With the increased use of contraceptives among teenagers, recent research has shown that women in their 40s are now increasingly getting pregnant and having babies but conception at 40 poses serious medical implications for women and children
Managing Director, Nordica Fertility Centre, Dr. Abayomi Ajayi, said this at a webinar held recently on Conception at 40 said that according to the Office for National Statistics, United Kingdom, women in their 40s are getting pregnant more and more now unlike before when we had more teenage pregnancies, partly due to the increasing use of contraceptives and other factors, but its come with its associate risk.
“Although teenage pregnancy has not reduced from available statistics, pregnancy at 40 had increased. The increase is obvious and is because people are getting educated and woman are having their own careers and some of them don’t find the right partner until they are old enough to make some decisions.
Ajayi noted that it is possible to get pregnant natural after 40 but usually the window is between 40 and 44. By 45, It is almost impossible to get pregnant naturally without any form of help.
“Even at 40, the chance of natural conception is quite reduced, looking from the point of view that a lady in her 30s has a 30 to 35% chance of getting pregnant every month. If you are 40, the chances of getting pregnant are by 5%. So it is not surprising that infertility is commoner in women above 40”, he said.
However, whether natural or through IVF, Ajayi said pregnancy at 40 years and above is considered high risk, especially if the woman has a medical condition like high blood pressure, which may increase her risk of a pregnancy complication called preeclampsia
Ajayi opined that In vitro fertilisation, IVF, can be done for them, but Intrauterine Insemination, IUI, is not particularly a good idea at this stage because of a low success rate of around 5 per cent, and so might not be worthwhile for women in their 40s.
Although IVF is recommended, it is less effective for these women, and the success rate of IVF is in the neighbourhood of about 15 per cent for women over 40, and so can be considered.
Ajayi said “for instance, the Non Invasive Prenatal Testing (NIPT), a method of determining the risk that the foetus will be born with certain genetic abnormalities, has cut down the need for abdominal paracentesis to about 80 per cent to 90 per cent.
“So it is good to do pre-conception counselling, to know the condition already present and if you have health conditions like high blood pressure and diabetes, your doctor will know what to do to save your life. The doctor will also conduct NIPT test, which requires drawing blood from the pregnant woman and does not pose any risk to the foetus”.
“NIPT is most often used to look for chromosomal disorders that are caused by the presence of an extra or missing copy (aneuploidy) of a chromosome. NIPT primarily looks for Down syndrome (trisomy 21, caused by an extra chromosome 21), trisomy 18 (caused by an extra chromosome 18), trisomy 13 (caused by an extra chromosome 13), and extra or missing copies of the X chromosome and Y chromosome (the sex chromosomes). The accuracy of the test varies by disorder.
“NIPT includes screening for additional chromosomal disorders that are caused by missing (deleted) or copied (duplicated) sections of a chromosome and it is also used to test for genetic disorders that are caused by changes (variants) in single genes.”
Ajayi further encouraged women in their 20s to preserve their eggs for later in life but this will not reduce the risk of pregnancy in the 40s. Because she is older, whether she is using her eggs or using donor eggs, the risks are the same, however, the congenital risks may reduce,
“It is always better to adopt positive lifestyle choices when you start your family are part of lifestyle choices. Freezing your eggs when you are younger might help so that you do not have to use donor eggs, but the stressful effect on the body will still be there”, he said.