Motherhood today

By Dr Jamie Friebe, a specialist at City Fertility Brisbane

Over the years, things have changed and what was once the average age for pregnancy has now advanced. Careers, travel, and just life, in general, can sometimes mean that you are suddenly considering trying for a baby and you are in your late 30s or early 40s.

There are many questions you may have including what are the options, what are the chances and what are the risks? Here we answer a few of these questions.

The chances

Age is the most important factor affecting egg supply and quality and your chance of pregnancy. Females are born with a finite number of eggs and the quantity and quality deteriorate with age. Although older women can have good quality eggs there are just substantially less of them.

Research shows that female fertility is at its optimum level until the age of 35. Conception rates for normal healthy couples are, at best, 20-25 percent per menstrual cycle.

By age 40, it is estimated that a woman’s natural conception rate is 5-8% and continually declining.

By age 43, the pregnancy rate is thought to be as low as 1-3 percent per month.

For men, sperm quality also declines as age progresses, but is not as rapidly as it is for women and their egg supply.

The options

The options for falling pregnant in this age group vary from unassisted to fully assisted and include:

Natural conception:

If you are in a relationship you could try for natural conception, based around when you ovulate in your menstrual cycle.

It is recommended to seek medical advice if you are over 35 and have been unsuccessful after six months of trying to conceive naturally.

If you are over 40, as time is of the essence, you may prefer to seek advice immediately to improve your chances of conception.

Some of these early intervention methods that can assist with natural conception include:

• Ovulation Induction
• Intra-Uterine-Insemination (IUI)
• Surgical intervention

Assisted conception (if you are single or in a relationship):

If trying to conceive naturally is not working or is not an option, or other medical or surgical interventions have failed to achieve a pregnancy, then City Fertility offers a range of IVF treatment options including:

• In-Vitro-Fertilisation (IVF), using donor or partner sperm.
• Intracytoplasmic Sperm Injection (ICSI), with donor or partner sperm. This is also an option for in cases of male infertility.
• Genetic testing
• Testicular aspiration, if you have a partner who has previously undergone a vasectomy.
• Laser-assisted hatching
• Embryo transfer media
• Frozen eggs or sperm (previously frozen)

Donor conception (if you are single or in a relationship):

Another option is to consider donor gametes which can assist individuals and couples to achieve their dream of parenthood. Options include:

• Donor sperm
• Donor egg
• Donor embryo

Surrogacy services (if you are single or in a relationship):

Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. The intended parent(s) may arrange a surrogate pregnancy because of: female infertility or other medical issues that make pregnancy or delivery impossible, risky or otherwise undesirable. The sperm or eggs may be provided by the intended parents, but donor sperm, eggs, and embryos may also be used.

Pregnancy risks

Advancing age, unfortunately, increases the risk of pregnancy complications too. The risk of miscarriage and chromosomal abnormalities in the foetus rises after the age of 35. Complications such as gestational diabetes, placenta previa. cesarean section and stillbirth are also more common among older than younger women. Some of these risks can be minimised through genetic testing, pregnancy testing, and medical guidance.

Where to now?

Regardless of your age, it’s important to know when to seek help from a fertility specialist. Therefore, if you are your are having no success trying to conceive, there are a range of options available to you. Call our Fertility Advice Team on 1300 354 354 to book an appointment with one of our specialists to discuss your personal circumstances and the options available to you.