What happens to your eggs after 35?

Western Medicine Studies

What happens to your eggs after age 35?

Many women now choose to conceive at an advanced age primarily for economic

and career reasons. What might the consequences be for pregnancy, childbirth and

the fetus?

Western Medicine defines first pregnancy at an advanced age – primigravida - when

the maternal age is over 35. In recent years there has been a marked increase in

first pregnancies relatively late due to minor changes in life expectancy, along with

technological developments in the field of IVF and egg donation. Medical progress

has been successful in helping women to postpone pregnancy and to choose a late

pregnancy primarily for economic and career based reasons.

A position paper issued by the Association of Obstetrics and Gynecology details the

risk assessment and treatment guidelines that should be in place before allowing a

woman 45 years of age to conceive. For example, even before pregnancy it is better

to have a query about the medical history (anamnesis), to perform a physical

(including gynecological) examination, to conduct ancillary tests to assess the risk of

pregnancy, to conduct recommended tests to rule out common malignancies and to

offer an assessment by a social worker, psychologist or psychiatrist for the older

women who might become pregnant and to consider the best timing for the

estimated date of birth of the newborn.

A large survey in the UK published in the British Journal of Obstetrics & Gynecology

in 2007 shows that in 1986 only 28 percent of women giving birth were over the age

of 30. This is compared to 2006 when 48 percent of women giving birth were over

the age of 30. The percentage of women first giving birth over the age of 40

increased - from 1.1 percent in 1986 to 3.5 percent in 2006. In the last ten years six

women gave birth to their first healthy babies - from the U.S.A, India, Spain, Austria,

the U.S.A and Romania – between the ages of 60 to 67.

Women of an advanced age who froze their eggs in the past or who are using egg

donations, are exposed to the risk of poor quality eggs.

A 20 week fetus - that is, half of intra-uterine life - has about seven million eggs, but

they are destroyed in the process of continued ovarian development. A baby is born

with one to two million eggs and the woman begins her reproductive age with a

number of about 300,000, that reduces to 34,000 eggs by the age of 36. Ovulation,

where the egg makes a hole in the wall of the ovary on its way to reach the fallopian

tubes, requires a lot of energy and hormone secretion and therefore causes the

dissolution of 700-1000 eggs cells in each month. In addition, because the eggs live

in the ovary they are very sensitive to any physical processes women undergo in their

lives, such as illness, medication and more.

Aging of eggs and exposure to these processes may also affect the quality of the

genetic material stored in them, so they may also affect the integrity of genetic

material that builds the body of the fetus and its chromosomal structure - that is, the

genetics that is passed on to it. Therefore, as doctors, we know with certainty that the

older the maternal age, the higher the risk of chromosomal- genetic diseases. Poor

egg quality may affect the genetic development of the fetus, and also cause a

slowdown in intra-uterine growth. So for example, if the probability at age 35 of

having a child with Down syndrome is 1: 350 at age 44 it goes up to 1:40.

With increasing age, a woman's hormonal system that is responsible for ovulation

may be structurally, productivity wise, and function wise modified. Ovarian function is

less and less well, and production of female hormones – which are required for egg

quality and with a sufficient quantity for normal pregnancy – will be on a decline. In a

man, however, the sperm cells are created each time and are not affected during his

lifetime.

In addition, the natural function of the organs and the systems of the body are no

longer equal to those of an adolescent young body. The elderly pregnant vascular

system that supplies blood to the uterus may lose shape, then the placenta will not

function optimally and the passage of materials that sustain and built the body of the

fetus may be damaged too. Also, like other muscles in the body, the function of the

uterine muscle may decrease with age. Obstetric literature indicates that women

who became pregnant the first time at an advanced age have a higher chance of

premature labor, gestational diabetes, low placental implantation and early

placental separation. These are all problems related to the large amount of blood

that uterine pregnancy and fetal development needs and demands from an aging

uterine muscle, which in turn is suffering from poor nutrition that is due to the weak

supply via the blood vessels to the uterus and placenta.

Therefore over the age of 35, the mother is exposed to more miscarriages and more

diseases including pre-eclampsia. The percentage of cesarean birth increases with

age, probably due to fetal distress during labor. Maybe the longer second stage of

labor in women of advanced age is because the muscles of the uterus and their

contractions weaken with age. Data from the Israeli Society of Obstetrics and Gynecology, shows that the cesarean rate in women over the age of 45 now stands at 70%.

