Right age to get pregnant

Giving birth & raising a child can be the most joyful and enriching experience of one’s life. Nevertheless, many a times, we may find ourselves feeling not quite ready to have a baby yet because of a variety of reasons ranging from financial instability, academic commitments, not finding the right partner and so on.

The decision to have a baby & the timing for the pregnancy is a completely personal choice to be decided upon by you & your partner. However, if you are planning to have a baby now or anytime in the future, it is a sensible idea to understand the effects of age on fertility and when is the best time to plan a pregnancy. 

Your decision to get pregnant should only be based on your readiness to have a baby.

When is the right time to have a baby?

Motherhood is without a doubt the most valuable gift that nature has bestowed on a woman. Is there, however, an ideal age to become pregnant? Well, the answer is different for each woman.

When it comes to the physical, emotional, and mental wellbeing of a woman to nurture a pregnancy, the best age is considered to be from the late teens to late 20’s. However, that isn't to say that you can't get pregnant and have a healthy child later on in life. This is why specialists agree that there is no perfect age for conception.  

Does age affect fertility?

Every girl is born with a fixed number of eggs (around 2 million) in their ovaries. This is known as the ovarian reserve. While this might feel like a lot of eggs, their number and quality keep deteriorating as the age increases. So, by the time a girl reaches puberty, this number of eggs decreases to approximately 300,000, which further reduces with each menstrual cycle and at the age of 37 years, it may reduce to only 25,000 or lesser.

To put things in perspective, you can try to ponder over the fact that out of all these eggs, a girl only uses upto 300 eggs for ovulation & menstrual cycle throughout her lifetime. The remaining eggs just gradually degenerate & disintegrate throughout life and are practically finished by the time a woman reaches menopause. 
Moreover, the quality & functionality of the eggs & sperms also deteriorates with age. 

So, what does this mean? Well, simply stated, it means that the number & quality of eggs is best in the earlier years of life after adolescence i.e during the 20 -30 years of age and as such, this is the best time to plan a pregnancy from a medical point of view ( Your personal & social preference may, of course, be different and that’s ok).

Depending upon the age, your chances of getting pregnant by natural methods after a year of trying are as follows

Thus, fertility decreases with age and both the quantity & quality of eggs deteriorates with age. Additionally, the chances of chromosomal defects in the eggs increase with age. 
As you get older, your chances of acquiring illnesses that can affect your fertility, such as endometriosis and tubal disease, medical disorders like diabetes or hypertension also increase. 

Taking all the factors into consideration,  a woman’s fertility begins to drop by the age of 32. 

Fertility begins to decline more rapidly once you reach your mid-30s and after the age of 35 years. 

By the age of 45, most women's fertility has plummeted to the point where they would be unable to conceive naturally. 

To understand it more clearly, you can consider the fact that the chances of conceiving for a woman in her 20’s are about 18-20% in a given month whereas it is only ~5% for a woman above 40 years of age. This means that out of 100 women in their 20’s who are trying to get pregnant, about 18-20 women will conceive within 1 month whereas only 5 women out of 100 who are above 40 years of age will be able to conceive in a month. 

Fertility in men also decreases as they become older, but not in the same way that it does in women. In men, the sperm quality starts to deteriorate after the age of 40 years but they can still produce viable, functional sperm late into their 70’s & 80 years of age.

Is there a way to check for fertility & ovarian reserve? 

So, all this talk about decreasing fertility with age might one wonder- what are my chances of getting pregnant naturally? 

Well, it is impossible to predict accurately what your chances of spontaneous conception are but there are multiple tests & assays which can help you get a fair idea of your fertility and ovarian reserve. Ovarian reserve refers to the number and quality of eggs ( oocytes) in a woman.

There are various blood tests that can be done to check your ovarian reserve. These include

• Follicle-stimulating hormone (FSH).
• Estradiol.
• Anti müllerian hormone (AMH).

Having a higher than normal level of FSH or a lower than normal level of AMH & Estradiol for a given age indicates diminishing ovarian reserve for that age.

