Tuesday, November 22, 2011
Conceiving after the age of 35
I thought this topic to be very fitting after my paper on stem cell research. It can be difficult for women to conceive later in life because ovulation is not always successful as we age. There is a chance of unintended pregnancy if no form of contraceptives are being used, consequently 60% of unintended pregnancies of women over the age of 40 end in abortion ("Getting pregnant during," 2011). For women over the age of 35 pursuing pregnancy in vitro fertilization and other forms of reproductive assistance are available. Here is what you should know if you are part of this demographic or love someone who is:
Risks of late gestation:
The longer a woman waits to conceive the higher risk the pregnancy she seeks. Complications are not just more likely for the woman, but also for the child.
Risks for mothers:
Women who become pregnant later in life are at risk for several health issues depending on how healthy they are at the time. Over the age of 35, particularly women who are overweight or practice poor eating habits, gestational diabetes is more common than in younger mothers-to-be, as well as preeclampsia (high blood pressure) and osteoporosis, a painful disorder of the bones (“Getting pregnant during,” 2011). According to cancer.gov, a website run by the National Cancer Institute, women having their first child after age 30 are at the highest risk of getting breast cancer. Breast cancer is attributed two hormones produced in the ovaries; progesterone and endogenous estrogen. Pregnancy in peak years of reproduction, as well as breast feeding, combat breast cancer by limiting the body’s levels of these hormones (“National cancer institute,” 2011).
Risks for babies:
Babies born to mothers over the age of 35 are at risk for still birth and miscarriage, and are also more likely to be born with low birth weight, in breech position or via a cesarean section(“Getting pregnant during,” 2011). Chromosomal abnormalities such as Down syndrome and open neural tube defects such as spina-bifida are also a higher risk for older mommies (LPCH, 2011).
Assisted Reproductive Technology (ART):
ART is comprised of 3 main methods of fertilization; in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), and zygote intrafallopian transfer (ZIFT). Success rates are listed individually per clinic and can be found on the website for the Center for Disease Control and Prevention, but on average, depending on age, the success rate is 6-25% for a woman over the age of 30 (“In vitro fertilization, 2007).
IVF is a very involved process that requires fertility medications and monitoring of egg release via ultrasound. Once eggs are produced, they are extracted and fertilized before an incubation period in which the ultimate goal is the procurement of usually several embryos. If expectations of egg fertility are low, sperm may be directly injected into eggs before incubation. This process is called an intractoplasmic sperm injection, or ICSI.
Less than a week after the gametes have begun dividing, multiple embryos are injected transvaginally with the help of an ultrasound machine for monitoring. Couples or single women seeking IVF may use their own gametes or those supplied by a donor (“In vitro fertilization, 2007).
GIFT & ZIFT:
GIFT & ZIFT offer alternatives to IVF but only make up for a combined total of less than 3.5% of ART in the US for aspiring mothers with fertility complications. GIFT is an injection of gametes into the fallopian tube of the mother with the idea of fertilization taking place there rather than in a lab. ZIFT is the injection of a zygote (created in the lab) into the fallopian tube via a laparoscopic surgery (“In vitro fertilization, 2007).
Screenings during pregnancy:
There are many screenings available to monitor the health of the mother and child during pregnancy and modern medicine currently offers several that benefit the 35+ mom.
The triple screen test is a blood screening that tests for hormones indicative of chromosomal abnormalities and open neural tube defects (ONTD), but amniocentesis and chorionic villus sampling (CVS) are more accurate (“Genetic testing during,” 2011). Amniocentesis is 99.4% accurate and is the testing of the amniotic fluid during the 15th to 20th week of pregnancy via a very fine needle through the abdomen, monitored by an ultrasound machine (LPCH, 2011). A CVS is every bit as accurate but is not capable of testing for ONTD. This procedure involves transvaginal or transabdominal procurement of a placenta sample at the 12th to 16th week of gestation, also monitored by ultrasound (LPCH, 2011).
I had both of my children early but plan to conceive again later in life. How much later, I am uncertain. I think I am at less of a risk for most complications due to the fact that it will not be my first and because genetics are on our side.
For others, I support the right of anyone to pursue what makes them happy, risk or not. Pregnancy has risks for everyone, even when the odds are in our favor. I also support adoption and surrogacy. I feel the decision is with the mother once she is educated of the risks, but educated she should be before she makes any decisions.
Genetic testing during pregnancy. (2011). Retrieved from http://www.womenshealthcaretopics.com/tests_during_pregnancy.htm
Getting pregnant during the menopausal years. (2011). Retrieved from http://www.epigee.org/menopause/pregnancy.html
In virto fertilization: Ifv. (2007, May 01). Retrieved from http://www.americanpregnancy.org/infertility/ivf.html
Lucile packard children's hospital. (2011). Retrieved from http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/pregnant/tests.html
National cancer institute. (2011, May 10). Retrieved from http://www.cancer.gov/cancertopics/factsheet/Risk/reproductive-history