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 becoming 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, expectant mothers in pregnancies aged 35 and above 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 gradual increase in risk.
First of all, if we consider the issue of getting pregnant; 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 high, this chance has been reported to be only 5% for those over the age of 40. In other words; While a 25-year-old woman can usually become pregnant within a few months, this period may take longer than 6 months for normal women over the age of 35. The risk of miscarriage similarly increases with age.
The "egg quality" decreases with the aging woman. , which causes their ability to be fertilized by sperm to decrease. If these eggs are fertilized, there is a greater risk of genetic disorders. For example, Down Syndrome (having three chromosomes 21 instead of two, Mongolian baby) is more common in the children of older women.
What makes it harder to get pregnant as you get older? s;
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 creating a good quality embryo decreases. The probability of resulting pregnancies ending in miscarriage also increases.
Decrease in the ability of the inner lining of the uterus to hold the fertilized egg
With advancing age, the ability of the endometrium (inner layer of the uterus) to hold the fertilized egg decreases and Therefore, the chance of pregnancy decreases
Increased incidence of endometriosis disease and myomas
As age progresses, endometriosis disease, which causes infertility by bleeding into the abdomen, and myomas that occupy space in the uterus 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 can also cause a decrease in sexual desire (libido). 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, early There is no maximum age limit for women to have children.
If an older woman decides to become pregnant;
First of all, it should be investigated whether there are any medical problems that may occur when pregnancy occurs. For example, conditions such as hypertension or diabetes may cause problems during pregnancy.
FSH and estradiol (E2) measurements 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.
Next An important issue that women in this age group should know is that their chances of carrying a baby with a genetic problem are higher than younger women. When they become pregnant, it is possible to reveal this situation with interventions such as amniocentesis or chorionic villus sampling.
For elderly infertile women who cannot get results despite effective treatment (such as insemination and in vitro fertilization), purchasing young women's eggs from some centers abroad, that is, egg donation, may be considered. However, since our laws do not allow this, this process is not carried out within the borders of the Republic of Turkey. Pregnant women with advanced maternal age may have to deal with many problems during pregnancy.
For example, high blood pressure (hypertension), which is a serious problem during pregnancy, gestational diabetes, premature birth, loss of the baby in the womb, peripartum cardiomyopathy ( Unwanted events such as heart failure, which can develop in the pre- and postnatal period), 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.
Are there risks to 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 prematurely due to pregnancy-related diseases in the mother, pregnancy-related hypertension, diabetes and placental abnormalities, the baby "As a result, it should be known that as the gestational age is delayed for women, infertility problems occur, the pregnancy process becomes more difficult, and the complications of pregnancy and birth increase.
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