The number of women having babies later in life has seen a significant increase in recent years. Currently, approximately 9% of first births in the United States are to women over the age of 35, marking a 23% increase compared to 20 years ago.
It is worth noting that over 100,000 women in the U. S. give birth annually after the age of 40.
As women age, it becomes increasingly challenging to conceive, especially after the age of 35. However, when pregnancy does occur, there are several positive aspects to consider.
An observational study focused on mothers over the age of 40 revealed improved health and development in their children up to the age of 5. Interestingly, these children experienced fewer injuries, had higher rates of immunization, and displayed enhanced social and language skills.
Additionally, older parents often exhibited greater patience, providing their children with increased attention. Furthermore, they typically enjoyed greater emotional and financial stability.
Egg quantity and quality diminishes
The main challenge of fertility after the age of 40 is the increased difficulty of getting pregnant naturally, even with the help of reproductive medicine. When a girl is born, her ovaries contain approximately 6-7 million eggs. During puberty, this number decreases to around 300,000 to 500,000, and by the time she reaches the age of 37, it further diminishes to about 25,000.
By the time a woman enters menopause, she typically has around 1,000 eggs remaining. However, it’s not just a matter of quantity but also quality.
As women age, their eggs are more prone to genetic mutations. These changes can have an impact on the development of a healthy embryo and fetus when the egg is fertilized. Consequently, the risk of miscarriage becomes significantly higher.
After the age of 37, there are notable changes in the ecosystem of the reproductive system. Egg quality tends to decrease, and there are shifts in the composition of reproductive hormones such as FSH, anti-mullerian hormone (AMH), and inhibin B. These changes make it more challenging to conceive and maintain a pregnancy. Additionally, certain diseases like leiomyomas, tubal disease, and endometriosis become more prevalent as one age.
Factors such as a history of ovarian surgery, chemotherapy, pelvic infection, smoking, or a family history of early menopause can also impact the size of ovarian follicles, which are responsible for holding and releasing eggs. All of these factors can have an impact on fertility.
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And let’s not forget: It’s not just about women.
As men age, their sperm count declines, they start swimming slower, and they develop more genetic abnormalities.
Research has shown that babies born to older fathers experience increased rates of many diseases, including neurodevelopmental disorders on the autism spectrum.
Reproductive technology can help
Reproductive technology is proving to be incredibly helpful and its usage is on the rise. According to a recent demographic study, it is predicted that by the year 2100, approximately 400 million people worldwide could be conceived with the assistance of reproductive technologies. However, it is important to note that these methods are not foolproof, and age still remains a significant factor to consider.
Among women under 35 facing fertility obstacles, slightly over 40% of in vitro fertilization cycles result in the joyous outcome of bringing home a baby. However, as age advances, these success rates decline significantly.
For women aged 41 to 42 years, the percentage drops to 12%. It further decreases to 5% for women aged 43 to 44 years, and finally, only 1% for women older than 44 years.
Fortunately, women over 40 have the option of using donor eggs from younger women, and more than half of these cycles result in the wonderful gift of a child.
If you are over 40 and hoping to get pregnant, it is important to discuss your options with your doctor before you begin trying. Working closely with your healthcare team and gaining an understanding of your own body, as well as the relevant statistics and risks, is crucial in making informed decisions and increasing your chances of achieving a healthy pregnancy and birth before reaching menopause.
