How does aging affect the chances of conceiving?

As the number of women standing tall in various sectors is rising with every passing year, so is the pregnancy age. With more and more women stepping out to pursue their professional interests and become self-dependent, the work-life balance is mostly coming at the cost of delayed family planning.

Studies show that the average pregnancy age currently around 28 years and many a times is extended up to 35. Some of the reasons for delayed parenthood are:

• Women reaching higher education levels, establishing their career
• Social and cultural shifts
• Desired financial stability for the child's secured future
• Lack of childcare
• Inflexible workplace policies
• Economic or housing uncertainty

The advancement in medical sector indeed provides with sufficient aid and several ways for women to deliver healthy babies irrespective of age. However, though there isn't any safe age, pregnancy at an early age can save both the mother and the child from several complications. Pregnancy, especially after the age of 35, is likely to come with certain risk factors. It must also be noted that it is not just the maternal age but also the paternal age which plays role significantly in increased complications. As the trend of late pregnancy looks like it's here to stay, doctors highlight the following as some of the risks involved says Dr. Sita Rajan, Senior Consultant - Obstetrics and Gynaecology, Columbia Asia Hospital Whitefield

Declined number of eggs/sperms

With the increasing age the possibility of women getting pregnant goes down because of the reducing number of remaining eggs and their decreased quality. The eggs in older women may not even fertilize as easily as in younger women. For males as well, the sperm count goes down with age and so does the semen volume and motility. These natural age-related factors add to the difficulty in conceiving for females.

Genetic factors

A few genetic risks like that of having a baby with Down syndrome are more probable to occur during pregnancy in women as they age. The chances of other chromosome abnormalities in the baby also increase with age.

Multiple pregnancies

With the increasing age, the possibilities of delivering twins also increases due to the release of multiple eggs at the same time. Assisted reproductive technologies are also responsible sometimes.

Miscarriage & Stillbirth

The decline in the quality of a woman’s eggs and other co-existing medical conditions possibly create increased chances of miscarriage and stillbirth which are extremely rare but likely.

Maternal mortality

Studies conducted have also found that the risk of mortality due to various other complications in the body also increases with the increased age of the pregnant woman.

Premature delivery

Doctors have observed cases of early deliveries when the baby has not completely matured (premature delivery) mostly in women delivering babies in later stages of their lives due to the associated health complications. Babies born pre-mature often have low birth weight, respiratory, cognitive and neurological problems. Preterm babies are more likely to have heart defects, brain damage, lung disorders, and delayed development.

Uterus complications

Medical research has also found that with age muscle contraction properties in the uterus were detected to be impaired, reduced sensitivity to oxytocin, and decreased mitochondria numbers. Change in progesterone signaling was also observed that further increases a delay in labor.

Cardiovascular problems

The older the woman gets pregnant, the more are the chances of ischemic stroke, hemorrhagic stroke, heart attack and other cardiovascular diseases in the woman which can even be fatal. These risks have enhanced all the more with the kind of lifestyle being lived these days.

Other health problems

It has been well established that as the age increases, the possibility of having health problems also increases especially in the current lifestyle. Hence late pregnancy increases the risk of issues like gestational diabetes, high blood pressure, emergency cesarean delivery, postpartum hemorrhage, pre-term birth, low birth weight, and high birth weight.

Late pregnancies with completely healthy births and minimum complications are possible as well.

Following are few tips that women conceiving in the later age can keep in mind for a healthier pregnancy and delivery:

• First and foremost, take good care of yourself and pay heed to the basics.
• Go for preconception appointments; be aware of your overall health and lifestyle changes
• Pursue prenatal care regularly
• Stay in constant touch with your health care provider and discuss all details and concerns
• Maintain a healthy diet with the sufficient amount of folic acid, calcium, iron, vitamin D and other nutrients required in your body after discussion with your doctor
• Stay active with regular exercise
• Avoid substances like alcohol, tobacco, etc.
• Manage pre-existing conditions like diabetes, blood pressure, anemia and thyroid disorders etc. to avoid comorbidity

Dr. Sita Rajan, Senior Consultant - Obstetrics and Gynaecology, Columbia Asia Hospital Whitefield