Is there an ideal age for pregnancy?

Married in 2015, Suvarna Borkar Dhekane, now a 33-year-old corporate employee, from Bengaluru experienced the joy of motherhood only in 2023, after eight years. Though Dhekane conceived in 2017, she suffered a miscarriage. Suvarna was constantly worried about her fertility and wondered if there was an ideal age for pregnancy which she missed. 

Speaking to Happiest Health, Suvarna explained her journey of motherhood and said that a healthy diet and positive outlook played a key role in her case. “I had a miscarriage and wasn’t able to conceive. After that I underwent fertility treatment and followed a strict diet plan for weight reduction. Between 2018 and 2019, I was able to shed weight and went from 70kg to 60kg,” she said. She diligently followed the gynecologist’s advice for weight loss and followed a healthy diet, as she understood the effects of obesity on pregnancy.

The ideal age for pregnancy

A woman’s fertility period begins with menarche (10-13 years) and lasts until menopause (49-51 Years). Pregnancy should neither be too early nor too late, say doctors warning against teenage pregnancy and efforts to conceive after late 30s.

According to Dr Subhashini Y, Consultant Obstetrician and Head of Academics at Fernandez Hospital, Hyderabad, pregnancy is the couple’s personal decision. However, she adds that post-30, the fertility rate decreases in a woman. “Additionally, there are metabolic issues such as obesity, diabetes and hormonal issues. Though these factors can be controlled by prenatal checks, they are still risk factors,” said Dr Subhashini, stressing the need for pre-pregnancy counselling.

While infertility is the major cause behind delayed motherhood, factors such as financial instability and lack of psychological preparedness also affect motherhood.

“There is nothing like an ideal age for pregnancy. However, medically, too early isn’t good and too late is also not good. Conceiving up to 30 years of age is good but most doctors do not advise conceiving after 35 years, as it can lead to certain complications,” says Dr Dr Manjiri Mehta, Consultant Gynecologist and Obstetrician, Fortis Hiranandani Hospital, Mumbai.

Teenage pregnancy is also concerning. According to Dr Geeth Monappa, senior consultant obstetrician and gynecologist, Sparsh Hospital, Bengaluru, the pelvic passage, calcium level and iron level aren’t generally optimal in teenagers. Hence, pregnancy before 18 years of age can cause complications like low birth weight of the baby and heavy blood loss post-delivery.

She recalls the case of an 18-year-old girl from Bengaluru who suffered acute bleeding post-delivery. “She had a normal delivery. The newborn’s birth weight was just 2 kg, as against the ideal 2.5 kg to 3.5 kg. She suffered from severe bleeding and required blood transfusion,” said Dr Monappa.

How does fertility change with age?

“With age, fertility drops as a woman’s ovarian reserve declines while risk factors such as blood pressure, weight gain or loss increases,” says Dr Mehta.

“Scientifically, above 35 years, the eggs (oocytes) undergo a decline in quality and quantity, increasing the chance of complications due to infertility. Beyond the 40’s, it is further a concern,” Dr Suhasini. Pregnancy beyond 40s increases the risk for fetal anomalies including chances of genetic abnormalities like Down’s syndrome.

What does delayed pregnancy mean?

Delayed pregnancy is defined as pregnancy occurring at the age of 35 or above. A few age-related complications are gestational diabetes, ectopic pregnancy (wherein the fertilised egg grows outside the uterus), placental abnormalities (such as placenta previa) and congenital anomalies (such as heart defects) in the child.

Dr Subhashini suggests that women above their 40’s must perform pre-pregnancy check-ups as the risk of the health conditions like diabetes and hypertension increases with ageing and must be treated before pregnancy. “Pre-pregnancy screening and genetic counselling are important, especially for late pregnancies,” says Dr Subhashini.

Late pregnancy and alternative methods

When natural conception fails, there are Assisted Reproductive Technology (ART)) such as In-Vitro Fertilisation (IVF), where matured eggs from a woman are retrieved and fertilised with the sperms in a lab to form an embryo. The embryo is implanted into the woman’s womb and conception is achieved.

According to Dr Monappa, women with uterine fibroids (a non-cancerous growth or tumor in the uterus) or other hormonal imbalances shouldn’t delay their pregnancy. “However, egg preservation is a good solution for late pregnancies,” she added, talking about oocyte cryopreservation where healthy eggs are retrieved at a young age.

Dr Monappa recommends that a woman can choose when she wants to become a mother using egg preservation. “If a woman wishes to have a late pregnancy, then she can come and evaluate herself with ovarian reserve test and to be aware of her egg reserves,” she added.

However, the success rate of IVF reduces with age. “The inner lining of the endometrium (tissue layer of the uterus) also reduces with age,” says Dr Monappa.

Takeaways

Discussions on the ideal age for pregnancy must also factor in a woman’s willingness to conceive, say doctors. However, they add that the right childbearing age is within 30s when the woman’s fertility is good. Doctors caution against both teenage or early pregnancy and also delayed pregnancy post 40s. Early pregnancies can lead to unhealthy babies while infertility and metabolic issues increase with age.