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Caught up in age-related fertility decline?

Health
 Caught up in age-related fertility decline?  (Photo: iStock)

The average age of first-time mothers has been rising over time. Years ago, it was commonplace for women to have children in their twenties and early thirties. But current lifestyles, and other competing interests, have pushed the average age of first-time mothers beyond the mid-thirties and into the forties.

The consequent effect is lower spontaneous conception rates and an increasing demand for assisted conception services. Spontaneous conception is mostly dependent on the female age. Younger women have many good-quality eggs. Their chance of conception month to month is therefore higher.

But as age advances beyond the mid-thirties, egg numbers are on a steep decline. Their quality is also very poor. The chance of a spontaneous pregnancy becomes ever so lower and is only about five per cent in the forties. This phenomenon happens in men too, but the effect is less dramatic due to the continuous process of sperm regeneration. So what should couples do to avoid the fertility-related age factor? The obvious solution is to have children at a younger age, but this may not always be practical. You could always consider what is referred to as fertility preservation.

Women can freeze their eggs at an earlier age for subsequent use. This is best done below the age of 35, even though it can also be done later accepting limitations with egg numbers and quality. Men too can preserve their sperm. They are best before they hit forty.

But what if age has already caught up with you? You can still take your chances, and you can still conceive spontaneously. It is worthwhile getting evaluated by a fertility specialist, with appropriate advice on what additional interventions may be helpful.

Advanced fertility treatment will, however, not compensate for age factors, and it might mean multiple treatment attempts to eventually succeed. When the female age is hovering around the mid-forties, fertility treatment with own eggs is mostly futile. The realistic option is to consider the use of donated eggs.

This is a major undertaking, which is not without psychological and social vicissitudes. All other fertility factors being constant, the use of donated eggs elevates the chance of pregnancy in older women to levels comparable to the egg donor’s age.

Other options when age negates conception include adoption, or just accepting to live childless. Adopting a child in Kenya, for citizens, has been streamlined and is a smooth process for most. Parents with adopted children have satisfaction rates similar to those who have borne their own. And if you choose to live childless, you may pursue other life adventures that are no less rewarding.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist.

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