Over the years, the chances of pregnancy are significantly reduced. However, many women choose to wait beyond the age of 35 before trying to have a child. This raises important questions: what are the advantages of waiting and what are the risks associated with postponing motherhood?
The context of late motherhood
Over the past few decades, the trend of postponing motherhood has increased significantly. The reasons for this decision are mostly professional and social, as many women try to meet professional goals before embarking on motherhood. According to Dr. Sandra Miasnik, a reproductive medicine specialist at CEGYR (Center for Gynecology and Reproduction Studies), "it is common for women in their late thirties to experience their first pregnancy."
This phenomenon is reflected in the increase in the number of women who decide to have their first child after the age of 35.However, the main risk faced by these women is decreased fertility, since from the age of 35, and more clearly from the age of 40, the quantity and quality of eggs decreases dramatically.
When to consult a reproductive specialist?
Many couples usually go to a specialist after trying unsuccessfully to get pregnant for a while. According to Dr. Miasnik, it is usually possible to start talk about infertility if after 12 months of trying you have not been able to conceive. However, for women aged 35 years or older, it is recommended to seek medical attention after 6 months of trying without success.
Other factors Other factors that may play a role in the need to consult a specialist much earlier, such as known diseases that affect fertility, or reproductive problems of either member of the couple.
Assisted fertilization methods
Since the first birth was achieved with assisted reproduction in 1978, Fertilization techniques and treatments have been advancing and improving. These procedures, depending on the complexity of the case, can be classified as low or high complexity methods, offering different options to couples who experience difficulties conceiving.
Low complexity treatments
The most common procedure within the low complexity methods is the intrauterine insemination (IUI), a treatment that involves depositing improved sperm into the woman's uterus at the precise moment of ovulation. This procedure is usually accompanied by a ovarian stimulation, to increase the number of eggs available.
Highly complex treatments: IVF and ICSI
When low complexity methods are not sufficient, science offers alternatives such as In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI)In these cases, the eggs are fertilised in a laboratory and the resulting embryos are transferred to the uterus. Generally, two to three embryos are transferred to increase the chances of success.
Egg donation as an alternative
For some women, the best option will be to opt for a Egg donationThis treatment is particularly useful in women who have a low response to ovarian stimulation. Donated eggs generally come from younger women, which increases the chances of success and ensures better oocyte quality.
In this way, patients can experience pregnancy, childbirth and breastfeeding, which offers a emotional and physical alternative to adoption, allowing the mother a complete motherhood experience.
Emotional factors: The role of the doctor
Coping with infertility is both a physical and emotional challenge. The fact that a couple needs the assistance of a professional to conceive can cause anxiety and stress. According to Dr. Miasnik, it is essential that the doctor not only focuses on the organic aspects, but also on the emotional ones.
The relationship with the doctor often goes beyond the assisted reproduction process, as in many cases, the bond continues even after birth, with doctors receiving visits or photos of babies born after treatments.
Emotional support from the doctor and those around them is key to ensuring that couples have a more bearable and less stressful experience throughout the entire process, whether or not they successfully achieve pregnancy on the first attempts.
Biological consequences of reproductive aging
As women age, their reproductive capacity decreases, something known as reproductive agingFrom the age of 35, a woman's ovarian reserve begins to decline rapidly, reducing both the quantity and quality of her eggs. This process is irreversible and is related to several biological factors, such as a decrease in the quality of the DNA in the eggs and a higher prevalence of genetic abnormalities.
In addition to infertility, the risks of spontaneous abortions and chromosomal abnormalities, such as Down syndrome, increase significantly after age 35.
Ovarian aging also affects the quality of the endometrium, which can make it difficult for embryos to implant and increase the risk of complications during pregnancy, such as gestational hypertension and diabetes.
Fertility preservation: an early option
Given the impact that age has on fertility, one of the most recommended methods for women who wish to postpone motherhood is fertility preservationThe most commonly used technique for this purpose is oocyte vitrification, a procedure that allows the eggs to be kept in good condition until the woman decides to use them.
Ideally, this technique should be performed before the age of 35, since after that age, the quantity and quality of the oocytes are affected. To ensure success, it is recommended to freeze between 12 and 20 oocytes, which offers a greater chance of pregnancy in the future.
Motherhood after 40: Additional risks
Getting pregnant at 40 or older It is possible, but the risks are considerably increased. The chances of conceiving with one's own eggs are drastically reduced, and the risks of having a baby with chromosomal abnormalities are increased.
The eggs that remain at this age often have genetic defects that can lead to complications for both the mother and the fetus. Additional risks include:
- Higher probability of premature birth.
- Higher risks of gestational diabetes y hypertension.
- Higher rate of spontaneous abortions.
- Risks of anomalies such as síndrome de Down.
Despite these risks, many women choose to have children later in life thanks to advances in reproductive medicine and probably due to greater economic and emotional stability.
The data indicate that, although risks increase with age, more and more women are choosing to become mothers at older ages, enjoying strong medical and psychological support that assists them at every step of the process.