The rate of pregnancy complications in older mothers is also related to the high rate

of multiple pregnancies following IVF (In Vitro Fertilization) technology use. In Israel,

according to the Ministry of Health instructions, the attempt to conceive in vitro – a

woman’s own oocyte fertilization - can be done until the age of 45, and with donor

oocyte up to age 54.

In addition, according to the Israeli Society of Obstetrics and Gynecology, at age 45

and older, the rate increases of future disease risk factors such as smoking, obesity,

diabetes, hypertension, cardiovascular diseases, malignant diseases and

depression. And assuming that pregnancy is a kind of biological-metabolic stress

test, these diseases can significantly affect both fetal development and the health of

the pregnant woman.

However obstetric literature indicates that mortality in older women at birth has

declined significantly. Already back in the 80’s studies revealed that in 1979-1982

women's mortality for those who conceived over 40 years was at 3.5 per 1,000

women - five times that of the younger women - and as a result of the improvement

in medical treatment, in 1984-1986 the mortality rate decreased by half. It is further

noted that to be mothers of advanced age has its advantages - these women are

considered to be more relaxed and confident than they were 15 years ago. The

older mothers experience less anxiety and postpartum depression due to hormonal

fluctuations reduction and mental tension, and they might have a more stable

economic situation which may help too.

In conclusion, it is recommended to conceive at a reasonable age under 40, in order

to prevent pregnancy and childbirth complications. However it is important to

remember that a healthy woman who keeps proper diet, exercise routine and proper

follow-up along pregnancy may give birth to a healthy child after the age of 40.

Effi Kfir L.Ac

Mobile: 054-4804538

effi@kfir.net

http://www.kfir.net

Selected Syndromes

Pregnancy

It is an excellent idea to have a pregnancy under Chinese Medical supervision as well as the Western one. Chinese Medicine can enhance the constitution ("infra structure") of any person in a very efficient way; thus it is very good for a pregnancy whichhe_pregnant takes usually a heavy toll of the mother. The treatment of Chinese Medicine during pregnancy is absolutely safe, providing that the practitioner has a good training and experience. There are some Acupuncture points and herbs that are contraindicated and therefore not used in pregnancy. But there are ample points and many herbs that are safe and can be used to the benefit of the mother and the baby. There can be a very safe and soothing Chinese herbal treatment without Acupuncture. As a general rule, no Acupuncture Points are employed in pregnancy on the abdomen area.

Chinese Medicine views pregnancy in terms of three trimesters:

In the first trimester, the first 3-months - the treatment is designed to keep the baby intact in order to avoid miscarriage. There is also a special treatment for Morning Sickness, to balance the sense of nausea and vomiting, if present, and to stop loss of appetite and malnutrition.

The second trimester doesn’t usually carry any noticeable problems. It is a very good time for tonification and enhancement, preparing the mother in a relaxed way for the last trimester and for the end result - giving birth.

In the third trimester – last 3 months, the treatment is designed to make sure that the baby will not come out too early due to a weakness or a deficiency of the mother. By the 32-36 week of the pregnancy the fetus is turning downwards and lays his head in the birth canal as a first step towards the coming birth. Sometimes this natural process doen't happen and the fetus gets "stuck" in a breech or horizontal position. Chinese Medicine has an elegant and wonderful solution to make the baby turn naturally towards the birh canal. The couple is invited to Effi Kfir's clinic for one treatment only and then continue at home by themselves. See more on that under Syndromes at the section called Malposition of Fetus.

Once the three terms are completed it is possible to assist a delayed birth by using special Acupuncture pressure points which are contraindicated in the pregnancy process itself. It is also possible to reduce pain and to relax the mother providing that the Chinese practitioner is asked to be part of the delivery team. Another good way of helping in the delivery room will be in conditions of neonatal distress, when the baby needs resuscitation. Among others, some Acupressure points employed on the newborn’s back (UB 13) and face (GV 26), will help it to bring out loud the much-expected baby’s cry.

After birth there is a need for helping the mother regarding constipation, if it exists. Also a general imagetoning and repair regarding after birth physical trauma or depression, if present. There is usually a need for toning the blood especially if the mother lost much of it while giving birth. It is important to treat the mother because the birth process is rather traumatic and may cause irreversible damage if not treated right away. If one takes a quick survey of a few mothers he will find out that many diseases that these women carry had started right after their pregnancies.

To sum it up, in our experience it is rather clear that supervision during pregnancy with Chinese Medicine alongside the Western, can not only benefit the baby and mother alike but can also prevent future problems of both.

Effi Kfir L.Ac - All rights reserved.

Mobile: 054-4804538

Email: effi@kfir.net