Things To Consider While Planning A Pregnancy In The Late 30s

Age is one of the most important factors affecting fertility in females, and fertility sharply declines once a woman crosses the age of 35. According to National Institute for Health and Care Excellence (NICE), the fertility rate is 94% in 3 years for women of 35 years and 77% for women of 38. These are conservative estimates, and some studies have found that the actual fertility is lower than what is reported above especially when we consider South Asian population.

Unfortunately, there is not a lot you can do about this. Many websites offer tips and tricks to improve fertility, but none of those methods has stood up to the scrutiny of science. It does not mean that women over 35 cannot conceive, and there are many success stories of women giving childbirth in their late 30s and, in fact, some in their early-40s.

There are a few ways that can protect and improve your fertility. 

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Eat Right   

Avoid excess fats and sugar and indulge in fresh fruits and vegetables. Take care of your protein intake. Indian women are notoriously deficient in proteins.

Take Multivitamins

It should not be a problem if you are taking a balanced diet. If you are thinking about taking supplements, talk to your doctor first. One of the vitamins indicated for women who want to be pregnant is folic acid, and it would be wise to start taking folic acid supplements. Vit D and Omega 3 fatty acid supplementation are very helpful. Again, consult your doctor.

Exercise

Include at least two to three days a week of strength training. Doing cardio everyday is a good idea.If you are overweight or obese, reducing your weight is a good idea.

Avoid Smoking And Alcohol

Consuming substances like cigarettes and alcohol can affect your fertility. So, do not consume them.

Manage Stress Levels 

It is easier said than done because stress can wreck your hormones and, consequently, your reproductive system.

Timing Of Intercourse Is Very Important  

Technically, pregnancy is possible only between a few days  before and after ovulation. That comes down to between day 10 to day 18 of the menstrual cycle for most women. In women with long cycles the window is wider and vice versa for women with short cycles.You must have sex regularly within this period, and you must consult your OB-GYN for periconceptional counselling. Also, talk to your partner, discuss all issues with him, and see that you both are on the same page concerning kids. If you are, conceive as soon as possible. American College of Obstetricians and Gynecologists (ACOG) recommends that women more than 35 years of age who do not conceive within six months of regular unprotected intercourse consult their doctor and undergo testing for infertility. This does not mean that they are infertile, but it is a preventive method to ensure that the women get adequate treatment while there is still time.

Consulting a medical professional is a must if: 

1. You have irregular periods.

2. You have a history of abortion/miscarriage, gynecological disease, thyroid disorder, heart problems, liver disease, etc.

3. You have a history of prolonged illness, major surgery, or long-term drug therapy for any reason whatsoever.

4. You have someone in your first degree relatives with a history of stillbirths, more than two spontaneous abortions, a child with genetic diseases, especially Down's syndrome.

Many studies have shown that South Asian (Indian, Pakistani, Bangladeshi etc ) women age 2-3 years ahead of Caucasian. Most data regarding age and fertility is western. Indian women in general should ideally attempt to complete family before 34 years of age. 

However, it is not a rule and many women can conceive as late as 42 years too but the chances drastically reduce over time. Assisted Reproductive technologies (IVF) have come a long way to help women with advanced age experience parenthood.

(Dr. Kaberi Banerjee, MD of Advance Fertility and Gynaecology Centre)

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