General Information in Woman Pregnancy and Giving Birth

Can A Woman Ever Be Too Old To Get Pregnant

January 2005 saw the birth of a baby daughter to a Romanian woman, Adriana Iliescu. Possibly an unremarkable event other than at the time of the birth the mother, Adriana, was 66years old. Eliza Maria Iliescu was born six weeks prematurely by caesarean section and weighed 3lbs at birth.

In western cultures there is an increasing trend towards women having their babies in their thirties, whereas previously the dominant trend was to have babies in their twenties. Generally women in their thirties and forties have the fastest rising birth rates. In the USA last year over 9% of births were to women over 40 years of age. Regardless of medical advice, women are increasingly opting to have their children when it fits in with their career, lifestyle and plans. Unfortunately their biological clock will not synchronize itself with their lifestyle and so, in turn,this leads to many of those same women looking to their medical advisors for help in order to conceive a child.

Society in general does not perceive anything wrong or odd for a woman over 40 years of age to be pregnant or even seeking to become pregnant. Media comments about women over 40 becoming pregnant currently seem to centre on those that are post-menopausal. However, is even this worthy of comment? Rather than these older women being seen as ‘going against the natural order’ is it that human and scientific development is outstripping Mother Nature? It’s not that long ago that a woman’s life expectancy would only extend a few years beyond her menopause. Improved medicine, diet, hygiene … etc all mean that compared to the past, women now live well beyond their menopause to 80 and beyond ie a woman age 60having a child could reasonably expect to be alive for a further 20 years to care for her offspring.

Despite the abilities of IVF and other assisted reproductive techniques to assist an older woman to conceive, the question also arises as to how well an older woman might cope with the physical strain of pregnancy and the demands of raising a child as she gets older. Adriana is a single mother who continues to work in order to be able to support her child and rejects any criticism that she is too old to care for her. It is her religious conviction that her daughter’s birth was divinely sanctioned and subsequently she will live to care for her child

No rules exist to govern the eligibility for an assisted reproductive procedure. With the womb transplants undergoing development and tests, women will be able to turn back their biological clock. Medical experts will take into account the welfare of the child, but for a multi-billion dollar international business, it is impossible to set boundaries. There are limits to which biology and biological clocks can be tweaked, other than that the only boundary is one of cost. Basically it comes down to - can the woman cope (psychologically as well as physically) with apregnancy and can she pay!

Risks to women who become pregnant at older and especially post-menopausal ages; over the age of 45 the risk of having a stillbirth doubles, over the age of 45 the risk of having a miscarriage is 50%, if a woman is dependant on donated eggs it can lead to a five-fold increase in the likelihood of developing high blood pressure, beyond the menopause gestational diabetes is 20% more likely to develop and beyond the menopause the risk of pre-enclamsia (rejection of the donated egg as a foreign body) is increased five times. The ‘generation chasm’ is a phenomenon to consider. Can someone who was born during or at the end of the Second World War relate to a child born into the iPod generation? Where will that generation gap be in another 10 years? Being an older parent means an increased risk of mortality prior to the child reaching maturity, this carries a social cost as well as a psychological one for the child. On the other side of the debate is that it’s been found that older parents, having been fully ‘around the block’, tend to be more relaxed about their children’s achievements and potential to succeed. In a recent study the learning scores of children with older parents were found to be higher than those of their peers with youngerparents.

Female Fertility And Abortion

The following article sets out to deliver facts regarding the impact of an abortion on the future fertility of a woman. Whilst abortion is anathema too many it is also for some a physiological and possibly even a psychological necessity. Regardless of the circumstances surrounding an abortion, it is likely that many women and couples will want to know if their future fertility will be affected by it. Please note: this article is not concerned with the ethics of any questions surrounding what is commonly referred to as the ‘abortion debate’.

The ‘bottom line’ on this issue is that when an abortion has been conducted; legally, safely, professionally and providing there are no complications arising from it, there is no significant risk to the future fertility of the woman involved. Some studies have shown a small increase in the risk of having a miscarriage or pre-term delivery in a future pregnancy following an abortion. This is usually caused by cervical incompetence (the cervix being unable to close tightly during pregnancy). The risk of cervical incompetence does increase according to the number of abortion procedures undertaken. However, a properly performed abortion will not affect the woman’s fertility.

