untitled design

Experts explain that chances of getting pregnant after 50 are small but likely

One of the challenges of pregnancy over the age of 35 — in addition to the gestational risks for the mother and genetic changes for the baby — is hormonal problems.

From this age group, the Ministry of Health considers a preexisting gestational risk factor — which requires special attention during prenatal care. In your 50s, pregnancy becomes even more complicated.

This week, actress Claudia Raia announced that she is pregnant. At 55, she is also the mother of Enzo, 25, and Sophia, 19, from her relationship with actor Edson Celulari.

Age over 50 interferes with the amount of eggs a woman produces, that is, the female fertility rate. When they are born, women carry more than one to two million primordial follicles.

This number decreases considerably with the first period (menarche), and with each menstrual cycle.

Maurício Abrão, coordinator of the Advanced Gynecology Sector at BP – A Beneficência Portuguesa de São Paulo, told CNN that the chances of a woman getting pregnant at age 50 are “very small”.

“It’s very difficult to say if it’s less than 1 or 2%, but it’s a very small number when it comes to the chance of getting pregnant with your own eggs, within a scenario without fertilization. But obviously it is possible,” she said.

For comparison purposes, the chance of a normal couple getting pregnant, without infertility problems and under 35 years old, is 15 to 20%, explained Abram.

Changes in body physiology with age

From a very early age, the flood of hormones completely changes a woman’s life. When the menstrual cycle begins, a series of changes appear in the body and change the entire lifestyle.

Menstruation is the shedding of the inner walls of the uterus, and it happens when there is no fertilization of eggs during adolescence. It’s like the body’s preparation for pregnancy, and when it doesn’t, the endometrium — the uterine membrane — sheds.

The closing process occurs, on average, between 45 and 55 years old, when the body begins to show some signs, oscillations in the menstrual period. This time is called perimenopause. The closing milestone, in the last menstruation, called menopause.

The BP gynecologist explains that the probability of getting pregnant drops with age. “This decrease stems from two issues: first, the decrease in the quantity of eggs, and second, their quality.

“To give you an idea, during the reproductive life, ten to 15 follicles (out of the thousands that a woman is born) are recruited for one to become dominant and release the egg that remains inside it”, he explained.

Around perimenopause, follicles are around 10,000. According to Abram, the second issue that makes pregnancy difficult from the age of 50 is the quality of the eggs — which begins to progressively decrease from the age of 35.

Endocrinologist Lorena Lima Amato says that the moment every woman wants to get pregnant is important, it needs to happen when she feels ready for such a decision.

“However, it is essential to be aware of the possible difficulties that can occur with the postponement of pregnancy”, he says.

According to Abram, the “modern woman, who takes care of herself, who does physical activity and has no comorbidity, can have a body prepared to receive a pregnancy in this age group — often even better than younger women who do not take care of themselves. so well,” he said.

The guideline for those who want to get pregnant over 50 is to seek the follow-up of a fertility specialist gynecologist and an endocrinologist, who will be able to evaluate the possibilities, such as freezing eggs, for example, so that this postponement is safe.

Other changes involve not just ovarian hormones, but thyroid, adrenal and pituitary hormones as well.

Pregnancy has a profound impact on the thyroid and its function. The gland increases in size by 10% when iodine is sufficient and by 20% to 40% when iodine is deficient.

According to the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), the need for iodine and the production of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) increase by approximately 50%.

According to Lorena, “these hormones are essential for the health of the mother and fetus during pregnancy”.

Risk and care of a pregnancy from the age of 50

A survey of data by the IBGE (Brazilian Institute of Geography and Statistics) earlier this year showed that Brazilian women are having children later and later.

From 2000 to 2020, the proportion of birth records whose mothers were under 30 years old dropped from 76.1% to 62.1%, the survey showed.

On the other hand, birth records whose mothers were 30 years old or older rose from 24.0% to 37.9%. The lower fertility rate and the trend of late pregnancy indicate a process of demographic transition in Brazil.

Late pregnancy involves a series of risks for the mother and baby, so prenatal care needs to be differentiated. For the baby the chances of chromosomal changes and syndromes increase.

For women, the risk of developing gestational diabetes, hypertension, in addition to other factors that become more complex over the years.

When pregnancy occurs in this age group, the woman “will need a dose of progesterone to help at the time of pregnancy, in the implantation of the embryo, but hormone replacement alone will not help to get pregnant”, said Lorena.

“However, if the patient uses estrogen, depending on the dose, which is the hormone that is used in hormone replacement therapy, it can inhibit pregnancy”, emphasizes the specialist.

Abram says that it is necessary to have a detailed follow-up for these cases.

“The first thing for a pregnancy over the age of 50 is a clinical and gynecological evaluation of the patient to screen for risk factors and a hormonal assessment”, said Abram.

The doctor points out that, after a deep and detailed hormonal evaluation, it is necessary to discuss with each patient the alternatives for her to become pregnant.

“Most of the time, with the help of egg donation”, he pointed out.

Source: CNN Brasil

You may also like

Get the latest

Stay Informed: Get the Latest Updates and Insights

 

Most popular