Delayed motherhood is becoming more and more common. We tend to postpone pregnancy waiting for a time of greater economic, professional, emotional and family stability.
So, we are having children later and later. In Spain, for example, el porcentaje de nacimientos en madres superados los 40 años es de más del 10%.
According to the data, yes, it is possible to become a mother from that age. But you should know that achieving pregnancy is much more complicated due to the natural decline in fertility associated with age. As women age, the quantity and quality of our eggs decrease, which decisively affects the ability to conceive naturally.
Furthermore, ovarian aging causes our oocytes to present a greater number of genetic mutations that can cause a greater number of spontaneous abortions or chromosomal alterations in the baby.
This is why a large proportion of pregnancies after the age of 40 are achieved through assisted reproduction treatments. For many women of this age, it is a brave decision that can pose additional challenges compared to younger mothers, but with adequate preparation and the correct IVF techniques, they achieve the dream of conceiving with their own eggs.
Understanding fertility at 40
The first thing you should do is get a detailed understanding of your fertility. You should be aware of the state of your ovarian reserve. Consult a fertility specialist to perform the relevant tests and receive personalized advice. Try to do this as soon as possible, since we have already explained that time is crucial in these cases: numerous studies claim that the chances of getting pregnant from this age in a single ovulation cycle is less than 5%. Most consultations are free and without obligation, as in the case of IGIN, and can be done online.
Reproductive health assessment
If the specialists determine that the best option for you is to undergo IVF-ICSI treatment, a complete evaluation of your reproductive health will be necessary. They will ask you for hormonal analyses, gynecological examinations and perhaps some additional tests. In addition, it will be necessary to perform a genetic analysis to rule out possible recessive mutations.
IVF treatment protocol
Most IVF procedures are now performed using intracytoplasmic sperm injection (ICSI) because of its much higher pregnancy rates. This treatment will require the following steps:
1. Ovarian stimulation: Using medication, we will induce the development of multiple eggs.
2. Monitoring: Constant monitoring of follicle development is carried out using ultrasound (and sometimes analysis).
3. Follicular puncture: Once the follicles reach the appropriate size, we perform a simple procedure to extract the oocytes. If the number of these is low, a new ovarian stimulation is recommended to accumulate oocytes and optimize embryonic creation.
4. Laboratory fertilization: The eggs are fertilized with selected sperm (from a partner or donor) in the laboratory to form embryos.
5. Embryo culture: This is the phase in which embryo development occurs. Ideally, wait until they reach the blastocyst stage (day 5 or 6 of development), since they have a greater potential for implantation.
6. Preimplantation Genetic Diagnosis: It is highly recommended for women over 40 years of age. This is a test to detect abnormalities in the genetic material of embryos. We only keep those that do not present genetic or chromosomal alterations, in order to limit the risk ofaborto y fallos de implantación, y reduciendo drásticamente la posibilidad de que el bebé tenga alguna enfermedad.
7. Embryo transfer: The selected embryo (the one with the best quality) is transferred to the uterus. It is a simple and quick procedure.
8. Beta-wait period and pregnancy test: A waiting period of about twelve days begins. After this time, a pregnancy test is performed to verify the success of the treatment.
Pregnancy Checkups
Please note that pregnancies from the age of 40 onwards are considered high-risk. This is why more frequent and thorough gynaecological check-ups are required.
In addition, it is always advisable to perform a fetal DNA test around the 12th week of pregnancy. It allows us to calculate the risk of a chromosomal abnormality early. It is a very simple test that does not entail any danger.