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Before your biological clock ticks

Last Updated 22 July 2016, 18:02 IST

After six years of marriage, Tanya gingerly brought up the topic of having a baby. Though Tanya and her husband had not given much thought about having children during their initial years of marriage, later they made up their mind and were in mutual consent to have kids. However, by the time they took the decision, they realised that it was too late for Tanya to conceive naturally.

Age is one of the major factors that causes trouble for women to conceive. Fertility experts across the globe agree that women’s fertility decreases with age. This is because women are born with a definite number of eggs in the ovaries that declines with age, unlike men whose sperm production is often not affected by age, with the exception of rare cases.

The average age of childbearing has also increased over the past few decades as many women do not think about marriage while in pursuit of higher education and career. Several factors have contributed to this trend such as easy availability of contraception, the increasing divorce rates, married couples delaying pregnancy until they are more financially secure etc.

Many women do not realise that their fertility begins to decline in their late 20s or early 30s. Female fertility begins to decline many years prior to the onset of menopause despite continued regular menstrual cycles. This is normal among most women. However, in many cases, the ovarian reserve is reduced drastically much before 30 years of age.

The risk factors for early loss of ovarian reserve include cigarette smoking, alcohol and drug abuse, overexposure to environmental pollutants, family history of premature ovarian failure, ovarian cancer and treatment, previous ovarian surgery, significant ovarian pathology, etc.

Delayed pregnancy results in many health troubles that sometimes can be life threatening for both the mother and the baby.

One of the most common problems in delayed pregnancy is the ability to sustain it till the end. Many women who conceive in their late 30s tend to miscarry because of the hormonal imbalances within the body or uterine abnormalities developed over the years.

A pregnant woman in her late 30s is more prone to health disorders like high blood pressure, thyroid or diabetes during second trimester of the pregnancy. These disorders mostly lead to premature birth of the baby.

During delivery, one might even suffer prolonged labour pain because of fatigue in older women, less effective contractions that are not strong enough to push the baby, etc.

As a woman’s body grows old and weak with age, the chance of delivering a healthy baby is also reduced. Some of the major risks that newborns develop include abnormalities like defects in spinal cord, Down’s syndrome, etc.

Information available in the world of internet leads one to believe that women can delay pregnancy and later when ready, they can get pregnant with the help of Assisted Reproductive Technologies (ART).

What these women are not aware is that age affects the success rates of infertility treatments as well as their ability to get pregnant naturally. At 30, if a woman has a 20% chance of pregnancy, then at 40, the pregnancy rate is reduced to 5% per month when trying naturally.

Infertility evaluation

Hence, women older than 35 years should receive an expedited evaluation and undergo treatment after six months of failed attempts to conceive.

For women older than 40 years, immediate consultation with a fertility specialist is recommended. The infertility evaluation in women of advanced reproductive age should include a thorough assessment of ovarian reserve.

For those who choose to delay their pregnancies, fertility preservation comes as a rescue. Fertility preservation is an effort to help individuals to retain their fertility or ability to procreate. With the use of freezing agent (liquid nitrogen), human tissues such as semen, oocytes for unmarried individuals, and embryos for married couples are frozen at a temperature of -196 degree Celsius and stored in specially designed tanks. When the couple is ready to start a family but find out that it has become too late to conceive naturally, they can then opt for IVF with the previously frozen gametes or embryos.

Delayed pregnancies include high risks that might be life threatening to both the mother and the baby. Conceiving in late 30s or 40s is not impossible, but a pregnant woman over 35 years of age should have her as well as her baby’s health monitored carefully so that she does not suffer the risks involved in delayed pregnancies.

(The writer is Fertility Consultant, Nova IVI Fertility, Bengaluru)

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(Published 22 July 2016, 18:02 IST)

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