Despite the claims of some people there is no evidence that an abortion will cause infertility, stillbirths, ectopic pregnancies or birth defects. However, there is a risk of infertility arising from any subsequent infection, especially when the reproductive organs become infected and are not promptly and correctly treated. Infection in the fallopian tubes could lead to scarring and blockage of the tubes. This would mean that the female gamete (ovum) would be prevented from moving into the uterus. The increased incidence of Chlamydia, which is a sexually transmitted bacterial infection, is known to cause fertility issues for women. Undergoing an abortion whilst suffering from the presence of Chlamydia in a woman would increase the risk of a post-abortion infection and, therefore, the risk of infertility. Screening for Chlamydia before an abortion, followed by an appropriate course of antibiotics will reduce the associated risks

After an abortion a routine ‘check-up’ by your doctor is usually carried out after a couple of weeks. At this the doctor will check for any post-abortion complications. Obviously, following an abortion, if the woman feels uncomfortable about any aspect of her health she should contact her doctor immediately.

Following an abortion, experts now no longer consider it necessary for a woman to undergo a few menstrual cycles before trying to conceive. For a woman who uses a chemical form of contraception after an abortion there is no reason why her fertility should not return to normal as soon as that contraception ceases. Of course, some chemical forms of contraception can take a while for their effects to wear off.

The main risks during an abortion are; haemorrhaging (heavy bleeding) occuring in 1 in 1000 abortions, cervical damage occurring in up to 10 in 1000 abortions and womb damage. Womb damage occurs in up to 4 in 1000 abortions, but it falls to 1 in 1000 for mid-trimester abortions.

To say there are no risks involved with fertility following an abortion would obviously be false. However, the few risks that there are must be considered along with the risks to a woman of continuing with an unwanted pregnancy or one that is dangerous to her health. Only the woman concerned can assess the risks and reach for herself a balanced conclusion.

Thinking Of Becoming An Egg Donor?

Many couples who wish to have a baby but are finding it difficult or impossible to do so using their own sperm or eggs can now realize their dream by using sperm or eggs donated by someone else. The practice of donating sperm is a fairly simple procedure and has been around for quite some time. More recent though is the practice of donating eggs for use by women who are unable to produce enough healthy eggs of their own.

Egg donation is a complex process and therefore pays well. If you are someone who is considering becoming an egg donor in response to an advertisement or because someone you know has requested you to do so, it is important to learn all you can about the process, and give very serious thought to all that is involved before committing yourself. This article is about suggesting some of the issues you need to consider and be informed about before taking a decision.

Donating your eggs involves surgery, taking hormones and fertility drugs and possibly, putting on weight. But first, you have to be accepted into an egg donation program. All women do not automatically qualify to donate eggs. Different egg donation programs have different requirements of their prospective donors, but certain criteria are standard for all of them and there are certain legal requirements all programs must cater to.

Most programs require you to be between 21 to 35 years of age which is considered to be the peak reproductive period. Also, while at 21 you can legally contract to donate your eggs, 35 has been kept as the upper limit as older women are likely to have abnormal eggs that could prevent conception or lead to birth defects. Also, older women tend not to react favorably to fertility drugs that they need to take before donating their eggs.

You would be required to undergo a number of medical tests before being accepted into the program. These tests would include a physical and gynecological examination, and blood and urine tests to detect any existing health problems. Genetic tests as also your medical and family history would be required to rule out the possibility of passing on hereditary/genetic problems. You would be asked about addictions with regard to tobacco, alcohol and prescription or illegal drugs.

Although genetic tests involve a simple blood test, the results could impact your ability to get medical insurance in the future. So you need to check whether they will provide or refer you to a genetic counselor and if and to who exactly the program will make your test results available.

Besides these tests, you will also have to undergo psychological evaluation. Donating your eggs is no simple matter. It involves complex emotional, ethical and social issues that you need to look at and come to terms with before going ahead. This is necessary so as to ensure your ability to fulfill the on complex process involved in donating your eggs as also, to avoid any post donation regrets or emotional trauma. Remember, once you donate your eggs, you have no control over their fate, only the recipient does. She will be the legal birth mother although the baby is genetically related to you.

