Both women and men should decide early in life if they want to have children, as the chance of conceiving and raising healthy children becomes narrower as they approach 40.
Speaking during an interview for The Situation Room podcast, Dr Wanjiru Ndegwa, a reproductive health specialist, said that although age affects female fertility more, male fertility is also affected.
Ndegwa says a woman is born with all the eggs she will ever have, roughly one to two million. The eggs are contained within the ovaries at different stages of development and diminish in quantity and quality over time.
At the age of 30, 70 per cent of a woman’s eggs are chromosomally normal, meaning they can produce a normal, healthy baby. By 34 years of age, about 60-70 per cent of a woman’s eggs are chromosomally normal. Age 35-37 is the fertility cliff, where the downward curve stiffens, such that by the time a woman reaches 40, only 10 to 15 per cent of her eggs are chromosomally normal.
According to Ndegwa, by the time a woman is 43, the success of getting pregnant is about five per cent.
And once a woman hits that magic number, she’s officially described as a “geriatric mother” or of “advanced maternal age”.
“Many by this age lack the egg quality and the quantity needed for a successful pregnancy,” Ndegwa says. “Every cell in our bodies ages. But now, they’re all ageing a little bit faster due to lifestyle habits, including smoking, alcohol, poor eating habits and leading a sedentary lifestyle,” she said.
“Specific cells such as hair cells and sperm cells are very fast growing and fast ageing. Likewise, eggs waste with every menstruation cycle and never get replaced. The quality and quantity can’t be improved or reversed. These aspects, coupled with lifestyle changes such as waiting longer to start a family, have made infertility a rampant issue in modern society,” she said.
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Factors that prevent quicker ageing of cells include healthy diet choices, exercising, avoiding excess alcohol and smoking, and shedding off excess weight.
“Fruits and vegetables have the oxidants our bodies need to fight these toxins buildup,” said Ndegwa.
“If a woman plans to start a family at some point, it is important to start planning early, preferably in their 20s,” she said.
“Many people are delaying childbirth because they want to get ahead in life and pursue their goals. We forget there’s a balance to strike if we ever want to start a family. I do get a lot of couples and women in their late 30s who come to me saying they want to start a family, and sometimes it’s too late,” Ndegwa said during the podcast interview.
However, all is not lost. For those who find themselves unable to conceive without a little nudge, there are fertility treatments that can increase their chances.
According to Ndegwa, the solutions range from simple to complex. Simple fertility treatments include straightforward factors such as losing weight.
“Excess fat cells release more oestrogen. Too much natural oestrogen can cause the body to react as if you are pregnant or are taking hormonal birth control with oestrogen, such as the pill, shot, or vaginal ring. This can prevent ovulation and having a monthly period.”
Simple treatments for men include boosting and concentrating quality sperm, and also lifestyle adjustments to boost sperm vitality.
“Where the sperm are not too bad, we put them on antioxidants,” Ndegwa said.
“Other patients have very erratic cycles, and so will require timing for when they ovulate. So we give them stimulation to help them ovulate, then tell them to use the window, and that works for some patients,” she said.
“For the patients who these methods don’t work, we go into more medical treatments, like intrauterine or artificial insemination, where we have sperm factors that are not swimming as well as we would want them to swim, and therefore we assist in that aspect,” Ndegwa said. “We help them swim faster and reach the target, which is the egg at ovulation,” she said.
“The man gives the sperm, then we concentrate it and give it some action in terms of mortality, then we insert it into the woman’s womb through the cervix using a catheter,” Ndegwa explained.
“The fallopian tubes are very important because it’s where fertilisation takes place. If the tubes are blocked, we go directly for the eggs. Through IVF, we remove the eggs, inject sperm into the egg, and implant the fertilised egg into the uterus,” she said.
If the tubes are blocked, there’s no other way to get pregnant except through IVF. Ndegwa adds that if a man is unable to produce any sperms after ejaculation, “we inject the testicles and remove sperms directly, then have artificial insemination on the woman.”
Stress also plays a huge part in fertility treatment. “It’s crucial that couples de-stress and manage their stress before starting to conceive or fertility treatment,” said Ndegwa, during the interview. The podcast interview, “All You Need to Know When Trying to Conceive” is available on Standard Digital.
It was previously believed that age only affected women’s fertility, and while Ndegwa agrees that women are at a higher risk, sperm don’t exactly age like fine wine. According to studies, sperm quality declines as men get older.
Research has shown that babies born to older fathers have an increased likelihood of health problems including Down’s syndrome, psychiatric issues and cognitive disorders.
According to a research article released in 2015 titled, “A unique view on male infertility around the globe”, men are solely responsible for 20 to 30 per cent of infertility cases due to low-quality sperm. Yet, we rarely hear campaigns urging men in their 20s and 30s to freeze their sperm.