has higher abnormal eggs in her egg supply.
What are the chances of abnormal eggs?
When a woman is 29, about 20% of her egg reserve will be abnormal)
When a woman is 31, about 30% of her eggs reserve will be abnormal
When a woman is 35, about 35% of her eggs reserve will be abnormal
When a woman is 37, about 42% of her eggs reserve will be abnormal
When a woman is 40, nearly 60% of her eggs reserve will be abnormal
When a woman is 44, nearly 90% of her eggs reserve will be abnormal
Ref: landmark study on aneuploidy done by RMA’s Dr Jason Franasiak, published in 2013.
Since late marriage is the culprit behind late conception, what are the real concerns?
The biological clock often ticks for both partners, it is advisable to be healthy by maintaining healthy habits, and weights as well as adopting a healthy lifestyle.
Do not wait for seeking the help of the expert as, most of the time trying and detecting the underlying cause delay the conception process.
Advances in reproductive sciences have offered options for fertility treatment and Assisted Reproductive Technology (ART). But it is wrong to assume that you can get pregnant at any time while doing Assisted Reproductive Technology. It is often seen that success rates for ART treatment while using their eggs are directly linked to the age of the women. That is why older women may have more success with Assisted Reproductive Technology using donor eggs.
ART is expensive and may not be covered by most insurance health plans for this indication.
Remember, complications of pregnancy increase for expectant mothers and their offspring, with advanced maternal age.
What are the symptoms I should watch for?
A. Menstrual cycle shortening, menstrual irregularity, and pelvic pain could be the clinical signs of ovarian ageing. This simply means that fertility is drastically reduced.
The doctor will order hormone tests to be done on day 2 or 3 of the menstrual cycle i.e FSH, estradiol, AMH, along with transvaginal ultrasound for checking the antral follicles. This will give an overall picture of understanding the ovarian reserve of the woman and depending on the results, the treatment plan can be designed.
Screening for Associated Medical Problems is advisable to
B. Women who have a medical disorder, such as high blood pressure or diabetes should be screened to have control over it. Change in medication or general health care before pregnancy is needed, as there are increased risks for older women.
Conditions such as high blood pressure or diabetes are often common in women who conceive after age 35.
Prenatal testing is often advised to check for certain birth defects.
Fertility preservation is often advisable like freezing embryos after IVF or retrieving the excess embryos for future use.
Pearls of wisdom for pregnancies after age 35.
1. Understand the importance of time concerning ovarian ageing.
2. Reduce the burden of other health conditions which may delay the conception
3. Maintaining the healthy lifestyle and habits of both partners is necessary.
4. Early consultation and the right diagnosis from a fertility specialist will reduce the time and cost to pregnancy.
5. Do have a check on the symptoms of menstruation, duration and timings, so you will able to produce the right information during a consultation.
6. Pregnancy is a joint effort of the couple so maintaining stress-free communication and a jovial atmosphere which goes long way in building a healthy family.
7. There are higher risks of caesarean, preterm delivery, pre-eclampsia, gestational diabetes, and fetal abnormalities.
8. Your obstetrician will be your companion till the time of delivery, choose the centre wisely as the consulting obstetrician knows your clinical history and can deal with you responsibly when the need arises.
At Pearl Women’s Hospital and Yash IVF, we provide comprehensive end to end solutions, from overcoming infertility to safe delivery.
We have a team of 5 obstetricians to provide expert cover 24 x 7. They are supported round the clock by a team of qualified and experienced resident doctors & nurses. Standardized, protocol based patient management adds the professional touch, with the friendly and competent staff providing the comfort.
One big headache – food, it’s very well taken care of. Tasty and wholesome meals are provided in house.
All in all, considering the quality and completeness of the services, the location & the cost effective pricing, our clients consider or option as being value for money.