If you are an ‘anonymous’ donor, some programs may require you to participate in an intelligence test also. The program will attempt to match you to a recipient who has similar physical and mental attributes as you do.

Egg donation requires you to dedicate time for the process, and it does take time. You will need to take medication for around three weeks and make several visits to the program for various tests. This could interfere with your daily routine, your work and your family responsibilities. You would need to make suitable arrangements to allow you to proceed with the program.

You will need to make some lifestyle changes. Drinking alcohol, smoking or taking illegal drugs will not be permissible. You will have to consult and get permission from relevant program authorities before taking prescription or non-prescription medication and you will have to abstain from unprotected sexual intercourse during specific periods of the donation program.

Some programs require their donors to commit to donate eggs several times, before accepting them for the program. Although there is no fixed limit to the number of times you can donate eggs, you need to be careful before agreeing. Firstly, because your eggs could be used to create a number of genetic half-siblings that could possibly end up relating to each other giving rise to a whole host of ethical and other problems. Secondly, since you don’t know how you are going to react to the medications or the procedures you need to undergo for the donating process, it may be a little premature to agree to donate a number of times.

Take time to study all aspects of the egg donation process, get fully informed, get counseled, look at the long term before going forward.

Timing Matters

Most people take fertility for granted. Couples imagine that getting pregnant is simple and often put a lot of effort into trying to avoid that very eventuality. Becoming pregnant is not really that easy, even for couples who do not have fertility problems.

Fertility has been studied and researched in great depth and a fact not many are aware of, is that humans are one of the least fertile creatures on the planet. Because conception is possible only during a fairly short period within the menstrual cycle, the chances of successfully conceiving is only around 25% each month even among ‘fertile’ couples. And there are so many other factors also involved in successfully conceiving - age, health, medical conditions, lifestyle and timing. Yes, that’s correct; the time has to be right.

So, how does timing matter?

A menstrual cycle is normally between 28 – 32 days and there are two parts to the cycle, pre-ovulation and post-ovulation. Day 1 is the first day of your menstruation. Day 7 is around when your egg is getting ready for fertilization. Based on a 28 day cycle, somewhere between days 11 – 21 are when the egg gets released and moves through the fallopian tubes and towards the uterus. The process where hormones cause the egg to get released from the ovary is known as ovulation. This is when the egg is ready to be fertilized. (It is important to realize that the pre-ovulation period differs in individual cases and can change from month to month, whereas the post-ovulation process is more or less the same for all women.) The gap from ovulation to the next period is normally around 14 days. This gap is used to track and narrow down a woman’s most fertile time in the month.

Once released, while the egg stays around for between 12 to 24 hours before disintegrating, the sperm can survive for up to 72 hours in healthy cervical mucous. It is during this time that the sperm meets up with the egg, penetrates it and the now, fertilized egg fuses with the uterus lining and starts growing.

Getting the time right.

It can be quite challenging to pinpoint exactly when ovulation is going to take place. There are a few ways to achieve this. The easiest but not always accurate method is to keep track of the woman’s menstrual cycle by using one of the following:

• Calendar Tracking Method - The history of past menstrual cycles is taken as a guide to estimate the most fertile time in the woman’s cycle. This method requires you to track your menstrual cycle for 8 – 10 months and to work out your own ‘fertility window’ which is the time when you are most likely to get pregnant.

• Basal Body Temperature Method - Your basal body temperature registers a change post-ovulation and remains elevated until your next menstrual period. Monitoring your temperature using a Basal Thermometer over a few cycles begins to show a pattern that allows you to anticipate when you are most likely to be ovulating. It is important that you take your temperature first thing in the morning, before your active day starts. Ill health, lack of sleep or alcohol or drug abuse can impact your temperature and disturb the charting of your basal temperature.

• Cervical Mucus Method - In this method the consistency of the cervical mucus is studied through the menstrual cycle. Normally, following a 5 day menstruation period, there are 3-4 dry days. The wetness of the mucus increases daily thereafter until it reaches its wettest condition when it becomes abundant, clear and stretchy. This condition is reached when you are ovulating. Remember that the use of spermicides and douches during this period impacts the consistency of the mucus thus nullifying the possibility of examining it.

These methods can achieve up to 90% accuracy if used correctly for women who have fairly regular cycles. They can be a bit of a challenge for those with irregular cycles though.