Planning pregnancy after 35? Here’s what you should know

In today's world, many individuals are choosing to start families later in life, often after the age of 35. While this decision can be empowering and fulfilling, it also comes with unique challenges and considerations for both men and women. Understanding these factors is crucial for anyone planning to conceive after 35, as it helps in making informed decisions and taking necessary precautions. 

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Biological Clock and Fertility 

For women: Women's fertility naturally declines with age, particularly after 35. This is largely due to a decrease in the quantity and quality of eggs. By the time a woman reaches her mid-30s, the chances of conceiving each month decrease to about 15-20%. Additionally, the risk of miscarriage and chromosomal abnormalities, such as Down syndrome, increases with age. This decline continues more rapidly into the late 30s and early 40s. 

For men: Men's fertility also declines with age, albeit more gradually. Sperm quality, including motility (movement) and morphology (shape), tends to decrease after the age of 40. This can lead to a lower likelihood of conception and an increased risk of genetic abnormalities in offspring. Additionally, advanced paternal age has been linked to a higher risk of conditions such as autism and schizophrenia in children.

Health Risks and Pregnancy Complications

For women: Women over 35 are at a higher risk for pregnancy-related complications, including gestational diabetes, high blood pressure, and preeclampsia. These conditions can lead to complications during pregnancy and delivery, such as preterm birth or the need for a cesarean section. Older mothers are also more likely to experience difficulties during labor, including prolonged labor or the need for interventions such as forceps or vacuum delivery.

For men: While men do not face the same pregnancy-related risks as women, advanced paternal age can contribute to complications. Older fathers may have an increased likelihood of having children with low birth weight or preterm birth. Moreover, there is a higher chance of genetic mutations in sperm, which could lead to congenital disabilities or other genetic disorders.

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Lifestyle Considerations

For women: Maintaining a healthy lifestyle becomes even more critical for women over 35 who are trying to conceive. A balanced diet, regular exercise, and maintaining a healthy weight can improve fertility and reduce the risk of complications during pregnancy. Avoiding smoking, excessive alcohol consumption, and managing stress are also essential steps. Prenatal vitamins, particularly those containing folic acid, are recommended to reduce the risk of neural tube defects.

For men: Men over 35 should also pay attention to their lifestyle choices. A healthy diet rich in antioxidants can improve sperm quality. Regular physical activity, maintaining a healthy weight, and avoiding smoking and excessive alcohol can contribute to better fertility outcomes. Additionally, managing chronic conditions such as diabetes or hypertension is essential, as these can affect sperm quality and overall reproductive health.

The Role of Assisted Reproductive Technologies (ART)

For couples experiencing difficulties in conceiving naturally, assisted reproductive technologies (ART) such as in vitro fertilization (IVF) can be an option. However, it's important to note that the success rates of ART decline with age, particularly for women over 35. Women may need to consider options such as egg donation or embryo adoption if natural conception or IVF using their own eggs is not successful. For men, sperm donation might be considered if sperm quality is significantly compromised. 

Emotional and Psychological Considerations

The emotional journey of trying to conceive after 35 can be challenging. The pressure of time, coupled with the potential for fertility issues, can lead to stress, anxiety, and even relationship strain. It's essential for couples to communicate openly and seek support when needed, whether from each other, a counselor, or a support group. Managing expectations and being prepared for potential challenges can help in navigating this emotionally complex journey. 

In conclusion, pregnancy after 35 is entirely possible, and many individuals and couples successfully conceive and have healthy babies later in life. However, being aware of the unique challenges and considerations is essential for making informed decisions. By understanding the impact of age on fertility, taking proactive steps to maintain health, and seeking medical advice, when necessary, men and women can optimize their chances of achieving a successful pregnancy and a healthy baby.

Dr. Nandita Palshetkar is an obstetrician, gynaecologist, director of Bloom IVF India and president of IVF Society of India (ISAR). 

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