Dr. Nandita Palshetkar, Obstetrician, Gynaecologist, Director of Bloom IVF India, President of IVF Society of India (ISAR)
Recently, there has been an observed trend where more people are opting to have children at an advanced age, most preferably after the age of 35. Although this can be quite liberating and fulfilling, it comes with some challenges and considerations for both, men and woman. Knowing these factors is necessary for anyone planning to conceive after 35, as it makes the decision more rational and facilitates all necessary safety measures.
Understanding fertility after 35
For women: Women’s fertility declines as they age, with a more noticeable decrease after age 35. This decline is mainly due to a reduced number and quality of eggs. There is a general increase in this rate of due to reduced number and quality of the eggs. Women in their mid-thirties can expect a 15 to 20% chance to get pregnant every month. Also, older women have an increased risk of miscarriage and chromosomal abnormalities including the risk of having a baby with Down syndrome. The rate of the drop becomes sharper as females get to their late 30s and early 40s.
For men: Fertility in men also decreases due to age, but at a slower rate as opposed to women. Age 40 and above usually denotes a change in sperm quality, affecting motility (how well the sperm move) and morphology (the shape of the sperm). This low-quality sperm lowers the chances of successful fertilization and increases the likelihood of genetic disorders among the children. Additionally, older fathers are more likely to have children with conditions like autism and schizophrenia.
Adverse effects and difficulties
For women: Women above the age of 35, are likely to develop pregnancy-related complications such as, gestational diabetes, hypertension and preeclampsia. These health concerns can lead to further complications such as preterm birth, or even the need to have a cesarean delivery. Women of advanced maternal age may also have more problems during the delivery period such as prolonged periods of labor or having to be assisted with forceps or vacuum extraction procedures
For men: Men do not incur the same risk factors which women experience. However, older aged men can lead to pregnancy related complications as well. There is higher probability of older fathers fathering low birth weight or premature children. Older paternal age also has poorer sperm quality with more genetic mutations which may cause defects or other genetic disorders.
Lifestyle choices and the impact
For women: For women aged over 35, who desire to get pregnant, a lifestyle modification is paramount. Eating healthy foods, exercising regularly and controlling one’s weight can enhance fertility and minimize any pregnancy complication. Also, they should consider refraining from smoking, drinking alcohol and work on stress management. Taking folic acid and other vitamins before pregnancy can help lower chances of development of neural tube defects.
For men: Men over 35 should also consider leading a healthy lifestyle. Antioxidants rich diet is beneficial to sperm quality. Also, for better fertility, weight control, exercise, and avoiding excessive smoking and drinking should be considered. It is very important to control chronic diseases such as diabetes or hypertension, as they can have a negative impact on sperm quality and on reproductive health.
Assisted Reproductive Technologies (ART)
Those couples who are unable to conceive in natural ways may consider the Assisted Reproductive Technology (ART) like In Vitro Fertilization (IVF). Nonetheless, it should be noted that higher a women’s age, the lower the success rate for ART. If a couple has already undergone IVF but did not succeed with their eggs, it is possible that women might need egg donation or embryo adoption. For men, sperm donation could be an option if their sperm quality is significantly affected.
Thought process and emotional factors
It can be difficult to cope, when people decide to have children after the age of 35. There is pressure of time ticking and if there are any fertility problems, a great amount of pressure develops which can cause stress, anxiety and in some cases even cause strain in relationships. Couples should seek help from each other whenever faced with a problem. They can also seek help from counselors or support groups. This situation can cause emotional turbulence and it is important to mentally prepare for the potential challenges and managing expectations of this complex situation in advance.
Conclusion
It is possible to have children after 35, and many people do manage to have healthy children late in life. That said, it must be emphasized that such a path comes with certain conditions and constraints. By being aware of how age impacts fertility, taking steps to maintain health, and seeking medical advice, when necessary, both men and women can improve their chances of a successful pregnancy and a healthy baby.
