Nowadays, the age of marriage and motherhood is constantly postponed by women. The reasons for this postponement include primarily consolidating one's professional career, concern about providing financial security, or trying to be psychologically ready for motherhood. In addition, as a result of technological developments, there is a great increase in the number of women who become pregnant with assisted reproductive techniques (microinjection-in vitro fertilization). Many women who have not been able to get pregnant for years experience the joy of becoming pregnant this way. As a result, older age pregnancies are more common today.
The important thing is that the woman is aware of the impact of age on a healthy pregnancy and her potential to become pregnant. The most physiologically appropriate reproductive age for a woman is between the ages of 20 and 30. The situation when expectant mothers are 35 years or older is called Advanced Maternal Age. These types of pregnancies are considered to be in the risky pregnancies group and require closer and special follow-up. In fact, the age limit of 35 was determined entirely based on statistical data. In other words, in pregnancies aged 35 and above, expectant mothers face a higher risk of complications, and the risk increases as the age of the mother increases.
This age is, of course, not an exact limit, but represents a gradually increasing risk. First of all, we should focus on the issue of getting pregnant. If we consider; 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 get pregnant within a few months, while normal women over 35 can take longer than 6 months. Similarly, the risk of miscarriage increases with age. Even with advanced infertility treatments such as in vitro fertilization, the chance of becoming pregnant over the age of 40 decreases, while the risk of miscarriage and anomaly babies increases.
With the aging woman,“ egg quality” decreases, causing their ability to be fertilized by sperm to decrease. If these eggs are fertilized, there is a greater risk of genetic disorders. ur. For example, Down Syndrome (having three chromosomes 21 instead of two, Mongolian baby) is more common in the children of older women.
The reasons that make it difficult to achieve pregnancy as age increases:
- 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. The chance of being fertilized with sperm and creating a good quality embryo after fertilization decreases. The probability of resulting pregnancies ending in miscarriage also increases.
The decrease in the ability of the inner lining of the uterus to hold the fertilized egg.
With advancing age, the endometrium (inner layer of the uterus) becomes less able to hold the fertilized egg. The ability to become pregnant decreases and therefore the chance of pregnancy decreases.
The incidence of endometriosis and fibroids increases
As we get older, endometriosis disease and uterine bleeding cause infertility by bleeding into the abdomen. Myomas that take up space inside the body 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.
Of course, aging does not only affect women. In men, although there is no menopause as in women, there is a decrease in sexual functions and changes in the ability to conceive with aging. Often with aging, there is a slight decrease in the levels of the male hormone testosterone, which affects sexual desire (libido). It may also cause a decrease. It has also been shown in men that the testicles shrink and soften somewhat with aging. Sperm shape and motility also tend to deteriorate slightly over the years. Despite these changes, there is no maximum age limit for men to have children.!
If a woman of older age decides to become pregnant;
First of all, when pregnancy occurs, It should be investigated whether there are medical problems. For example, conditions such as hypertension or diabetes may cause problems during the pregnancy process.
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FSH and estradiol (E2) measurements made on days 2-4 of the menstrual period and evaluation of the appearance of the ovaries with ultrasound provide important information to evaluate the potential for pregnancy.
Increased blood pressure (hypertension), which is a serious problem during pregnancy, gestational diabetes, premature birth, loss of baby in the womb, peripartum cardiomyopathy (in the pre- and postnatal period). Unwanted events such as heart failure), postpartum bleeding, placental abnormalities, premature birth, and stillbirth are also experienced more frequently. As the age of the mother increases, the chance of other systemic diseases during pregnancy also increases.
But all this should not scare the expectant mother.
Are there any risks waiting for the baby?
Being a mother at an advanced age may carry 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 women As the gestational age is postponed, infertility problems occur, the pregnancy process becomes more difficult, and the complications of pregnancy and birth increase.
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