Ask the Experts: How old is too old to have a baby?

The daily hustle-bustle and career orientations often shift our focus from deciding upon the correct time to have a baby. These days many women are delaying childbearing to their later reproductive years for various reasons which include late marriage, higher education, career pursuit, longer life expectancy, social and (probably the most important) economic status.

Biologically speaking, women are stated to be the most fertile between the ages of 15 and 30, a time in which many are not willing to take the responsibility to start a family. From a perspective of a stable career, the years from age 35 to 45 would make the most sense; but these years represent the terminal decline in normal fecundity. So, if you have waited until a bit later in life to try to conceive, you may wonder if you’re too old to have a baby.

Advanced maternal age and fertility

Any conception after the age of 35 automatically comes under the “advanced maternal age” (AMA) category. However, one should not be intimidated only by this term because successful pregnancy after 35 is still possible, with or without assisted reproduction. But, keep in mind that usually it is not advisable as a few complexities might occur while trying to conceive naturally. While the road to achieve the joy of motherhood may be harder for some after a certain age, others may sail through relatively easily. There are many factors at play, including your current health status and how close you are to menopause.

Here’s more about your chances of conceiving at an older age, what risks may be involved for you and your baby, and what questions you may want to ask your doctor before you embark on this journey.

Role of assisted conception    

An increasing number of women are choosing pregnancy later in life which has increased the number of women of advanced maternal age (AMA) opting for assisted reproduction. Women should be under the knowledge that there is an age-related complexity to fertility, including a decline in the oocyte quality and reserve in addition to an increase in the number of oocyte chromosomal aberrations.

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Success rates of assisted reproductive technology (ART) cycles decrease with advanced maternal age. There are different fertility options for women of AMA, including fertility preservation (oocyte or embryo freezing), in vitro fertilization (IVF treatment) with or without preimplantation, genetic screening and oocyte or embryo donation. Detailed counselling needs to be offered to the women with regard to the risks. Women of AMA should be screened for underlying medical conditions that could have an impact on maternal and neonatal morbidity and mortality.

The natural deterioration in female reproductive ability, particularly in AMA, has two main reasons:

• Progressive depletion of the number of oocytes in the ovary
• An age-related decrease in oocyte quality

Reproductive choices for women at an advanced maternal stage

• Social egg freezing (SEF)
• Embryo freezing
• IVF 

Maternal health risks of pregnancy at an advanced age

Elderly women who become pregnant at an advanced maternal age are at higher risk of caesarean delivery, gestational diabetes, preeclampsia, and preterm delivery of a baby with low birth weight. However, these risks vary widely, depending on the woman’s health status, and increase with maternal age at delivery.

Other ways to conceive if you’re older 

• IVF with donor eggs: With this process, you prime your body for pregnancy using hormones. Instead of doing a traditional egg retrieval to later fertilize and transfer, you do an embryo transfer using embryos created with donor eggs that are fertilized with either your partner’s sperm or donor sperm.

• Egg freezing: If you know in advance that you’d like to wait to have a baby and you’re still under the age of 35, you might consider freezing your eggs right away. If you freeze your eggs in your early 30s and plan to use them in your 40s, your odds of having a healthy baby will relate to your age when you froze your eggs and not your current biological age.
• Embryo adoption: Whether you choose to do IVF yourself or to use a surrogate, embryo adoption is another favourable option. Embryos are generally frozen and donated by couples who aren’t using them in their own ART procedures.

You can make a choice based on your particular case but it is highly recommended that you speak with an expert before taking any major step.