Obstetrician-gynecologist T.Lūža says that pregnancy is a matter of self-determination for every woman and there is no term suitable for giving birth, according to which you could forbid a woman to get pregnant.
“It simply came to our notice then. Clearly, we can talk about physiologically defined possibilities. Going towards your question about deadlines, it is believed that after 35 years there is a much higher risk of conceiving and a much harder to conceive a healthy newborn, as the risk of genetic diseases increases, according to the literature – gynecological diseases such as polyps, fibroids, endomedriosis and others, not necessarily gynecological, which significantly complicate a woman’s health and reduce the chances of conceiving and carrying a baby, ”said the doctor.
We talked to T.Lūža about what women need to know when planning a pregnancy at a later age, why it is necessary to take folic acid and vitamin D, what are the possible risks, what are the most common genetic fetal diseases, when a woman may be advised not to try to get pregnant and what, if all goes well, there is a good side to mature motherhood.
– Could you say from your practice that the risks are really higher when women cross 35 year limit?
– From practice, I can see that the number of pregnancies of 35-year-old women is increasing. The problem is that more of them seek help because it is more difficult to get pregnant. Even ancillary measures make it much more difficult to provide assistance.
The main factor here is the ovarian reserve, which decreases significantly with age. For most women, the ovarian reserve is already very depleted for about 40 years. And it is much more difficult to stimulate the ovaries – to get more eggs, to fertilize them, if you think about assisted reproduction.
For most women, the ovarian reserve is already very depleted for about 40 years.
There is another side. Women read articles, talk to friends, decide that when they are 40, they have little chance of getting pregnant, so they are no longer safe. So another problem arises when a woman takes and becomes unplanned, believing that this will no longer happen. Then the dilemma arises – what to do? It is not uncommon for abortion to be chosen in such cases. Motivated by the fact that he is already too old, will immediately have or have grandchildren and so on.
Thus, the fact that it is more difficult to conceive or carry a baby at this age does not mean that women cannot conceive at all and that she no longer needs to be careful if she does not want an unplanned pregnancy.
– For women over the age of 35 who are planning to become pregnant, what should they know, what to take, what to use, what not, what research to do?
– As the incidence of various gynecological diseases increases with age, it is important to have regular gynecological examinations and a cytological examination for precancerous conditions of the cervix, an ultrasound to assess the presence of cysts, fibroids, polyps that could complicate pregnancy and eliminate these problems. , time would still be delayed.
No special preparation is required, but it is very important to start taking folic acid before pregnancy. It will not help you get pregnant, but it will reduce the risk of certain birth defects.
When planning a pregnancy, it is important to use vitamin D. Especially now, in autumn, as well as in winter and spring, almost all Lithuanians lack it. It is important for the whole metabolism. When it is lacking, the quality of the eggs significantly deteriorates, and in the end, the quality of fertility. It is possible to study, see what its disadvantage is, but from experience – it is lacking for many, so taking prophylactic doses, it will certainly not be too much.
Also, as early as possible, if you are already planning a pregnancy, both a woman and a man should give up bad habits to have the best chance of conceiving and carrying a healthy baby. Sometimes it is thought that a glass of wine a week may not hurt, but then there are also thoughts that if a glass of nothing, maybe two – nothing. To avoid this, it is better to strictly give up alcohol when planning a pregnancy.
Photo by Vida Press / A woman drinks vitamins
–
– When should you start taking folic acid and for how long?
– Folic acid has been shown to be ideal for at least three months before a planned pregnancy. In general, the global recommendation is that all women of childbearing potential should take folic acid regularly. In other words, if you don’t know when the stork will come to be ready. Here is such an ideal option.
Folic acid is one of the vitamins included in the hemoglobin structure of erythrocytes. It is important for the body in general, so although it is often thought, it is not a vitamin that should only be taken by those planning to become pregnant or pregnant.
Women often ask how long to take it after getting pregnant. The answer is that it can be used throughout pregnancy. Some pregnant women say they use folic acid for birth defects, well, folic acid will no longer help them avoid it in the middle of pregnancy. But if taken as a vitamin supplement, a building block for erythrocytes, it can be used throughout pregnancy.
It is very important to start taking folic acid before pregnancy. It will not help you get pregnant, but it will reduce the risk of certain birth defects.
It is also recommended for men if the couple is planning to become pregnant.
The minimum daily dose should be 400 to 800 micrograms. That dose may be increased to 5,000 micrograms with certain medicines or diseases. If you are planning to become pregnant, it would be a good idea to consult your doctor, tell them about the medications you are taking, the diseases you are suffering from so that you may need a higher dose to be diagnosed.
If any medications are used to treat other conditions, such as epilepsy, this should also be discussed with your doctor, and some medications may need to be changed and some may even be stopped, as there are medications that worsen pregnancy and increase the risk of various birth defects.