Apart from these blood tests, Ultrasound can also give us a fair estimate of the number of antral follicle/growing oocytes & eggs in the ovary along with the volume /blood flow in the ovary, which can be used to determine your fertility & ovarian reserve.

Benefits of having a baby at an earlier age

• It is better for your child's health if you are a younger mother. 
• Your possibility of getting pregnant is higher if you are trying for a baby in your late 20s or early 30s. 
• It's also less likely that you'll have a pregnancy complication if you get pregnant during this period.
• You are physically fit and more likely to get involved directly in your child’s gameplays & sports activities, which is a great way to bond with the child in the growing up years. 
• By the time you have completed your childbearing activities and finished with their education & settlement, you are still in a physically & financially secure position to plan for more adventures & challenges in life ahead.

Benefits of delaying pregnancy

Not everything is negative about a late pregnancy. Instead, look at the brighter side.

• It will give you plenty of time to focus on your career, build your relationships, and gain financial stability, all of which are crucial aspects of one's life. 
• Wisdom and tolerance can come with age. There's also some evidence that children born to older parents do better in school and other social settings.
• Older parents are more patient with their children & less likely to lose their temper & punish the children over minor issues which build the foundation of a strong & emotionally stable childhood for their kids. 

So, enjoy your time without kids because, for a few years, you might hardly find time for yourself once they arrive!

Risks associated with a late pregnancy

When you become pregnant, complications may arise no matter how old you are. By the time you reach the age of 35, however, several problems & complications in pregnancy become more likely, such as

• Miscarriage.
• Stillbirth.
• Low birth weight.
• Preterm labor.
• Down syndrome and other chromosomal abnormalities in babies.
• Problems during labor that necessitate a C-section.

Premature ovarian failure/ Early menopause- Some women may inherently be born with a low ovarian reserve or may suffer from accelerated loss of follicles early in life leading to early menopause or Premature Ovarian Failure, which makes it very difficult for them to conceive later. 

Medical complications like Diabetes, High Blood pressure, etc are more likely to complicate the pregnancy in later age groups.

For males also, the quality of the sperm deteriorates.

When to visit a doctor?

Deciding when to have a baby is entirely your choice. But it is advisable to be aware of the biological facts in order to make an informed decision. Turn to your doctor if you are planning to start a family after 35 or even if it is earlier. Your doctor may recommend certain fertility &  ovarian reserve tests and do a general check-up to assess your health status.

Trying to conceive at a late age

As discussed above, when you are trying to conceive in the later years, you may need some help as it may be difficult to conceive naturally. So, fertility treatments depending on your age, personal preference, and fertility issues may be advised. These include

• Invitro fertilization (IVF).
• Fertility drugs.
• Surgery to correct certain conditions like endometriosis, blocks in the fallopian tubes, fibroids, etc.
• Intrauterine insemination.
• Zygote intrafallopian transfer / gamete intrafallopian transfer.

Do you worry that the “baby fever” has kicked in way too late for you? Talk to your doctor about it. Make an appointment for a pre-conception visit. Regardless of your age, you can still find alternative ways to expand your family. Other possibilities include

• Egg Freezing.
• Embryo Freezing.
• IVF with donor egg.
• Surrogacy.
• Adoption.

Leading a healthy lifestyle is always recommended; however, this becomes an essential factor in influencing your chances of pregnancy later on in life. With increasing age comes a lot of health conditions such as diabetes and hypertension. It is necessary that you keep them in control before planning a pregnancy. Stay away from drugs, alcohol, and smoking. Lastly, eat healthily and exercise regularly to keep yourself fit.

The final takeaway

While age does play a role in fertility, it isn't a black-and-white situation. Recognize the pitfalls, but also remember that each woman and marriage is unique. At any age, infertility and pregnancy difficulties can emerge. So, take your time and plan for a baby when you feel ready physically, emotionally, mentally, and financially.

For more information on Fertility, please check our other videos.