With pregnancy, the old, well-known, popular phrase that age is just a number does not apply. A woman’s age is one of the most significant factors affecting her fertility. Many women do not realize that not being able to conceive after 40 is a natural process of ovarian aging. Studies carried out on a sample of women who do not use any contraceptives have confirmed that the average age at the end of the childbearing period is 41 years.
Quality and quantity matter
A woman is born with a certain number of eggs and no more eggs are produced during her lifetime. The largest number of eggs is in the ovaries of an unborn girl around mid-pregnancy, at which time their number is estimated at 6-7 million. Then the eggs begin to disappear. At birth, a girl has 1-2 million eggs in her ovaries, when she reaches the age of first menstruation the number of eggs is 300-500 thousand, and a postmenopausal woman has less than 1000.
After 35. year of a woman’s age, their quality is already decreasing, the eggs do not have the right genetic make-up. Normally, a healthy egg contains 23 chromosomes. A sperm has the same number of chromosomes, and when a healthy egg is joined with a healthy sperm, an embryo is formed with 46 chromosomes – the number that a healthy person has in each of his or her cells. However, at an older age, women experience egg maturation disorders. “A certain number of such eggs are also produced in young women, but the older the woman is, the higher the number of so-called. aneuploid eggs higher, with more than 90% of such eggs forming by the age of 40. Statistically, then, this means that a healthy woman and a healthy man can only have a healthy baby once every 10 menstrual cycles at 40, because all the other eggs cannot give a chance of producing a healthy baby and either do not fertilise at all, or such pregnancies end in spontaneous abortion, or a baby is born that does not have the right number of chromosomes in the cells. Probably the most well-known example of such a disorder is Down syndrome,” explains gynaecologist Doc. Dr. Silvia Toporcerová, PhD. from the Gyncare Assisted Reproductive Centre.
Even artificial insemination is not a cure for age
V 35. year of a woman’s age, the incidence of infertility is 10 to 20%. The chances of getting pregnant are mainly genetic, but are also influenced by external factors such as smoking, obesity, lifestyle and associated diseases.
At older ages, the chances of getting pregnant with artificial insemination are higher than with natural attempts to conceive, but nowhere near the success rate of artificial insemination as for younger women. While women under 35 are 42% likely to take home a baby after IVF, women between 38-40 are 42% more likely to have a baby. for women it is only 22% and after 44. year of age, the success rate is less than 1%. In addition, women at older ages are at increased risk of spontaneous abortion. “It should be noted here that the success of artificial insemination is the birth of a healthy baby, not a spontaneous abortion,” adds doc. MUDr. Toporcerová, PhD., MBA.
Every woman is different
Each elderly patient should be treated on a highly individual basis. Dr. Toporcerová explains, “We give different advice to a 43-year-old woman who, after two children, had sterilization 10 years ago and now wants a third baby, and differently to a 42-year-old woman who has not been able to conceive for 10 years and has already undergone 3 cycles of artificial insemination with low egg retrieval and low embryo quality. While the first patient may be advised to try a cycle of artificial insemination, the second patient should rather consider using donor eggs. When using donated eggs, the chances of giving birth to a healthy baby depend on the age of the egg donor.”
And what about age in men?
Nor is it unlimited for men. Especially after 50, the spermiogram parameters begin to deteriorate. Some studies attribute the older age of fathers to an increased risk of various diseases in children, such as achondroplasia (a disorder of cartilage and bone development), autism, schizophrenia and other psychiatric illnesses.
Egg donation programme or egg freezing is also a solution
It is important to understand and accept that a woman’s fertility is age-limited and that the ideal age to become pregnant is under 30. If it is not possible to have a small child by the age of 30, the solution is, for example, to freeze eggs at a young age (optimally by the age of 30). Older women desiring a baby should realistically consider a donor programme where the likelihood of having a healthy baby is higher.
