APRIL 9, 2019 BY SARAOGI
On a daily basis, I get a lot of couples suffering from fertility related issues whom I counsel. Quite a few of these cases are those of secondary infertility, which means that they have either had a delivery or abortion a few years ago, and they haven’t been able to conceive after that. Quite often some couples had earlier opted for an MTP or an abortion who later come back with fertility related issues. These are the hardest hit of the lot. As when they didn’t desire pregnancy – they conceived & later when they were ready, pregnancy evaded them.
One of the daily challenges is having to explain to patients that the fertility potential of a couple will never be the same as it was a few years ago. The hardest part for them is coming to terms with the fact that, what occurred naturally earlier, now requires assisted guidance on the part of a fertility specialist.
Most of the best IVF specialists in Mumbai will tell you like me, that age has a major role to play in the fertility potential of a couple. Its impact is more on women than men. A woman is at her fertility peak between the ages of 20-24. After that, there is a mild decrease in the fertility potential of a woman from the age of 25- 29. After the age of 30 – things start taking a turn for the worse. There is a decrease in both the number of eggs as well as the quality of the eggs produced by the woman.
The chances of spontaneous abortion following conception increase and the risk of congenital anomalies in the baby also go up marginally. However, this risk is still not very serious at this stage. The biggest trouble starts after the age of 35. Almost 60% of the IVF cases being performed by IVF specialists in Malad or for that matter by IVF specialists in Mumbai belong to the age group of 35 and above. After this age, the decline in the quality and the quantity of the oocytes is tremendous, and the risk of spontaneous abortion is extremely high.
The reasons for declining fertility in women by age is as follows:
- Decrease in the ovarian reserve and the number of eggs in the ovary
- Decrease in the quality of the egg (female gamete ) due to age-related changes in the DNA
- Changes in the uterus with age – Eg. The occurrence of the fibroid, polyps, adenomyosis, etc.
- Changes in the hormonal milieu of the body which is less favorable for fertilization
Impact of age on male fertility:
The impact of age on male fertility is less dramatic than that in women. Age causes a mild decrease in semen volume and a moderate decrease in potency of men ( especially hypertensive and diabetic men ). However, the impact on semen parameters is limited. The only thing it affects is the time to the conception which is mildly increased.
Impact of age on endometrium and uterine receptivity
Age can cause some changes in the uterus as well. These include the development of fibroids, polyps, etc. All of these changes may be unsuitable for implantation to occur ( lodging of the embryo into the endometrium of the uterus). In extreme cases, the uterus may be entirely hostile to receiving embryos increasing the requirement for surrogacy. There are many surrogacy centers in Mumbai like ours which provide surrogacy services. The objective is to find the best and most cooperative surrogate and to reach agreeable terms with the commissioning parents. This is where the role of the best surrogacy centers comes into play.
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