The most physiologically appropriate reproductive age for a woman is between the ages of 20 and 30. Increasing age is not a definite obstacle to pregnancy, but as age increases, the time until pregnancy is achieved increases.
While the chance of getting pregnant in any month under the age of thirty is 20%, this chance is reported to be only 5% for those over the age of 40. In other words; A 25-year-old woman can usually become pregnant within a few months, while for normal women over 35, this period may take longer than 6 months. The risk of miscarriage similarly increases with age. Even with advanced infertility treatments such as in vitro fertilization, the chance of getting pregnant over the age of 40 decreases, while the risk of miscarriage and a baby with anomalies increases. With advancing age, "egg quality" decreases, which causes their ability to be fertilized by sperm to decrease. If these eggs are fertilized, there is a greater risk of genetic disorders. For example, Down Syndrome (having three chromosomes 21 instead of two, Mongolian baby) is more common in the children of older women.
Reasons that make it harder to get pregnant as you get older:
- Aging of the ovaries: When girls are born, there are approximately 400,000 eggs in their ovaries. After birth, there is no egg production, and as the woman gets older, the eggs irreversibly decrease and age.
- Decrease in fertilization rate: As you get older, the chance of the egg being fertilized by sperm and forming a good quality embryo after fertilization decreases. The probability of resulting pregnancies ending in miscarriage also increases.
- Decreased ability of the uterine lining to hold the fertilized egg: With advancing age, the ability of the endometrium (the inner layer of the uterus) to hold the fertilized egg decreases and therefore the chance of pregnancy decreases.
- Increased incidence of endometriosis disease and fibroids: As we get older, endometriosis, which causes infertility by bleeding into the abdomen, and myomas that take up space in the uterus are more common.
In addition, until the age of forty, many women may experience surgical interventions due to inflammations, ectopic pregnancy, appendicitis, endometriosis or other reasons that may affect their fertility and block the tubes related to the female organs. However, it should not be forgotten that women's biological age is more important than their chronological age in terms of reproductive health. Sometimes a 45-year-old woman may produce eggs regularly, while a much younger woman may have entered menopause early. Married couples over the age of thirty-five should not wait more than six months to consult a physician if they cannot conceive despite having regular intercourse.
If an older woman decides to become pregnant;
First of all, it should be investigated whether there are any medical problems that may occur when pregnancy occurs. For example, conditions such as hypertension or diabetes can cause problems during pregnancy.
To evaluate the potential for pregnancy, FSH and estradiol (E2) measurements on days 2-4 of the menstrual period and evaluation of the appearance of the ovaries by ultrasound provide important information.
An important issue that women in the older age group should know is that their chances of carrying a baby with genetic problems are higher than younger women.
When they become pregnant, it is possible to reveal this situation through interventions such as amniocentesis or chorionic villus sampling.
For elderly infertile women who cannot get results despite effective treatment (such as insemination and in vitro fertilization), purchasing young women's eggs from some centers abroad, i.e. egg donation, may be considered. However, since our laws do not allow this, this process is not carried out within the borders of the Republic of Turkey.
Pregnant women with advanced maternal age may have to deal with many problems during pregnancy. For example, undesirable events such as high blood pressure (hypertension), which is a serious problem during pregnancy, gestational diabetes, premature birth, and loss of the baby in the womb, are also experienced more frequently.
As maternal age increases, the chance of other systemic diseases during pregnancy also increases.
But all this should not scare the expectant mother. These risks can be minimized with careful follow-up and on-site interventions by experienced physicians.!
Are there any risks for the baby?
Being a mother at an advanced age may pose risks not only for pregnant women but also for babies.
As mentioned before, one of the important problems that occur in pregnancies over the age of 35 is the increased possibility of chromosomal abnormalities. Among these, Down syndrome (mongolism) has an important place.
In cases where the baby is delivered early due to pregnancy-related diseases in the mother, pregnancy-related hypertension, diabetes and placental abnormalities, the baby is exposed to dangers arising from premature birth.
As a result, it should be known that as the gestational age is postponed for women, infertility problems occur, the pregnancy process becomes more difficult, and the complications of pregnancy and birth increase.
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