Instituto BernabeuTrying for a child after 40 years of age is a growing trend in today’s society and not only in Spain, but in Europe, too. Professional, personal and social reasons have joined together in making women decide to put motherhood off for longer and longer. But nature takes its course and each woman is only fertile for a certain period of time and this can affect her chances of getting pregnant. In the light of such a common situation, what do we need to take into account? What is the key role played by experts in health and fertility?

Since 2002, the average age at which a woman has her first child has increased two years. Whilst in 2002 the average age was 29, the Spanish National Statistics Institute’s most recent figures show that it has now gone up to 31 and that there is an upward trend.  This increase in the age at which women have their first child is similar to the increase in other European Union countries where an increase of around two years has been registered. Figures show that women are waiting until they are near their 40s and even older before trying to get pregnant.

As a result, oocyte cryopreservation, a technique that involves advanced and sudden cell cooling of a woman’s oocytes so that she may make use of them in the future, is an increasingly used and common option. With this technique, women can extend the period during which they are biologically capable of getting pregnant and reduce the number of risks because the oocytes are retrieved during the woman’s optimum age and this reduces the likelihood of pregnancy loss or chromosomal abnormalities.

In fact, ovarian reserve decreases quickly from the age of 35 and even drastically from 40 onwards. However, women tend to be over 35-40 years of age when they think about maternity and decide to embark on the adventure of becoming a mother.

Despite this age, which is thought of by experts as late for motherhood, and the limitation on pregnancy imposed by a woman’s biological age, there is no doubt that a woman’s health during her 40s is at its best. This is down to healthy living, healthy and appropriate lifestyles, healthcare programmes or early diagnosis of illnesses, as Instituto Bernabeu in Alicante explains.

However, when facing pregnancy later on in life, other things need to be taken into account: “an early prepregnancy appointment is recommendable in order to detect any hidden pathologies, give advice on healthy living, provide folic acid treatment prior to pregnancy, etc. A general blood test, mammogram, blood pressure test and a gynaecological check-up are also advisable”, explains IB.

Specifically, Dr Francisco Sellers, Director of the Obstetrics Department and head of the Ultrasound and Antenatal Diagnosis Section at Instituto Bernabeu, adds that “checks also need to be done to determine if there are any chronic illnesses.” In short, a prepregnancy appointment “is very useful” due to the information it can provide on the state of a woman’s health.

The two main illnesses in older women are high blood pressure and diabetes, both of which are illnesses that can happen during pregnancy. This is why “more check-ups during pregnancy” are necessary. Dr Sellers also explains that, on the whole, check-ups of this kind should be carried out regularly during pregnancy since “the risk of pregnancy loss is greater when the mother is older.”

Once a woman has managed to get pregnant, if she is taking any medication for these or other illnesses, “her medication needs to be evaluated.” The expert from Instituto Bernabeu in Alicante also recommends carrying out an “antenatal diagnosis” due to the “possibility of abnormalities in the amniotic fluid or in the mother’s blood and with a view to avoiding the risks associated with amniocentesis”. The fertility clinic in Alicante explains that antenatal genetic diagnosis consists of detecting genetic or chromosomal abnormalities prior to birth. That is, tests carried out on the foetus. Dr Sellers explains that when it’s time to give birth “if the mother is a little older, the option of a caesarian section is taken into account, especially if she is over 45 years of age because she may take longer to dilate.”

The fact is that motherhood at 40 years of age is a reality and a sign of profound social changes in the life of women. With adequate check-ups and specialised care by experts in gynaecology and fertility, pregnancy at that age or at any age can conclude with total normality and end in the birth of a new life.

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