Does age impact your fertility?
When people see celebrities like Farah Khan, Naomi Campbell, Kareena Kapoor Khan, Neha Dhupia, Gauri Khan deliver babies in their peri-40s, the general perception created is that age is not a factor in conception and pregnancy and the idea of having your first child before you hit the 30s is just a myth. Age, in fact, is the single most important factor impacting fertility levels.
With an increasing number of Indian women getting educated today and becoming a part of the workforce, getting married and planning for a baby often takes a backseat. An increased career orientation, late marriages, and a high rate of divorce and remarriage have pushed up the average age of having a baby.
Women must know that there is a biological clock and with advancing age, the ovarian reserves deplete. This means that both the number and quality of eggs reduce and the chances of having anomalies like Downs Syndrome considerably increase in the baby.
According to statistical models, the correct age for planning one child is no later than 32 years and for a two-children family is no later than 27 years. If the couple is willing to undergo an intervention like In Vitro Fertilization (IVF) to get pregnant, the age of the woman should be 35 years for those planning one child and 31 years for couples planning for two.
Many women have a mistaken belief about their fertility. They feel that if they have a healthy lifestyle, no family history of infertility, and a regular menstrual cycle, they can get pregnant without any problem even at 40. The fact is that ovarian reserves start to decline at the age of 30 years.
A woman in her early to mid-20s has a 25-30 percent chance of conceiving in one cycle. And by the time she reaches the age of 40 years, the chances are reduced to just 5 percent in each monthly cycle.
Pregnancy at an advanced age also brings with it an increased risk of gestational diabetes, preeclampsia, pre-term deliveries, low birth weight babies, ectopic pregnancies, and C-section deliveries. There is also a risk of developing disorders like endometriosis, fibroids, which can affect fertility in the long run.
Those who are 35 can follow the mantra of preventing, solve, compensate and reduce.
Prevent means take measures to counter the impact on ageing on having children through processes like oocyte preservation. Women who want to defer a pregnancy as they want to focus on their careers and not take time out to raise a family can freeze their eggs.
Solve means be aware of new technologies in the offing like generation of new gametes In Vitro from stem cells or oocyte donation or surrogacy for women with a history of repeated miscarriages.
Compensate means maximisation of ovarian response to the stimulation by medication. The attempt is to collect more eggs in each cycle to increase the chances of having a healthy baby.
Reduce means minimise the chances of infertility. For someone who is under 30 years, the chances of a healthy embryo are up to 68 percent and when the age of the woman is over 42 years, the number drops to just 13 percent.
When you look at the embryo, it may look perfectly healthy under a microscope. But the DNA could be damaged.
Who is at an increased risk?
Women who smoke are at an increased risk of developing fertility-related problems. Those with a family history of early menopause or those who have had pelvic infections, prior ovarian surgery, or those who are either overweight or anorexic must not delay planning for a family. They could be at an increased risk of developing complications with advancing age.
Advanced age for men
Age is not just a factor for women. Even for men, after the age of 40, the genetic DNA of the sperm produced by the body gets fragmented. This can be linked to autism and other genetic problems. Such babies are five times more likely to develop neurocognitive problems such as schizophrenia later in life.
Dr. Shivani Sachdev Gour is the Director and Fertility Expert at SCI IVF Centre, New Delhi.