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docyard | Plan in advance for healthy baby
India is projected to become the youngest country by the year 2030 and overtake even China in this regard. In this era of increasing urbanisation and women embarking on careers, planning a family has taken a backseat. More and more women are opting for late marriages and putting off starting families to even later. Just as planning pregnancy in a very young age is considered risky for the woman and also unborn child, so is pregnancy at an advanced age (above 35 years), that can lead to more complications both in the mother and the child. It’s not only pregnancy above 35 years leading to more complications, the risks increase for all pregnancies above 32-33.
What are the risks associated with planning pregnancy with increasing age on the women?
It is extremely essential for all women to be aware that the biological clock is actually a reality. A woman is born with all the eggs at the time of birth which will last for her entire reproductive life. So as age increases, the eggs get older. Older eggs means that increased chances of malformation in these eggs present for the last 35-40 odd years. Imagine the quality of eggs in 25 year olds and 40 year olds? Thus the chances of having malformed babies increases as women age. The risk at 25 years if 1:1,500 will increase to 1:400 at 35 years of age.
This is the reason that while doing follow ups in pregnancy by blood tests and ultra sounds, all software now incorporates mother’s age as an important parameter.
Chances of having miscarriages increases as age increases, because the hardened arteries carrying blood supply to the unborn child are unable to do so very effectively, again, due to the aging process in the mother. The rate of losing a pregnancy in the initial stages itself climbs gradually with age, from a 9% miscarriage rate among 22-year olds, to approximately 30% in women in their 30s. High rates of miscarriage in older women are also more related to egg quality than the physical ability to stay pregnant.
There is an increased risk of still birth in pregnant people as they age. Not only this, even if the lady were to get pregnant, increased chances of her having lifestyle related diseases like diabetes, blood pressure or thyroid problems which may be present before hand or may develop due to the stress of pregnancy. These days lifestyle related hormonal problems like Polycystic Ovarian Disease have also taken centrestage and is creating more problems in older women wanting to start a family.
Is there a biological clock in men too?
To some extent yes. Male fertility declines with age as well. Researchers have found strong evidence that as men age, they can expect a decline in sperm counts, semen volume, sperm motility, and the number of normal sperm. But the effect is not as drastic as in women.
Now what if the biological clock is ticking, is there any hope?
These days as women are delaying pregnancy and are opting for fertility treatments because again chances for natural conception also decrease dramatically with age. Thus, couples resort to fertility treatments meant for both men and women. This initiative has been proven to be fruitful and given hopes to millions of childless couples. But this process is more cumbersome and complicated as compared to the natural way of reproduction. Also outcome may not be as satisfactory.
Another trend among women who want to put off planning pregnancies to later years in their lives, is to go in for freezing of their eggs. These eggs are frozen at a young age and can be thawed at a later age when the woman wants to plan pregnancy, so that the effects of age do not come into play. But the flipside is that treatment is quite costly and patient can conceive only through IVF, which again has low success rates.
The writer is Dr Ritu Sethi Consultant Obstetrics and Gynaecology Columbia Asia Hospital, Palam Vihar, Gurugram
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