Q: I’m 36 and single, but I really want to have a family someday. What are the risks of pregnancy in my late 30s or early 40s?
A: After age 32, a woman’s fertility starts to decline dramatically. At the same time, your risk of disorders that can impact fertility increase.
However, many women successfully conceive and give birth in their late 30s and early to mid-40s.
Getting pregnant close to 40 presents a challenge. The 1 to 2 million eggs you are born with decrease throughout your life – from about 400,000 at puberty, to 25,000 at age 37 and 1,000 at age 51. As you age, your chance of developing fibroids, tubal disease and endometriosis increases. Those conditions can affect your ability to conceive.
Other factors that make conception more difficult include a history of ovarian surgery, chemotherapy, radiation, smoking and pelvic infections. These trigger a premature drop in your pool of eggs and, subsequently, a decline in fertility.
Older women have a higher risk of having a pregnancy with a chromosomal abnormality and suffering a miscarriage. If you are over the age of 35 and you have failed to conceive after six months of trying, your doctor likely will expedite your evaluation.
Another option for women who are unable to spontaneously conceive is in vitro fertilization (IVF) with a donor egg. In this procedure, an egg is donated by a woman who is between the ages of 21 and 34.
Once you are pregnant your doctor will monitor you closely for serious health conditions, such as pre-eclampsia, gestational diabetes and stillbirth. Older women are at a higher risk for these conditions.
Pregnancy at your age is possible, as long as you are aware of the risks and challenges. Talk to your ob-gyn about whether or not pregnancy is right for you.
Q: Is it safe to freeze my eggs to use when I’m older?
A: Many more women are choosing to delay childbearing until later in their reproductive years. Freezing eggs is a viable way to help preserve your fertility until you are ready to start a family.
The older you are when you freeze your eggs, the lower your chance of having a successful pregnancy in the future. For women who are age 33 when their eggs are frozen, there is a 5 percent possibility the thawed eggs will successfully implant and a 4 percent chance it will result in a live birth.
So it takes about 20 to 25 thawed eggs to improve your chances of a successful pregnancy.
Preserving fertility can be complex, so discuss your options with your gynecologist, who should refer you to a reproductive endocrinologist.
Joanne Price Williamson, M.D., is an obstetrician-gynecologist who sees patients at Memorial Health University Physicians at Legacy Center, 14 Okatie Center Boulevard South, Building 101.
