Thursday, September 13, 2007

Planning a baby once you've crossed 35

All women have a biological clock , but many women more than the age of 35 are blissfully unaware of the fact that it is relentless ticking away until they try to have a baby - at which point they get a rude shock when they find out that their eggs are too old for them to be able to conceive. By the time the alarm goes off, it's too late, and they often kick themselves for postponing child-bearing . What can you do to prevent this tragedy ?

First, some facts. Every girl is born with a finite number of eggs, and their number progressively declines with age. A measure of the remaining number of eggs in the ovary is called the "ovarian reserve"; and as you age, your ovarian reserve gets depleted. One third of women over 35 have difficulty conceiving, and this increases to two thirds when they are over 40. The live birth rate in women more than 44, is less than 1%. ( As usual, Mother Nature is very unfair, and men have it much easier - their fertility generally remains constant throughout their 40s. )

Don't let the fact that your periods are regular lull you into a false sense of security. Also, just because you are fit and healthy and just because your annual medical check up by your gynecologist has revealed no problems, does NOT mean that your eggs are allright !

You can test how young your ovaries are (the ovarian reserve) is by doing a blood test to measure the level of FSH ( follicle stimulating hormone) in the blood on Day 3 of your cycle - the basal ( day 3) FSH level. A high level suggests poor ovarian reserve; and a very high level ( more than 20 mIU/ml) is diagnostic of ovarian failure. The other test is an ultrasound scan to check your antral follicle count. Women with poor ovarian reserve have reached the oopause.

The best way of improving your fertility is to have sex frequently. This maximise the chances of conception, by increasing the chances of the eggs and sperm meeting. You can calculate your fertile days if you need to time "baby making sex" by using the free fertility calculator at www.drmalpani.com/freefertilitycalculator.htm ! You can also use Ovulation Test Kits ( which check for the LH surge) and track your cervical musus to determine when you ovulate.

Time management is important, not only to maximize your chances of conceiving, but also to minimize the risks of pregnancy. As you get older, if you have medical problems such as diabetes and hypertension, the pregnancy does become “high-risk”. Also, the risk of having a baby with birth defects goes up because older eggs have an increased chance of being chromosomally abnormal.

If you are not pregnant in 6 months and need , go to an infertility specialist straight away – don’t fool around. For the older woman , time is at a premium , and you cannot afford to fritter away your precious time on treatments with low pregnancy rates. You need to take a proactive approach, so that you can maximize your “ return on investment” . This is why IVF is such a useful option– it maximizes your chances of conceiving in a short span of time, and by magnifying your fertility, it telescopes time, allowing us to accomplish in one month what Nature would ordinarily take 3-6 months to do !

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