The number of expecting mothers aged above 35 years is now increasing in developing countries like India. Today’s women are more educated, becoming independent, and career oriented. This is one of the major reason that pregnancy after 35 years is common especially in Metro cities. Though for women age is just number but from the conception point of view age is not only a number but an indication about the decline in fertility with the age. According to American College of Obstetricians & Gynecologists (ACOG), pregnancy after 35 years of age brings some risks along with it, causing some ill effect on health of both mother and baby.

Fertility in women starts to decrease at age 32 years and after age of 37 years it declines rapidly. Every woman has fixed number of eggs in her ovaries, with advanced age her fertility chances also decline as the number and quality of the eggs reduces. The eggs are not as easily fertilized in older women as in younger women. With advanced age a woman may also suffer from the different medical conditions like endometriosis, uterine fibroids, blood pressure and diabetes and these can also hinder the fertility.

The age-related decline in fertility is also accompanied by significant increases in the rates of aneuploidy, spontaneous abortion, and autosomal trisomy. The fetal loss rate also is significantly increased with advanced age. The same problems are associated in assisted reproduction (IVF) in women of age 35 years or above. The data in IVF shows that the rate of miscarriage increased progressively with age, from 13% in women younger than 35 years to 54% in women aged 44 years or older. So, ACOG recommends that women older than 35 years should be:

• Counseled, educated and aware of the effect of age on fertility
• Should receive expedited evaluation and treatment after 6 months of failed attempts to conceive or earlier, if clinically indicated.
• In women older than 40 years, immediate evaluation and treatment are warranted.

So any woman above 35 years of age and wants to get pregnant naturally or assisted reproduction technique then the knowledge and information about the fertility chances, pros and cons of getting pregnant and what necessary precautions she needs to take, is very important. With advanced age, the eggs are also getting old and with the poor quality of eggs, chances of pregnancy are also less as 1 in 5.

Some women may think that we can conceive by IVF or assisted reproduction but the same problem is here also as chances of embryo development are only 1-2 percent especially after 45 years of age and the risk of abortion are more than 50 percent. In such circumstances a woman needs to go with donor eggs. The interesting thing is that though ovarian function and eggs are decreased with advanced age the uterine activity is good and it increase the chances of good implantation with successful pregnancy.

Whatever may be the condition, becoming pregnant and having baby is the dream of a woman and to overcome the problem, consult the doctor before reaching any conclusion, follow the advice of the doctor, keep yourself healthy by adopting healthy life style, healthy nutritional diet, doing regular exercise to keep yourself physically fit, do meditation and relaxation techniques to keep yourself emotionally and mentally fit to achieve the ultimate desired goal, “Pregnancy in advanced age”.

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