And, of course, you don’t have to do the way you decided to plan your pregnancy, you read that you need to take folic acid for three to four months before that, and that’s why you’re now postponing planning. If we are talking about a later age, it is more difficult to get pregnant anyway, so there is no need to waste any more time. You have planned to start taking folic acid as soon as possible and take it in the first months of pregnancy.
– You have heard that you should check for iron and possibly take iron supplements when planning your pregnancy.
– There is more to the myth that iron should be used when planning a pregnancy. The study should be done first and then addressed. Prophylactic use of iron is not recommended. Especially since hemoglobin levels are different during pregnancy.
In non-pregnancy, the lower limit is 120, and in the first and third trimesters the lower limit is 110, and in the second trimester it is as low as 105. This is due to an increase in blood volume during pregnancy, an increase in plasma initially, the blood would not be so thick. Everything happens physiologically as it should be, so it should be noted that those rates are different during and outside pregnancy, and consult a doctor.
Photo album of personal album / Tomas Lūža
–
– When it comes to pregnancy at a later age, the issue of risks is touched upon. You mentioned that one such risk is the possibility of getting pregnant in general. What other risks do women who give birth later face?
– Another high risk group is the increased number of complications of pregnancy – starting with miscarriage, non-developing pregnancy, as well as a much higher risk of genetic malformations. Among younger women, the miscarriage rate is around 15-20%, and among those over 40, it is as high as 50%.
– There is no pre-emptive opportunity for a woman to be investigated for possible genetic malformations of the unborn child, right? What are the most common genetic diseases?
– Yes, there is no such possibility in advance. Genetic testing is performed on pregnant women aged 35 years and older from 9 to 10 weeks of gestation.
And the most common genetic diseases are Down, Edwards and Patau syndromes. These are trisomies on chromosomes 21, 18, and 13. This means that there should be two chromosomes and three of them appear. Depending on the level of the lesion, the fetus dies already in the womb or may survive to give birth and some time after delivery.
Down syndrome is not a life-threatening pathology. Nor is it a medical indication for termination of pregnancy. And in the case of birth defects that are incompatible with life, the pregnancy can be terminated according to medical indications.
– Why could a woman in a later age be advised not to even try to get pregnant?
– Therapeutic diseases, which increase and get worse with age, such as high blood pressure, diabetes, which are very difficult to correct, require a lot of medication.
Pregnancy further highlights all the weaknesses of a woman’s health, so if there are very significant health problems before pregnancy, it is often not recommended for a woman to get pregnant, because it will be even more difficult to treat that disease, it can harm her health. Of course, this can only be advice, because you can’t ban childbirth. But it is important to inform the woman so that she knows what the possible risks are and can be able to put together the pros and cons.
– Do you have a lot of patients who want to give birth at a later age? If it is not possible to conceive naturally, aids are used. Is there an age limit in that case?
– Come women who – 40 and over 40, they want to get pregnant, consult about opportunities. We discuss the state of health, evaluate the gynecological aspects, it is impossible to tell whether to get pregnant or not, the only advice may be to try to do so. And if that fails, then think about why, whether you have your own eggs, or medicine in general can still help.
Among younger women, the miscarriage rate is around 15-20%, and among those over 40, it is as high as 50%.
Another option is donor eggs, donor embryos. You can then get pregnant at any age. In India, a 74-year-old woman carried triplets. There are a wide variety of those records. Theoretically, the possibilities of carrying a baby are endless, just not always with your eggs. Unless the woman had saved them.
There is a growing trend in the world to freeze eggs while a woman is still young, wants to study, work, pursue a career, and plan a family later. When she finds a man and wants children, the eggs will be thawed, fertilized, and the woman will be able to carry the baby. This is possible not only in foreign countries, but also with us in Lithuania.
In my practice, women who have become pregnant naturally have been between the ages of 46 and 47, and the pregnancies of women who have crossed the 50-year limit have been monitored after the above-mentioned aids. For some, their pregnancies were very complicated due to therapeutic diseases.
From experience, I can say that pregnancy at an age when menstruation is no longer particularly difficult for a woman’s health.
Photo by 123RF.com/Pregnant woman
–
– There is a lot of talk about risks, diseases, but there is a good side to late motherhood? What do you see her?
– Very good question. There are studies that just show a huge plus in pregnancy, childbirth in the elderly. And the plus is that the older woman has better financial opportunities to take care of the child, to spend in a better kindergarten, school, university. It is also believed that the psychology of women of this age is more stable, stronger, they have accumulated more knowledge and experience.
In summary, the children of older mothers are smarter, achieve better quality of life results, and receive a better education. So, if you manage to get pregnant and successfully carry the baby, there are a lot of pluses to see.
– .
