Advanced Maternal Age (AMA)

 

 How old is too old? 

Today we are analazying the scientific paper The impact of advanced maternal age on pregnancy outcome1.  This article talks about the relatioship between advanced maternal age and the increased risk of potential adverse pregnancy outcomes.

The advanced maternal age is affected by sociologic, ethnic, and cultural considerations. However, from a scientific point of view, fertility gradually declines, but it is from the age of 35 when we see the greatest decrease in oocyte quality and quantity.

AMA is related to spontaneous abortions, trisomy diseases, non-chromosomal congenital malformations and birth defects. There is even a greater risk of complications for the mother, not only for the baby, especially hypertension-related conditions and gestational diabetes. Despite this, recent studies claim that there is an independent relation between intrapartum cesarean section and AMA. Well at least not all news are bad... 

This is when ART (Assisted Reproductive Technology) appears. Oocyte donation (OD) is used for achieving pregnancy in AMA gravidae and even in perimenopausal and menopausal women. If you have lost sight of your period, not all is lost. 

According to a study from the US, women treated by in vitro fertilization/OD were almost exclusively ≥35years of age, The fact that more than one embryo is transferred in some ART programs leads to a higher incidence of pregnancies of multiples, but there's always room for one more isn't it?

Hum, wait wait, not all the responsability falls on women. Advanced paternal age is also associated with adverse effects upon neonatal outcomes. But yeah, they can start worrying later, at the age of 45.

Talking in psychological terms, it has been demonstrated that women of advanced maternal age have a higher level of stress and postpartum depressive symptoms. Nevertheless, they have showed better parenting skills. 

So, yeah maybe you should have a plan B in case you feel in a countdown. Thanks to advancements in medicine and technology you can vitrify oocytes and even embryos. Prices are not very affordable but is there anything we would not do for our children?

1. Attali, E. & Yogev, Y. The impact of advanced maternal age on pregnancy outcome. Best Pract. Res. Clin. Obstet. Gynaecol. 70, 2–9 (2021).