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Advanced Maternal Age

Advanced Maternal Age

How Old is Too Old to Have a Baby?

Many women are delaying having children because they are building careers, working to become financially independent, or just haven’t found the right partner to parent with. After 35 and into the early 40s egg quality diminishes and young donor eggs are often necessary in order to create normal embryos that can implant and become babies.

But how old is too old to have a baby?

And what exactly is advanced maternal age? NJ fertility doctor Jane Miller explains that biologically we were meant to have children in our late teens through early 20s but socially we were not. Recent statistics reveal that 1 out of every 5 women are delaying pregnancy until age 35 and there has been a 50% increase in first birth to women ages 40 and over. With the use of donor eggs women into their early 50s can, if appropriate candidates, become pregnant.

There are, however challenges and risks to pregnancy after 35. These include higher chances of gestational diabetes (diabetes of pregnancy), high blood pressure, pre-eclampsia, premature delivery and the need for delivery via caesarean section. For these reasons fertility doctor Jane Miller requires that all women aged 45 and above get cleared medically by a competent internist before treatment to get pregnant is initiated.

Menopause (the cessation of periods for at least 1 year) is not a contraindication to pregnancy.

A simple regimen of estrogen pills or transdermal estrogen patches followed by progesterone will prepare the uterus to receive an embryo. In fact this is the same regimen that is used in younger women when they are preparing for transfer of previously frozen embryos. Dr. Jane Miller has her menopausal patients undergo mock or trial cycles with estrogen to see if their endometria (uterine linings) can respond appropriately to hormonal stimulation. After 2 weeks of either pills or patches a simple vaginal ultrasound can indicate whether the woman’s lining has obtained the required thickness and pattern required for pregnancy. If so, and if appropriate medical clearance has been obtained – it’s a go. The donor egg IVF is then begun. For women who cannot obtain adequate endometrial development Dr. Jane Miller discusses the option of employing a gestational carrier (surrogate) to carry their embryos to term.