Advanced Maternal Age: Can You Conceive After The Age of 35?

As women age, pregnancy becomes more challenging. Beyond 35, many changes occur: eyesight weakens, energy levels decrease, and susceptibility to conditions like blood pressure, diabetes, and heart problems increases. Hair greys faster, and fertility declines. Despite these challenges, the desire to have a baby often intensifies.

What Is Advanced Maternal Age?

Advanced maternal age (AMA) refers to women conceiving at 35 years or older. Fertility declines as egg quality and quantity diminish, making conception difficult and increasing the risk of miscarriage and high-risk pregnancies.

The reproductive age of women spans from their first menstrual cycle around 12 or 13 years old until menopause. Fertility gradually declines with age, highlighting the traditional view that the ideal age range for childbirth is between 25 and 35 years.

However, delayed parenthood is becoming more common. Many couples are now starting families after age 35, driven by advancements in fertility treatments such as IUI, IVF, ICSI, and options like egg freezing. This trend reflects a shift where age is no longer a barrier to parenthood.

Why Does Fertility Decrease With Age?

• Ageing eggs: As women age, the eggs in their ovaries also age, leading to DNA damage that can affect fertilization. Even if fertilization occurs, embryos may struggle to implant in the uterine lining.
• Gynecological issues: Older women often experience conditions like damaged fallopian tubes, uterine fibroids, and endometrial polyps, which can impact fertility.
• Libido and sperm quality: Both men and women experience a decrease in libido with age. Additionally, older men may see a decline in sperm quality, further affecting fertility.

Risks Associated With Advanced Maternal Age

When considering starting a family at an advanced maternal age, it's crucial to consult a doctor and undergo thorough medical check-ups. This is especially important if there are underlying health conditions such as hypertension, diabetes, or thyroid problems. These conditions can directly impact the health of both the mother and the developing baby.

Managing Weight Through Diet and Exercise

For those who are overweight, adopting a strict, healthy diet and exercise regime before pregnancy is recommended. This proactive approach can help optimize health outcomes for both mother and baby

Risks at 35 and Beyond

Decreased Fertility: Women are born with a fixed number of eggs, and as they age, both the quality and quantity of available eggs decline significantly, reducing fertility.

• Chromosomal Abnormalities: Older women face an increased risk of chromosomal abnormalities in eggs, leading to higher chances of genetic conditions like Down syndrome and an elevated risk of miscarriage.
• Miscarriage Risk: Advanced age is associated with higher rates of miscarriage due to poor egg quality and underlying health conditions such as hypertension and diabetes.
• Pregnancy Complications: Advanced maternal age increases the likelihood of various complications:
  • Ectopic Pregnancy: The risk of ectopic pregnancy, where the embryo implants outside the uterus, is higher.
  • Preeclampsia: Elevated blood pressure during pregnancy can lead to preeclampsia, potentially causing serious complications for both mother and baby.
  • Gestational Diabetes: Older mothers are more prone to developing gestational diabetes, characterized by high blood sugar levels during pregnancy, which can result in larger-than-average babies.
  • Stillbirth: The risk of stillbirth increases due to pre-existing health conditions and complications during pregnancy.
  • Pre-term Delivery: Older mothers have a higher risk of delivering prematurely, often due to complications like high blood pressure and reduced uterine blood supply.
  • Multiple Pregnancies: With age, the likelihood of conceiving twins or triplets increases as the ovarian reserve diminishes and the body releases more eggs.

What Can Be Done to Increase the Chances of Pregnancy in Older Women?

Women in the advanced maternal age group often face challenges in conceiving and may experience longer wait times. To support these women, it's beneficial to establish advanced maternal age pregnancy guidelines that outline essential considerations before planning pregnancy.

Recommendations to Enhance Pregnancy Chances

• Healthy Lifestyle: Adopting a healthy lifestyle, including stress reduction techniques, and starting prenatal vitamins such as folic acid and DHEA supplements. DHEA (Dehydroepiandrosterone) can improve egg quantity and quality, potentially reducing miscarriage risk.
• Counselling: Providing counselling to increase awareness of how age impacts fertility is crucial.
• Timely Evaluation and Treatment: Women over 35 should seek evaluation and treatment after six months of unsuccessful attempts to conceive. Immediate evaluation and treatment are recommended for women older than 35 due to declining fertility.
• Pre-Conception Check-Up: A comprehensive pre-conception check-up is essential. It includes a detailed family history assessment and investigates any chronic health conditions that require medical management to reduce the risks associated with pregnancy.
• Genetic Counselling: Women above 35 should undergo genetic counseling to assess the risk of genetic abnormalities like Down syndrome. The risk increases with age, with genetic testing recommended to understand the likelihood of genetic abnormalities in pregnancy.

What Are the Treatment Options for Conceiving After The Age of 35?

For Conceiving Naturally

• Fertility naturally declines with age. Women under 30 years have about a 25% chance of getting pregnant each cycle, which decreases to 20% for those above 30 years, and as low as 5% by age 35
• Trying to conceive naturally after 35 may take longer or be unsuccessful due to declining fertility rates. It's advisable to consult a fertility specialist if conception has not occurred after trying for some time.
• Age-related factors such as reduced ovarian reserve and poorer egg quality can contribute to infertility in older women.

Assisted Reproductive Techniques (ART)

• In Vitro Fertilization (IVF): IVF involves stimulating ovulation to retrieve eggs, which are then fertilized outside the body and implanted into the uterus. This method maximizes the use of remaining eggs.
• Donor Egg IVF: For women who cannot produce viable eggs, using donor eggs from a younger woman with a matching profile can increase the chances of successful pregnancy.
• Donor Embryo IVF: In cases where both partners have fertility issues, using donor embryos can be a practical option.
• Surrogacy: In situations where carrying a pregnancy is not possible due to medical reasons, surrogacy involves implanting embryos into a surrogate mother who carries the pregnancy to term.

Each of these assisted reproductive techniques aims to optimize the chances of pregnancy for women of advanced maternal age, considering individual circumstances and medical histories.

How Medicover Fertility Can Help Women Conceive in Advanced Age

Medicover Fertility clinics, renowned in Europe and now in India, offer advanced fertility solutions utilizing state-of-the-art technology and expert medical professionals. They specialize in assisting older women in achieving successful pregnancies.

Supporting Delayed Parenthood

• With modern priorities favoring careers and financial stability before starting a family, more couples are opting for delayed parenthood.
• This trend has led to an increase in cases of infertility due to factors such as work-related stress, irregular eating habits, diminished ovarian reserve, and ageing eggs.

Advanced Fertility Treatments

• Medicover Fertility provides comprehensive fertility treatments tailored to the needs of older women.
• Their expertise includes advanced procedures like IVF, donor egg programs, and other assisted reproductive technologies.
• These treatments offer viable options for older women seeking to conceive and overcoming age-related fertility challenges.

Conclusion

Despite age-related fertility declines, advances in fertility treatments at Medicover Fertility clinics offer hope and practical solutions for older women aspiring to become mothers.

Frequently Asked Questions