Marriage and maternal age is continuously postponed by women today. Causes for this postponement include to strengthen the professional carrier, concern to provide financial assurance or trying to be ready for being a mother psychologically. The important issue is that woman should be aware effectiveness of age on a healthy pregnancy and potential to get pregnant. Physiologically, the most appropriate fertility age for a woman is between 20 to 30 years of age.
Advanced age is not a definite obstacle for a pregnancy, however, the period to obtain pregnancy becomes longer by aging. While chance to get pregnant in any month under thirty years is 20%, this chance has been reported as 5% only after 40 years.
In other words; while a 25 year old woman may get pregnant within a couple of months in general, this period may be loner than 6 months for normal women over 35 years. Risk for miscarriage also increases by aging.
While pregnancy chance decreases over 40 years even for advanced level infertility treatments such as in-vitro fertilization, risks of miscarriage and babies with anomalies increase. “Ovum quality” reduces by an aging woman, this causes decrease on fertilization capacity by a sperm. In case of fertilization of these ova, more risk appears in terms of genetic disorders. For example, Down Syndrome (third copy of 21st chromosome instead of second, Mongolian baby) is frequent in children of elder women. When girls are born, there are 400,000 ova in their ovaries. No ovum production occurs after the birth and woman’s ova reduces and becomes older irreversibly by age.
Chance for fertilization of the ovum by a sperm and occurrence of a well qualified embryo after fertilization reduce by aging. Possibility of conclusion of pregnancies obtained by miscarriage also increase. Capacity of endometrium (inner layer of the uterus) to hold fertilized egg reduces by advanced age and pregnancy chance also reduces. Endometriosis which cause intraabdominal bleeding and infertility and intrauterine occupying myoma are frequent by aging.
Furthermore, many women may experience inflammations which may obstruct the tubes, ectopic pregnancy, appendicitis, endometriosis or surgical procedures due to different causes and these may affect infertility.
However, it should be reminded that biological age of women is more important than chronological age for reproduction health. While a 45 year old woman produced ova regularly, a very younger woman may enter into menopause period earlier in some cases. When couples over thirty five years old can not obtain pregnancy, they should not wait for more than six months to refer to a physician.
Of course aging does not affect women only. Although a menopause like women exists in men, sexual functions reduce and changes appear in pregnancy creation capacity by aging. Frequently, a slight decrease appears in testosterone levels by aging and this may cause decrease in libido as well. It has been shown in men that testicles become smaller and softer by aging. Sperm forms and motilities also tend to worsen even less.
Despite these changes, there is not any maximum age limit for men to have a child. First, it should be searched whether medical problems may exist when pregnancy occurs. For example, hypertension or diabetes may cause problems during pregnancy period. FSH and estradiol (E2) measurements performed to assess pregnancy potential at 2nd to 4th day of menstrual cycles and evaluation of ovaries by ultrasonography provide important information.
Another important issue to be known by women in advanced age group is that they are more likely to carry a baby with genetic malformations than a young woman. It is possible to reveal this with come interventions such as amniocentesis or chorionic villus sampling when they get pregnant. Please click for more information about amniocentesis.
For old infertile women who can not achieve pregnancy despite efficient treatment (insemination and in-vitro fertilization), ovum donation, in other words, purchase of ova of young women from some centers abroad may be considered. However, since our law does not allow this, this procedure can not be performed within territory of Turkish Republic.
Pregnant women with advanced age may face many problems during their pregnancy period. For example, hypertension, gestational diabetes, premature delivery, miscarriage are more frequent in these pregnant women.
Appearance of systemic diseases also increase during pregnancy in advanced age. All these should not fear expectant mothers. These risks may be minimized with a careful monitoring and timely interventions by experienced physicians!
Are there any risks for the baby?
Advanced age may not be risky for pregnant women, but also risky for their babies.
As mentioned before, one of the important problems appeared during pregnancies over 35 years is possibility of increased chromosome abnormality. Down Syndrome (mongolism) keeps an important place among these. Please click for more information about Down Syndrome. When the baby is delivered earlier due to pregnancy-induced diseases, pregnancy-induced hypertension, diabetes and placenta abnormalities, the baby is exposed to risks of early delivery. Please click for more information about these problems experienced during pregnancy.
Finally, it should be recognized that infertility problems are experienced, pregnancy process becomes harder and pregnancy and delivery complications increase when pregnancy age is postponed.