पीरियड्स बंद होने के बाद गर्भधारण... Pregnancies after Menopause

Defying Nature’s Rule :  

Author : Dr. P. D.GUPTA

Former Director Grade Scientist, Centre for Cellular and Molecular Biology, Hyderabad, India


Technically, women can get pregnant and bear children from puberty meaning when they start getting their menstrual period to menopause when they stop getting it. The average woman's reproductive years are between ages 12 and 51.however A woman's peak reproductive years are between the late teens and late 20s. By age 30, fertility (the ability to get pregnant) starts to decline as one gets older, which could make it harder for you to conceive. This decline happens faster once you reach your mid-30s. By 45, fertility has declined so much that getting pregnant naturally is unlikely; it’s a nature’s rule.  

Therefore it is very important in infertility practice to recognize the major impact of advancing age on the chance of success of any treatment leading to pregnancy. Now recently it is in practice for most women to leave it later and later to have children, and thanks to advances in fertility treatments, women in their 60s or older now have the chance of giving birth.

Human beings are relatively sub-fertile species. Average fecundity is 200 births per 1000 women per month, which is a fertility rate of 20% per month. 85% of couples achieve a successful pregnancy within one year of their married life or ceasing contraception. Normal fertility was defined as achieving a pregnancy within 2 years by regular coital exposure, failing which the couple comprises the infertile population. Apart from simple aging, the risk of gynecological disorders such as fibroids or endometriosis increases with age. In addition, recent well-controlled human studies indicate that pregnant women with high stress and anxiety levels are at increased risk for spontaneous abortion and preterm labour and for having a malformed or growth-retarded baby (reduced head circumference in particular).   Anxiety and high stress seems to be very common in elderly women. One in three women aged >35 have fibroids. As it is said, that “Motherhood is self sacrificing“. It is very much essential to set the guidelines for young couples for safer pregnancy by which minimal harm to the mother and child can be achieved. Nevertheless, taking into consideration the mother and the child’s welfare an age limit should be set, as Manu Rishi suggested in our scriptures.

No doubt, we should take advantage of scientific and technological advancements for the treatment of infertile young couples but we should not misuse the assisted reproductive technology for producing babies by the menopausal women under compelling circumstances, if at all one has to use the assisted reproductive technology for old ages couples, a through checking of foetal tissue should be done in order to avoid any genetic abnormality creeping in due to ageing sperm and /or ovum. The aging uterus as it seems has not much influence after hormonal manipulation.

But should IVF be used in this way? Women should not delay their attempts for childbearing and doctors should minimize delay in the process of diagnosis and treatment of infertility. Delay in child bearing causes more accumulation of all the risk factors, including difficulties in conception, increase in the miscarriage rates, increase in the rate of malformation, increase in pathology during pregnancy, and increase in the prenatal and maternal mortality. Reproductive physicians and obstetricians should correctly counsel couples of the potential problems of delaying motherhood.

We should attempt to bring pleasures in the form of healthy babies and not sorrows in the form of sick and disabled babies in this world. Women who seek pregnancy at advanced reproductive age are more likely to experience difficulty in delivering a healthy infant compared to their younger counterparts. As early as 31 to 35 years of age, spontaneous cumulative pregnancy rates begin to decline. At 35-39 years of age, one third of women experience difficulty in achieving pregnancy and by 40 to 44 years of age, one half of women have impaired ability to reproduce. Spontaneous pregnancy rates approach zero soon after 45 years of age.

Older Mothers world wide

In Australia, nearly a decade back, not by adopting assisted reproductive methods, a 90 years old man fathered a child to a woman who was 48 years old. (In this case, A normal out of wed lock child was born, without even assisted reproduction in abnormally advanced aged couples.)

A born blind California woman, 62, gives birth to 12th child, Baby Adam., Adriana Iliescu, 67, who teaches Romanian language literature at Hyperion University in Bucharest, Romania gave birth to Eliza-Maria, a baby girl, following several attempts at in vitro fertilization from donated eggs and sperm.

Though, this way she has become the oldest mother in the world but only by surrogacy and not by using her own oocyte.

In Jaipur, a maternal grandmother lent her menopausal uterus to produce her daughter’s child nearly a decade back. (In such cases, menopausal women rented their uteri and gynaecologist prepared the uterus to accept the developing embryo for implantation and development.).

UK woman oldest natural mom at 59

A British housewife has become the world oldest natural mother after giving birth at the age of 59 , breaking the previous global record for a pregnancy by two years . Dawn Brooke gave birth to a healthy boy without any fertility treatment only 12 months before she becomes, eligible for her old age pension. Her husband Raymond was 74 years old.

World’s oldest mom welcomes motherhood

Fig.: Adriana Iliescu, 67, holds her one-year-old daughter Eliza-Maria in her apartment in Bucharest, Romania January 16, 2006.

Bucharest—Another baby may not be on the cards, but the 67-year-old Romanian woman who became the world’s oldest mother. Raising her daughter was easier than she thought and she feels that age had little impact on controversial pregnancy. Celebrating her baby girl’s first birthday, Adriana Iliescu said her age had little impact on the controversial pregnancy, her daughter’s health or her ability to care for her child.

Proud Father of Ninth Child at 90 !

On August 1, 2006, it was first reported in newspapers the incredible story of 88 year old Barmer farmer Virmaram Jat fathering a bonny boy. Now a 90 years old has stolen a march on him by siring a baby girl, his ninth child to boot.

Walking tall, smoothing his moustache, Nanu Ram Jogi has joined the league of proud old pops: apart from Virmaram there is Ratanakar Nath of Sambalpur district in Orissa, who became a father at 83 in June 2006 . Virmaram put down his virility to camel milk and it is very likely that Jogi, who lives in Panch Imli village, about 5 km from Pratapgarh town in Chittorgarh district , imbibed the same elixir.

Jogi’s wife has been in the family for a while. Saguri, who is 60 years younger than him, was his daughter-in-law. When his son Shiv Lal died a few years ago, Jogi stepped in to fill the void and not only married her but soon put her in the family way.

From such examples, it is obvious that the uterus seems to retain its receptivity to embryo implantation beyond the age of natural menopause. Only the hormonal balance is disturbed due to ageing, And as long as sufficient doses of hormones such as estrogen and progesterone are administered properly, endogenously or exogenously, the uterus can function as it functions in young age and will not show ageing effects. The success of the procedure seems not to be influenced by the age of the woman who receives it. Nevertheless, advanced paternal age is associated with increases in foetal and sometimes maternal morbidity and mortality due to exposure of genes in hostile environmental conditions for a long time.

Older women are more likely to conceive twins because rising concentrations of a naturally occurring hormone over stimulate their ovaries, according to a new study identical twins come from a fertilized egg dividing to develop two babies. Non-identical twins occur when two eggs are fertilized at the same time. Dr Cornelius Lambalk, said “About half of the increase has been caused by the number of spontaneous multiple pregnancies probably due to the fact that women are delaying childbirth to a later age.”

Medical tourism has taken a different turn in India. It is emerging as a preferred destination for surrogate mothers. Childless NRI’s are flocking to India to rent a womb. The procedure is much simpler and much cheaper here; this has also added old age baby boom. In Anand, a small town in Gujarat, it is reported that in last 2 years 14 NRI’s have hired the uterus of menopausal women. (The author has his own study and views)